Case 400

Medical history

A 58-year-old female patient comes to the emergency department presenting fever for the last 2 days, associated with dysuria and left thoracolumbar pain. She reports recurrent pyelonephritis in the last 4 years. She also had a diagnosis and surgical treatment of colon carcinoid tumor fifteen years ago, and has irregular cancer monitoring nowadays. Routine urinalysis presents parameters suggestive of urinary tract infection (UTI). A computed tomography (CT) of the abdomen and pelvis was requested.

Considering the clinical case and the complementary images showed above, which condition below best explains the clinical evolution of this patient?

Test question

(Cruz Vermelha’s Hospital - PR - Urologia - 2014) It is a chronic disease, often leading to destruction of the renal parenchyma. It is more common in middle-aged women. Fever, general malaise and palpable renal mass may be present. Granulomas, abscesses and Foam Cells (macrophages loaded with lipids) are found in the renal parenchyma.

The description above characterizes which of the diseases below:

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