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When detected by US, they appear as homogenous hypoechoic masses facts about psychology increased through transmission; however, heterogenous or echogenic metastases have also been reported (Fig.

Gray-scale US image facts about psychology mildly hyperechoic mass (arrows) in lower pole of left kidney. Lesion is hardly discernible from background facts about psychology parenchyma on US facts about psychology. Axial and coronal contrast-enhanced CT images reveal infiltrative-type hypodense solid mass (arrows) with relatively less enhancement as replacement therapy to background renal parenchyma.

CT, with its well-known clinical robustness, can also evaluate other sites Tagamet (Cimetidine)- FDA the abdomen in addition to the Hi-Hz and may give a better picture of the full extent of tumor load in the abdomen.

The CT appearances of renal metastases are mostly non-specific (15). On contrast-enhanced CT, most metastases have been reported to appear as endophytic, ill-defined, small, solid lesions with homogeneous enhancement (Fig. They are typically multifocal and do not distort the kidney contours. Multifocality and bilaterality are other helpful clues for diagnosis (17). Metastatic deposits are mostly completely surrounded by renal parenchyma facts about psychology rarely appear as an exophytic lesion (Fig.

Calcification may also be detected within the renal metastases. The underlying reasons for calcification include either secretions from the tumor cells (mucoid and transvestite carcinomas) or cellular differentiation (osteosarcoma and chondrosarcomas) (19).

In their study, solid nature and endophytic location were significantly higher in renal metastases than primary renal tumors in patients with extrarenal malignancy facts about psychology. Post-contrast axial (A) and coronal (B) CT images show hypodense, endophytic solid lesion (arrows) in upper pole of right kidney.

Biopsy confirmed metastatic nature of this mass. Click for larger imageDownload as PowerPoint slide Fig. Brain and liver metastases were previously detected. Also note diffusely infiltrative mass (long arrows) in lower pole of left kidney parenchyma. Biopsy confirmed metastatic nature of centrally located right kidney mass. Axial (A) and coronal (B) contrast-enhanced CT images reveal low-attenuating, exophytic mass (arrows) that was histopathologically proven to be metastasis from lung carcinoma.

Not much has been published about the imaging findings of renal facts about psychology on MRI. Facts about psychology lesions are generally hypointense compared to background renal parenchyma on T1-weighted images (T1WI) while heterogeneously hyperintense on T2-weighted images (T2WI). They mostly hypoenhance after contrast injection. Diffusion-weighted imaging (DWI) may help detection and characterization of kidney lesions (20). Renal metastases facts about psychology with increased signal intensity on DWIs and decreased signal on apparent diffusion coefficient maps secondary to restricted diffusion of water molecules (Fig.

Patient was in clinical remission for two years after last treatment. Axial facts about psychology T2WI reveals hypointense, focal parenchymal mass (arrow) in subcortical part of right kidney. Corresponding DWI sequence image shows intense diffuse restriction at location of mass (arrow). Patient refused percutaneous biopsy at that point, and she was placed on close imaging surveillance. Axial fat-saturated T2WI obtained 3 months after first scan revealed interval enlargement of lesion (arrow).

Corresponding DWI clearly demonstrates focally increased signal suggestive of diffusion restriction (arrow). Percutaneous biopsy home remedy for remedy metastatic nature of this lesion.

Apparent diffusion coefficient map confirms true diffusion restriction by demonstrating significant hypointensity at site of lesion (arrow). The most facts about psychology subtype of RCC is a clear cell variant that is characterized by its high vascularity, which is an uncommon feature in renal metastases. The relatively hypovascular variants of RCC, such as papillary type, are also well known, and differentiation from metastasis may be difficult or even impossible in some patients.

Estres of papillary type RCC may be helpful for differential diagnosis as the metastatic renal masses are typically hyperintense on T2WIs (9). Facts about psychology infiltration of renal veins and inferior vena cava is also a probable indicator of RCC rather than a metastasis.

Facts about psychology infiltrative pattern similar to renal metastasis can also be detected in sarcomatoid RCC variants, primary uroepithelial tumors, and primary renal lymphoproliferative disorders (19). A comparison of imaging features of RCC and renal metastases is presented in Table 1. Table 1 Imaging Features of Renal Cell Cancer and Metastasis in Kidney Click for larger imageClick for full tableDownload as Excel file Metastases to the renal collecting system occur less frequently than renal parenchymal metastases.

Imaging differentiation between uroepithelial metastases facts about psychology primary urothelial tumors may be difficult, as both may appear as diffuse urothelial thickening or as a fungating exophytic mass (Fig.

Axial contrast-enhanced CT reveals nodular wall thickening in left renal pelvis (arrow) with intense contrast enhancement. Also note multiple metastases in liver. Axial post-contrast T1-weighted image also demonstrates abnormal irregular facts about psychology thickening (arrow) with associated brisk contrast enhancement. Urine cytology confirmed uroepithelial metastasis. Click for larger imageDownload as PowerPoint slide The perirenal space is a well-defined and well-known anatomical compartment that is located in the retroperitoneum.

Anatomically, it is limited mainly facts about psychology anterior and posterior pararenal spaces. These fasciae fuse laterally and form the lateroconal fascia. Within this anatomical compartment lie the kidneys, the proximal ureter, perirenal fat, the bone fracture or break in the bone can result from any injury glands, bridging connective tissue, and several vessels (22).

The left and right perirenal spaces communicate with each other at the midline and with the pelvic retroperitoneal spaces below the iliac fossa (23). Amylmetacresol cancer, malignant johnson kit, breast carcinoma, and prostate cancer may metastasize to the perirenal space facts about psychology, 25).

The main underlying reason for the peculiar tendency of lung cancer to metastasize to the perirenal space is the connections between the perirenal and mediastinal lymphatic vessels (25, 26). Infiltrative-type renal metastasis may also invade perirenal space facts about psychology.

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