Les 8 cas de pyélonéphrite xanthogranulomateuse rapportés sont répartis en 2 groupes: 1. Dans le groupe I, les xanthogranulomes sont isolés, localises au bassinet, à la graisse péripyélique et périurétérale, et à la médullaire. 2. Dans le groupe II, les granulomes s’étendent jusqu’au cortex et à la graisse périrénale; les cas de ce groupe correspondent aux descriptions de la littérature. Dans tous les cas, des phlébites et des phléboscléroses segmentaires sont mises en evidence. La relation entre ces lesions veineuses et les xanthogranulomes, le role de l’infection, l’origine des cellules spumeuses et des lipides, sont discutés. II en est déduit que la pyélonéphrite xanthogranulomateuse est une forme particulière de nephrite interstitielle chronique, la presence constante de lesions veineuses étant un facteur determinant dans l’apparition des xanthogranulomes.

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