kidney

In the name of God, the most gracious, the most merciful Regarding Adrenal metastasis, Adrenal metastasis is an important thing They say, is Adrenal metastasis common? Yes, it is common Adrenal metastasis is common? Yes, it is very common They say, it is the fourth most common site of Adrenal metastasis after liver, lung and bone So, it is very important Adrenal metastasis is very common What is the most famous place for Adrenal metastasis? Most people have a wrong idea When they are asked, what is the most common site of Adrenal metastasis They say, it is the lung, bronchogenic carcinoma This is a good thing, bronchogenic carcinoma is very common Dr. Saria likes to say that bronchogenic carcinoma is common We can see that bronchogenic carcinoma is common They ask you, if a person has a CT test, where does the test end? It ends in the Adrenal, until you see the Adrenal Because if a person has bronchogenic carcinoma for a while, he will see the Adrenal in the liver But this is the second most common site The lung is the second primary tumor The first one is the melanoma Melanoma is the most common site of Adrenal metastasis The melanoma is 50% of Adrenal metastasis, 40% of Adrenal metastasis is the lung and breast After that, the adrenergic carcinoma is 10% of Adrenal metastasis Adrenomas look like a normal adenoma Adults have normal adenoma-like areas Adults have necrosis and hemorrhage The first problem we face is the difference between the two The scenario is like this The patient has lung cancer and Adrenal lesion Is Adrenal lesion a metastatic of lung cancer or an adenoma? This is the problem we face Why? First, Adrenal lesion is a common site of Adrenal metastasis Second, Adrenomas are very common There is a lot of incidental findings It is very normal to find a patient with lung cancer and Adrenal lesion There is no problem at all It is also normal to find a patient with lung cancer and Adrenal metastasis We will not be able to distinguish between the two instances This is the problem we face How can we solve this problem? The solution to this problem depends on the characteristic feature of the adenoma We said that if the house field unit is less than 10, it is a lipid-rich adenoma There is no doubt about that First, we measure the house field unit without And we measure if it is less than 10, it is a lipid-rich adenoma This is the first thing The second solution to the problem If the house field unit is more than 10, it is a lipid-poor adenoma If the house field unit is less than 10, it is a lipid-poor adenoma There is also a problem There are times when hypervascular metastasis They have the same characteristics of the lipid-poor adenoma When we calculate the absolute and the relative washout We find that they have the same characteristics of the lipid-poor adenoma So, we get confused The contrast washout is not very specific There are cases like the hypervascular metastasis It can have a rapid washout Sometimes, they refer to this topic Honestly, I have seen this topic only in one website It is called Radiology Assistant I have not seen any other website that relies on this theory But Radiology Assistant is a website that is mentioned in it So, if it says something, it is probably good So, what does it do? They said that we depend on two things On the morphology and the density of the lesion They said that we make a formula like this We will collect a point I will tell you the letters We will collect a point from it If we find more than 7 points It is probably a metastasis Nothing else Go for metastasis First, calculate the unenhanced house fit unit of the lesion And divide it by 10 Then, put it here This is the first thing Then, the size in centimeters And put it here Then, combine these two Then, check the contour blurring If you check the margin of the lesion Is it well-defined or ill-defined? If you find it ill-defined, add 2 Then, check the homogeneity of the lesion If you find it inhomogeneous, add 1 If it is homogeneous, do not add anything If the total is more than 7 It is a highly accurate metastatic lesion This formula is good It is found in the cardiology section And it looks good So, what do I do? I depend on the density and morphology of the two And I collect these points If I find that it is higher than 7 It is probably a metastatic adrenal This is an example of the melanoma adrenal Melanoma follows the adrenals in a very large shape Yes, it is very large And it is related to the genitals So, this is related to the adrenal adenoma There is a very good thing It tells me a nice information It is true that the adrenal is a common site of metastases But when the tumor sends to the adrenal It usually sends something else What does it mean? Adrenal metastases are rare to be isolated Or to be single What does it mean? If I find a long lesion And this long lesion decided to send to the adrenal It usually has something else So, if you find this long lesion You will find adrenal with liver, bone, etc On the contrary If you find isolated adrenal lesion In a tumor of lung cancer It is less likely to be metastatic So, if I find only adrenal No liver or spleen And nothing else If I find only adrenal lesion It usually is not metastatic Because if it is metastatic It usually has something else So, it is less likely So, I told you all the differences between adenoma and metastasis So, you can know Now, I finished the adrenal And we will go to the kidney There is a big part of it is anatomical This is an introduction It has an important part The important part will be next time It is very important This is the adrenal kidney lesion The lung is the sender of the adrenal Even if he has lung cancer If he has long lung cancer If he has kidney lesion in the adrenal It is a primary lesion If he has lung cancer It is the sender of the adrenal It is not the opposite The kidneys are The first thing It is a retro-protein structure A bean shaped retro-protein structure Like a bean Where are they? This is the lateral border It is called the muscle They are on the right side It is called the gluteus It is important The left kidney is different than the right The left kidney is in front of the spleen It is in front of the pancreatic pill It is in front of the splenic fiction The right kidney is in front of the liver It is in front of the second party of the adrenal It is in front of the hepatic fiction The kidney is a capsule It is a very adrenal capsule If there is a hematoma under the capsule It will do a very special thing It will do an indentation To the capsule To the kidney If there is a lesion It will do an indentation To the surface of the kidney To know that it is a sub-capsule It is not a perinephric We took it the first time There is a perinephric space If there is a hematoma In the perinephric space It will do an indentation To know if it is in the perinephric space Or in the sub-capsule If there is a lesion Between the fluid collection It will know that it is a sub-capsule If there is a fluid Without indentation It will know that it is a perinephric hematoma The capsule will be stuck On the kidney The kidney As an interior structure We know that it is made up of An important part The outer part is called the cortex And the inner part is called the medulla The cortex Contains the glomeruli We know that the main unit of the kidney Is the nephron This nephron is made up of the glomeruli Made up of the proximal conveyor tube And the lobe panel Then the conveyor tube Then the collecting duct The glomeruli is in the cortex This is the outer portion of the kidney This is the cortex of the kidney This is the medulla The inner portion is the medulla This medulla is made up of Triangles They call them renal pyramids It contains the collecting duct Of the nephron Between the renal pyramids There is an extension From the cortex To the medulla They call it the renal column The renal column is an extension From the cortex Between the renal pyramids And the medulla The renal pyramids Have an apex They call it the renal papilla The renal pyramids Open in the calyx The calyx of the kidney There is a minor calyx The minor calyx collects The major calyx collects To make the pelvis This is the anatomy of the kidney The anatomy of the kidney is made up of The cortex The medulla The pyramids The pyramids are separated by The renal column The renal pyramid The renal pyramid opens in the calyx This is the anatomy of the kidney What is the importance of this? The importance of this is In the CT Like the other In the CT The kidney is like the liver It has phases We do the triphasic kidney And we do the triphasic liver But the difference is in the timing The triphasic kidney is in the non-contrast Then we have a phase From 25 to 70 seconds We call it corticomedullary phase From 25 to 70 seconds Then we have a paraphysic phase From 80 to 180 seconds And after 180 seconds we call it excretory phase This is the view This is the non-contrast study Before we go to the CT Then we go to the CT We have corticomedullary phase Corticomedullary phase Corticomedullary