Authentic pyelonephritis with arratia vessels under the mask of urothelial cancer

Macrogematuria is an absolute indication for an urgent urological examination aimed at identifying the source of erythrocyte loss. The most common causes of erythrocyturia are benign prostatic hyperplasia, acute cystitis, bladder cancer, prostate cancer. On the contrary, with inflammatory lesions of the kidney tissue this urinary symptom is extremely rare. The purpose of this work was to demonstrate a rare form of chronic diffuse pyelonephritis with a difficult differential diagnosis.