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7/21/2019 Tumor Tiroid Husnul.pptx
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Tumor Tiroid
Husnul Khotimah
Preseptor :Dr. Yahya Merpaung Sp.B
BAGIAN ILM B!DAH
"K NAND#SP M. D$AMIL
%&'(
7/21/2019 Tumor Tiroid Husnul.pptx
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Identitas Pasien
Nama : Anizarnis
No. MR : 698439
Jenis Kelamin : Perempuanmur : !! ta"un
Alamat : Padan# $arat
Pe%er&aan : i'u ruma" Tan##aMasu% R( : )9 Januari )*+!
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Kelu"an tama :
Penurunan 'erat 'adan se&a% , 6'ulan se'elum masu% Ruma" (a%it.
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Ri-aat Pena%it (e%aran# :
- Penurunan 'erat 'adan , 6 %# dalam -a%tu6 'ulan. Penurunan 'erat 'adan disertaina/su ma%an an# 'er%uran#.
- $en&olan pada le"er an# 'er#era% %eti%a
menelan. $en&olan a-alna dirasa%an se&a% ,4* ta"un an# lalu dan tida% 'ertam'a"'esar. $en&olan tida% disertai neri0 #atal dantida% ada %emera"an pada %ulit.
- $en&olan di tempat lain 12 di daera" le"er'a#ian atas %iri. $en&olan "ilan# tim'ul tida%disertai neri dan mera" se&a% + mi##ura-atan Ruma" (a%it.
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Ri-aat Pena%it a"ulu
• Pasien tida% perna" men#alamipena%it di daera" le"erse'elumna.
• Pasien tida% perna" men#alami%e#anasan se'elumna.
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Ri-aat Pena%it Keluar#a
• Tida% ada %eluar#a an# menderitapena%it den#an %elu"an an# samaseperti pasien.
• Tida% ada %eluar#a an# men#alamipena%it %e#anasan.
7/21/2019 Tumor Tiroid Husnul.pptx
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Nilai
(esa% saat 'era%ti5itas
1
$erde'ar 1
Kelela"an 1 2 2)
(u%a dara panas 12 !
(u%a dara din#in 1
Kerin#at $erle'i"an 1
7u#up 1
Na/su ma%an nai% 1
Na/su ma%an turun 12 3$$ Nai% 1
$$ Turun 12 23
Nilai
Tiroid tera'a 23
$isin# tiroid 2)%so/talmus
Kelompa% matatertin##al
iper%ineti% )
Tremor Jari 2)
Tan#an Panas )
Tan#an 'asa" +
i'rilasi Atrial
Nadi 18*9*;<menit
INDEX WAYNE PASIEN
Kesimpulannya : -1 : hipotiroid
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(tatus 7eneralis
• Keadaan umum : (a%it (edan#
• Kesadaran : =M=0 7=( +!
• (tatus 7izi : underweight
Tanda 5ital :
• Te%anan ara" : +)*<>* mm#
• Nadi : 88 ;<menit
• Respirasi : )4 ;<menit• (u"u : 3608 o=
• Neri : ?A( 3
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• Kepala: Kon&un#ti5a tida% anemis
(%lera tida% i%teri%
%so/talmos 1
• @e"er: (tatus @o%alis• ada: Tida% terdapat %elainan
• A'domen: (upel0 Massa 10 epar dan
lien tida% tera'a. $isin# usus 12 normal• %stremitas: A%ral "an#at0 =RT ) deti%
(tatus 7eneralis
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Regio Colli Sinistra• Inspeksi :
Tampa% 'en&olan tun##al di %iri le"er an#i%ut 'er#era% %eti%a menelan0 %emera"an 1
• Palpasi :
Tera'a massa tun##al0 'entu% 'ulat0u%uran !;3;) Bm0 permu%aan rata0
%onsistensi %eras0 'er#era% saat menelan0neri te%an 10 panas 10 ul%us 1.
• Auskultasi : $ruit 12
(tatus @o%alis
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KGB colli:
Inspe%si : tera'a massa di daera" &u#ularis superior. Carna sama den#an &arin#an se%itar.
Palpasi : %onsistensi %eras0 u%uran);+;+ Bm0 'atas te#as0 tida% mo'ile0neri te%an 1
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asil Pemeri%saan @a'oratorium
Darah rutin :
' : +3 #<dl 1N : +) #<dl
t : 38D 14*48D
@eu%osit : +*.+** mm3 1!.***+*.***
Trom'osit : 4+>.*** mm3 1+!*.***4**.***
Fungsi Hepar :
(7ET : )* 13)
(7PT : +60! 13+
Hormon iroi! :
• T3 : +0+8 nmol<@ 1+.* F 3.3 nmol<@
• /T4 : +30>3 n#<dl 1*.8 F +.> n#<dl
• T((: *03 Gl<ml1*.3 F 3.8 Gl<ml
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ia#nosis Ker&a
Tumor Tiroid (inistra suspe% #anas
ia#nosis Tam'a"an
@im/adenopati Bolli sinistra re#io &ularis superior
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ia#nosis $andin#
(troma Nodusa Non To%si%
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SI"#"GI$FNAB
• alam sediaan "apus 'a&a" nodul
tiroid u%uran 3;3 Bm %enal padat i%ut'er#era% saat menelan. Aspirasi dara"se'ana% + BB mi%ros%opi% tampa%
se'aran leu%osit PMN0 lim/osit0 tampa%'e'erapa %elompo%an epitel 'ulato5al0 monomor/ tampa% pula %oloiddan 'e'erapa ma%ro/a#.
• Kesan : $eni#n =stiB @essin 1T"roid
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(7
• @o'us %iri Tiroid mem'esar. Tampa% nodul"etero#en den#an %omponen pada %isti%'erseptasi0 'atas te#as0 tepi ire#uler0
u%uran sulit dinilai %arena mele'i"i le'arpro'e. KalsiH%asi 12 pada doppler tampa%penin#%atan 5as%ularisasi intranodul.Ist"mus ta% mene'al0 "omo#en.
Kesan : Massa tiroid %iri suspe% mali#na
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Terapi
Rese%si Tumor