RPS-K11 Patologi Paru

7/25/2019 RPS-K11 Patologi Paru

1/83

Lung Pathology

Respiratory System Block

Dr. H. Soekimin, SpPA

Dr. T. Ibnu Alferraly, SpPA

Departemen Patologi Anatomi

Fakultas Kedokteran USU

2008


2/83

TUBERCULOSIS

!"# $ %& !UBR'U(#S

(#' $ ) (U*+ ,,

) !''("*"' $ ) -AR"A!"#* ) D.SP*#

) (#SS B#D. /"+!

) FBR"S ) D"S!RSS ) S/A!"*+ ) '#U+


3/83

TUBERCULOSIS

!.P $ ) PR"%A"R

) S'U*DA"R

) %"("R

D1'("*"'A( S"+*

(AB $ ) SPU!U% ) %A*!#U

) B(##D

RAD"#(#+.

"%%U*"SA!"#* B'+


4/83

TUBERCULOSIS

PR"%AR.$

) F"RS! '#*!A'!) PR"%A"R (S"#* 3+#* (S"#*4 5

R+& (.%P*#D 3+#*

'#%P(4)F"BR#'A('"F"'A!"#*6 BA'"( 354


5/83


6/83

TUBERCULOSIS

S'#U*DAR.$

) RA'!"-A!"#* 3PR"%A"R4

) (#'AP 3 57) B"(A!RA( 4

)

F"BR#'A('"F"'A!"#*


7/83


8/83

TUBERCULOSIS %"("R

) PR"%AR. 7 S'#U*DAR.

) "%%U*"!.

)#R+A*

9 %*"*+S 9 K"D*. 9 BRA"* 9 ("-R

9 #S!# 9 (.%PA

) +RA*U(#%A%& !UBR'U(#SA 354


9/83


10/83


11/83

Ghon Complex


12/83

Typical cavitating granuloma


13/83

Miliary TB

%illet like grain& 1tensi:e micro spread&

!;roug;


14/83

Miliary TB


15/83

Miliary

prea!TB


16/83

Miliary TB Lung


17/83

Cavitary Tu"erculoi

/;en necrotictissue is coug;ed up

ca:ity&

'a:itation is typical

>or large

granulomas& 'a:itation is more

common in t;e

secondary

reacti:ation

tu


18/83

Tu"erculou Granuloma


19/83

Caeation #ecroi


20/83

Epitheloi! cell in Granuloma


21/83

Cell in Granuloma


22/83

Cavitary Secon!ary TB


23/83

Sytemic Miliary TB


24/83

$!renal TB % $!!ion &ieae


25/83

Tete TB Orchiti'


26/83

TB Peritoniti ( liver Miliary TB


27/83

TB Brain ) Cau!ate n'


28/83

TB Intetine


29/83

Protate TB


30/83

Spinal TB % Pott &ieae


31/83


32/83


33/83

Granuloma or LH

giant cell isnot pathagnomonicof TB!

Foreign ections&

Sarcoidosis&

'ro;ns disease&


34/83

P#EUMO#I$

A(-#(AR "*F(A%%A!"#*

"+ PR#!"* UDA!

P%*6(.%P#'.! ? %A'R#PA+

"*F"(!RA!"#*

(#BAR ? BR#*'#P*U%#*"A


35/83

P#EUMO#I$

'("*"' $ ) PR"%A"R

) S'U*DAR. !"# $

) BA'!R"A(

9 S!RP& P*U%#*"A

9 S!AP& AURUS

9 %& !UBR'U(#SA6 !'

) -"RA(

9 "*F(U*@A6 %AS(SS ) .AS!

9 'R.P!#'#''US6 'A*D"DA6

ASPR+"((US


36/83


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38/83

P#EUMO#I$ !"# $ #!RSP*U%#'.S!"S

'AR"*""6 %.'#P(AS%A6 ASP"RA)

!"#*6 ("P"D ? #S"*"P.("'

#S! RA'!"#* $) F"BR#US

) SUPURA!"- A*A!#%"' $

) BR#*'#P*U%#*"A

) P*U%#*"A (#BAR"S


39/83


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41/83

BRO#C*OP#EUMO#I$ +P$T*,

'#*S#("DA!"#* P(AUBR#*'"#(US ?

BR#*'USAR#U*D A(-#("

"*FA*! ? #(D ? /AK*SS

PA!"*! 3 'A6 'ARD"A' FA"(UR6

'R#*"' K"D*. FA"(UR6 !RAU%A)

!"' 'RBR#-AS'U(AR46

A'U! BR#*'"!"S6'R#*"' #BS!R& RSP& !RA'!6

#R '.S!"' F"BR#S"S ? P#S! #P&


42/83

BRO#C*OP#EUMO#I$+P$T*,

) (S"#* $

) F#'A( 3'*!R #FRSP"RA!#R. !RA'!4 7 P(AU

) B"(A!RA( 3 BASA( 4) AUS'U(!A!"#*'RP"!A!"#*

) !"# $) Stap;ylococcus) Streptococcus

) & in>luenae) 'oli>orm6 .east

) P $) A'U! "*F(A%%A!"#* 5 UDA!


43/83

LOB$R P#EUMO#I$

A(( #F (#BUS "*FA*! ? #(D PA!"*! A+ $ 20 C0 .RS %A* , /#%* 0 E S!RP& P*U%#*"A

3P*U%#'#''US4 '("*"''#U+RUS!. SPU!U%

FBR"S 30#'46 "*SP"RA!"#*

PA"*6 BR#*'"A( RSP"RA!"#* K(BS"((A

#(D6 D%6 A(K##("'


44/83


45/83

P#EUMO#I$ +ST$&IUM,

'#*+S!"#*$

) "2 RS

) UDA! 3PR#!"*4 A(-#(" SPA'

) #D%A PU(%#*A(

) RD '#(#UR


46/83

P#EUMO#I$ +ST$&IUM,

RD PA!"SA!"#*

) , 2 RSDA.S

) A''U%U(A!"#* 3(.%P#'.!6

%A'R#PA+4A(-#(AR

) !RA-ASA!"#* RD '((S

) F"BR"*#US UDA! 3P(URA(4

) +AS 3)4 6 '#*S#("DA!"#*3PAR4

+ ,


47/83

P#EUMO#I$ +ST$&IUM,

+RA. PA!"SA!"#*

) F/ DA.S 3S!AD ""4

) F"BR"* 3A''U%U(A!"#*4

) /"! ? RD '((S 3(.S"S4

) DARK +RA.


48/83


49/83

P#EUMO#I$ +ST$&IUM,

RS#(U!"#*$

) 8 G0 DA.S U*!RA!D

) UDA! ? "*F"(!RA!"#*

DBR"S 3ABS#RB4

) A(-#(US /A(( 3*4

) A(( #F 'ASR'#-R. 354


50/83

SPECI$L P#EUMO#I$

*#R%A( #S!

) %.'#P(AS%A ? -"RA(

) (+"#**A"RS

AB*#R%A( #S! 3"%%U*4

) P*U%#'.S!"S 'AR"*""

) 'A*D"DA ? ASPR+"((US) '.!#%+A(# ? %AS(SS


51/83

P#EUMO#I$ #O# I#-ECTIO#

ASP"RA!"#*

) ("U"D 7 F##D'#*S#("DA!"#*

"*F(A%%A!"#* 3S'#*DA"R.4) R"SK FA'!#R $

P#S! #P6 '#%A6 S!UP#R

(AR.* 'A6 !'

) (S"#* $P#S"!"#* HH


52/83


("P"D P*U%#*"A

) *D#+*

#BS!RU'!"#* 3%A'R#PA+

+"A*! '((4

) #+*

PARAFF"* ("U"D"*!RS!"!"A( F"BR#S"S


53/83


#S"*"P.("' P*U%#*"A) #S"*#P.( ,,

"*!RS!"!"A( ? A(-#("

3AS!%A6 ASPR+"((US6%"'R#P.(AR"A46

(#FF(R S.*DR#%

3"D"#PA!"'4


54/83

OBSTRUCTIO# LU#G &ISE$SE

(#'A(

D"FUS 3 'R#*"' 4

) 'R#*"' BR#*'"!"S) %P.S%A

) AS!%A

) BR#*'"'!AS"S


55/83

LOC$L OBSTRUCTIO#

LU#G&ISE$SE %'A*"' FA'!#R#BS!RU'!"#*

3'& A(6 !U%#R4'#((APS 7PA*S"-

'#%P("'A!"#* 3 ("P"D6 "*F&6 P*U%#*"A4

FU*'!"#* !S!*#R%A(


56/83

&I-USE OBSTRUCTIO#

LU#G &ISE$SE

'R#*"' BR#*'"!"S

%P.S%A AS!%A

BR#*'"'!AS


57/83

C*RO#IC BRO#C*ITIS

!"# $ ) S%#KRS ,,6

) P#(U!"#*

S!RP& P*U%#*"A & "*F(U*@A ? -"RA(

S-R.PR'AP*"A6

.P#"A ? '.A*#S"S 3B(U B(#A!RS4

Chronic Bronchitis


58/83

Chronic Bronchitis Definition:Persistent cough with sputumproduction for at least 3 months in at

least 2 consecutive years Cause :Initiated by smoking(by causing Chronic irritation of the bronchial

mucosa) infectionsare secondary

Pathology:Hypertrophy of mucus glandsHyper secretion of mucus Reid Inde=ratio of thickness of mucous gland layer !CD"to the thickness

between the epithelium and the cartilage!#B"(normally $%&). The closer to 'means theres an increase in thic!ness and correlated to progression of disease

Normal

CD/AB = 0.4


59/83


60/83

Chronic Bronchitis

Clinical course "ronchi # bronchioles are obstructed by mucus plugs (ronchiolitis o(literans.

In long$standing cases%

s)uamous metaplasia# dysplasia (precancerous"

predisposes for s&uamous cell carcinoma


61/83

EMP*.SEM$

A(-#(US

D"(A!A!"#* 5 (AS!"'"!. 34 F#R% $

) '*!R"(#BU(AR %P.S%A

) PA*(#BU(AR %P.S%A

) PARASP!A( %P.S%A

) "RR+U(AR %P.S%A


62/83

EMP*.SEM$

#!R F#R%

) BU(#SA %P.S%A

) "*!RS!"!"A( %P.S%A

) S*"( %P.S%A

'("*"' $

) D.SP*# ) '#U+

) SPU!U%


63/83


64/83


65/83

$ST*M$

BR#*'US "RR"!AB( 354

BR#*'US SPAS%

%U'#US 3,,4#BS!RU'!"#*D.SP*#

!.P $ ) A!#P"'

) *#* A!#P"'

) ASP"R"* "*DU'D

) #''UPA!"#*A(

) A((R+"' 3ASPR+"((US4


66/83


67/83

Bronchial Asthma


68/83

Bronchial Asthma


69/83

#O# $T.PIC $ST*M$

!& RSP& "*F'!"#*

'R#*"' BR#*'"!"S

A((R+* !S! 3)4 (#'A( "RR"!A!"#*BR#*'US

'#*S!R"'!"#*


70/83

$SPIRI#E I#&UCE& $ST*M$

%'A*"S% 3I4

57) PR#S!A+(A*D"*

D'RAS 7 (UK#R"*"*'RASRSP& !R&

"RR"!AB(

R"*"!"S6 *ASA( P#(.PS6

UR!"'AR"A 354

OCCUP$TIO#$L $ST*M$


71/83

OCCUP$TIO#$L $ST*M$

RA'!"- .PRS*S"-"!.

3A((R+*4

D.SP*#

'#U+ 3'R#*"'4

A((R+* $

) /##D

) '%"'A(

) !'


72/83

$SPERGILLUS BRO#C*ITIS

$LLERG. SP#RA ASPR+"((US FU%"+A!US

.PRS*S"!"-"!AS RA'&

D.SP*#

%U'#US +(#BU(ASPR+"((US

.PA 354


73/83

BROC*IECT$SIS'

!"# $

) BR#*'US #BS!RU'!"#*

) "*F'!"#* 3S-R4

) '#*+*"!A( 34 BR#*'US ? BR#*'"#(USD"(A!A!"#* '#U+ 3'R#*"'46 D.SP*#6 SPU!U% 3,,,4

5 B(##D


74/83

BRO#C*IECT$SIS

'("*"' $

) (#BUS "*FR"#R 5 "*F'!"#*

) '(UBB"*+ F"*+R

'#%P("'A!"#*

P*U%#*"A6 %P"%A6

SP!"'A%"A6 %*"*+"!"S6

ABS'SS %!AS!AS"S

3'RBRA(46 A%.(#"D 354


75/83

"ronchiectasis'ross

Di!"en#e# perip$eral

bron%$i &Due to =eakening o>=all4


76/83

LU#G #EOPL$SM$

PR"%AR. (U*+ 'A

A*#!R (U*+ *#P(AS%A

) B*"+*) %A("+*A*!

S'#*DAR. (U*+

*#P(AS%A


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*It is nice to have money and the*It is nice to have money and the

things that money can (uy+ (ut it,sthings that money can (uy+ (ut it,s

important to make sure youimportant to make sure youhaven,t lost the things money can,thaven,t lost the things money can,t

(uy%*(uy%*

'eorge orimer

*+,$-,% /ditor of 01aturday /2ening Post0

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RPS-K11 Patologi Paru