Documentos de Académico
Documentos de Profesional
Documentos de Cultura
,
SpP.DTCE,MARS
FK UWK Surabaya
Januari 2014
-Lungs
Tumor Jinak
Primary malignant
tumor
Lymph
Carries:
Dead cells, abnormal
and cancer cells
through
lymphatic vessels
to
Lymph nodes
(filter unwanted substances)
Blood
If too many cancer cells :
Lymph nodes cannot remove all,
some may travel in the lymph to
other parts of the body
(Lung cancer, spread to bone,
brain, liver, adrenal gland)
My also break away from
primary tumor and form new
tumor in some or opposite lung)
PATOGENESIS
NSCLC
1. Adeno Ca
30-35% of all NSCLC
usually develop at the edges of the lung, but some times occur
toward the center of the chest
Often slow growing and dont typically cause symptoms in early
stages
Often found and diagnosed at more advanced stages
The most common subtype of the lung Ca in women and in non
smokers
Divide into subcatagories such as Bronchoalveolar Carcinoma.
NSCLC
2. Squamous cell Ca
- account about 30% of all NSCLC
- unlike Adeno Ca, this type strongly associated with
smoking
- usually foundin the larger airway tubes and toward
the center of the chest
3. Large cell Ca
- account about 10-20% of all NSCLC
- more difficult to diagnose
- grow at the edges of the lung
- tend to grow fast and spread to other areas of the
body (metastasize)
- like Sq Cell Ca, are associated with smoking
Chest X-Ray
CT-Scan
MRI
Common test
used
Uses small of
radiation
Compare old
chest X-rays
with
recent ones
to see if
tumor is
growing or
shrinking
Is another
test used to
Help
diagnose
lung ca
Similar to
CXR but
gives a more
detailed
picture of the
lung
Can detect
extremely
small tumors
-Similar to
CT scan
-Clear
images
internal body
part,
including
tissue,
muscle,
nerves, and
bones.
- used to
detect the
presence of
tumor
Sputum
Cytology
-Sputum is
collected to
look for
cancer cells.
- most
accurate
to collect
and analyze
earlymorning
mucus for
three days
Biopsy
- A simple
cells be taken
from the
tumors.
- Can be
obtained in
several
different
ways
depending
on the
location and
size of a
tumors.
Bronchos
copy
Transthora
cic Needle
Aspiration
Fine
Needle
Aspiration
Cervical
Mediasti
noscopy
Endoscopic
Lymph
Node
Biopsy
Video
Assisted
Thoracos
copy
Explora
tory
Thoracoto
my
To see the
inside of the
lungs and
airways.
Theres small
camera on
the end of
the bronchos
cope that
takes
pictures .
Theres also a
small tool
thats used to
remove a
sample of the
tissue from
the tumors.
Inserts a
needle into
chest wall
and uses the
needle to
make a
sample of
tissue
- Is used for
tumors closer
to the chest
wall
-Using a CT
scan for
guidance, an
incision is
made in the
skin so a
needle can be
inserted into
the tumor to
remove a
sample of
cells.
- May be
used to
biopsy
theprimary
tumor or
metastases
- This
technique is
often used to
biopsy
lymph nodes
around the
lungs
-Small tube
passed
through
mouth into
the
esophagus.
- small tool
passed the
tube, it can
take tissue
sample of
nearby
lymph nodes
- Tube
containing a
small
television
camera,
inserted
betweenribs
after making
a small
incision
through the
skin, can see
the tumor.
- This is a
surgical
prosedure
where opens
the chest to
visually
examine and
remove the
tumor.
Deteksi Dini
Prosedur Diagnosis:
Gambaran Klinis
- Gambaran Radiologis
Pemeriksaan Lain
Penderajatan (Staging)
Dekeksi Dini:
-Keluhan dan GX penyakit tdk spesifik,
-Batuk darah, Batuk kronis, BB menurun dan Gx lain, juga
dapat ditemui pd penyakit paru lain
- Penemuan dini berdasarkan keluhan saja jarang terjadi
-Biasanya keluhan ringan terjadi pada mereka yg telah
masuk stadium II dan III
-Sasaran utk deteksi dini terutama ditujukan pada subyek
dengan resiko tinggi :
* Laki-laki, usia > 40 tahun, perokok
* Paparan industri tertentu
+ satu @ lebih gejala: batuk darah, batuk kronis, sesak
napas, nyeri dada, BB menurun
Re-skrining 4-6
bulan
Teruskan prosedur
diagnostik kanker
paru
Foto thoraks
Skema
Sitologi sputum
(+)
( - )
( + )
( - )
N (Node)
M
(Metastase)
Stage I
Stage II
Stage III
Stage IV
TNM
Occult Ca
TX,N0,M0
Tis,N0,M0
IA
T1,N0,M0
IB
T2,N0,M0
IIA
T1,N1,M0
IIB
T2,N1,M0; T3,N0,M0
IIIA
IIIB
Sembarang T,N3,Mo
T4, sembarang N, M0
IV
Sembarang T, sembarang N, M1
1. Pembedahan
2. Radioterapi
3. Kemoterapi
4. Hormonal
5. Immunologik
T N M STAGING NSCLC
N-0
N-1
N-2
N-3
T-1
IA
IIA
IIIA
IIIB
T-2
IB
IIB
IIIA
IIIB
T-3
IIB
IIIA
IIIA
IIIB
T-4
IIIB
IIIB
IIIB
IIIB
All M-1 = IV
OPERABLE