rps-k11 patologi paru
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Lung Pathology
Respiratory System Block
Dr. H. Soekimin, SpPA
Dr. T. Ibnu Alferraly, SpPA
Departemen Patologi Anatomi
Fakultas Kedokteran USU
2008
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TUBERCULOSIS
!"# $ %& !UBR'U(#S
(#' $ ) (U*+ ,,
) !''("*"' $ ) -AR"A!"#* ) D.SP*#
) (#SS B#D. /"+!
) FBR"S ) D"S!RSS ) S/A!"*+ ) '#U+
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TUBERCULOSIS
!.P $ ) PR"%A"R
) S'U*DA"R
) %"("R
D1'("*"'A( S"+*
(AB $ ) SPU!U% ) %A*!#U
) B(##D
RAD"#(#+.
"%%U*"SA!"#* B'+
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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
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TUBERCULOSIS
S'#U*DAR.$
) RA'!"-A!"#* 3PR"%A"R4
) (#'AP 3 57) B"(A!RA( 4
)
F"BR#'A('"F"'A!"#*
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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
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Ghon Complex
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Typical cavitating granuloma
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Miliary TB
%illet like grain& 1tensi:e micro spread&
!;roug;
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Miliary TB
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Miliary
prea!TB
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Miliary TB Lung
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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
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Tu"erculou Granuloma
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Caeation #ecroi
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Epitheloi! cell in Granuloma
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Cell in Granuloma
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Cavitary Secon!ary TB
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Sytemic Miliary TB
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$!renal TB % $!!ion &ieae
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Tete TB Orchiti'
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TB Peritoniti ( liver Miliary TB
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TB Brain ) Cau!ate n'
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TB Intetine
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Protate TB
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Spinal TB % Pott &ieae
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Granuloma or LH
giant cell isnot pathagnomonicof TB!
Foreign ections&
Sarcoidosis&
'ro;ns disease&
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P#EUMO#I$
A(-#(AR "*F(A%%A!"#*
"+ PR#!"* UDA!
P%*6(.%P#'.! ? %A'R#PA+
"*F"(!RA!"#*
(#BAR ? BR#*'#P*U%#*"A
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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
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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
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BRO#C*OP#EUMO#I$ +P$T*,
'#*S#("DA!"#* P(AUBR#*'"#(US ?
BR#*'USAR#U*D A(-#("
"*FA*! ? #(D ? /AK*SS
PA!"*! 3 'A6 'ARD"A' FA"(UR6
'R#*"' K"D*. FA"(UR6 !RAU%A)
!"' 'RBR#-AS'U(AR46
A'U! BR#*'"!"S6'R#*"' #BS!R& RSP& !RA'!6
#R '.S!"' F"BR#S"S ? P#S! #P&
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BRO#C*OP#EUMO#I$+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 $) A'U! "*F(A%%A!"#* 5 UDA!
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LOB$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##("'
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P#EUMO#I$ +ST$&IUM,
'#*+S!"#*$
) "2 RS
) UDA! 3PR#!"*4 A(-#(" SPA'
) #D%A PU(%#*A(
) RD '#(#UR
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P#EUMO#I$ +ST$&IUM,
RD PA!"SA!"#*
) , 2 RSDA.S
) A''U%U(A!"#* 3(.%P#'.!6
%A'R#PA+4A(-#(AR
) !RA-ASA!"#* RD '((S
) F"BR"*#US UDA! 3P(URA(4
) +AS 3)4 6 '#*S#("DA!"#*3PAR4
+ ,
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P#EUMO#I$ +ST$&IUM,
+RA. PA!"SA!"#*
) F/ DA.S 3S!AD ""4
) F"BR"* 3A''U%U(A!"#*4
) /"! ? RD '((S 3(.S"S4
) DARK +RA.
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P#EUMO#I$ +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
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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
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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"#* $P#S"!"#* HH
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P#EUMO#I$ #O# I#-ECTIO#
("P"D P*U%#*"A
) *D#+*
#BS!RU'!"#* 3%A'R#PA+
+"A*! '((4
) #+*
PARAFF"* ("U"D"*!RS!"!"A( F"BR#S"S
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P#EUMO#I$ #O# I#-ECTIO#
#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
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OBSTRUCTIO# LU#G &ISE$SE
(#'A(
D"FUS 3 'R#*"' 4
) 'R#*"' BR#*'"!"S) %P.S%A
) AS!%A
) BR#*'"'!AS"S
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LOC$L OBSTRUCTIO#
LU#G&ISE$SE %'A*"' FA'!#R#BS!RU'!"#*
3'& A(6 !U%#R4'#((APS 7PA*S"-
'#%P("'A!"#* 3 ("P"D6 "*F&6 P*U%#*"A4
FU*'!"#* !S!*#R%A(
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&I-USE OBSTRUCTIO#
LU#G &ISE$SE
'R#*"' BR#*'"!"S
%P.S%A AS!%A
BR#*'"'!AS
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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
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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 $%&). The closer to 'means theres an increase in thic!ness and correlated to progression of disease
Normal
CD/AB = 0.4
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Chronic Bronchitis
Clinical course "ronchi # bronchioles are obstructed by mucus plugs (ronchiolitis o(literans.
In long$standing cases%
s)uamous metaplasia# dysplasia (precancerous"
predisposes for s&uamous cell carcinoma
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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
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EMP*.SEM$
#!R F#R%
) BU(#SA %P.S%A
) "*!RS!"!"A( %P.S%A
) S*"( %P.S%A
'("*"' $
) D.SP*# ) '#U+
) SPU!U%
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$ST*M$
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
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Bronchial Asthma
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Bronchial Asthma
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#O# $T.PIC $ST*M$
!& RSP& "*F'!"#*
'R#*"' BR#*'"!"S
A((R+* !S! 3)4 (#'A( "RR"!A!"#*BR#*'US
'#*S!R"'!"#*
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$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 $ST*M$
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OCCUP$TIO#$L $ST*M$
RA'!"- .PRS*S"-"!.
3A((R+*4
D.SP*#
'#U+ 3'R#*"'4
A((R+* $
) /##D
) '%"'A(
) !'
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$SPERGILLUS BRO#C*ITIS
$LLERG. SP#RA ASPR+"((US FU%"+A!US
.PRS*S"!"-"!AS RA'&
D.SP*#
%U'#US +(#BU(ASPR+"((US
.PA 354
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BROC*IECT$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
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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
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"ronchiectasis'ross
Di!"en#e# perip$eral
bron%$i &Due to =eakening o>=all4
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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
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important to make sure youimportant to make sure youhaven,t lost the things money can,thaven,t lost the things money can,t
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