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  Tumor T iroid Husnul Khotimah Preseptor : Dr. Yahya Merpaung Sp.B BAGIAN ILM B!DAH "K NAND #SP M. D$AMIL %&'(

Tumor Tiroid Husnul.pptx

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Page 1: Tumor Tiroid Husnul.pptx

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

%&'(

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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.

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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