KULIAH PA

KEGANASAN UROGENITAL
gambaran mikroskopik

Oleh
Noor Yazid AD
 DEFINISI

PERTUMBUHAN BERLEBIH
SATU JENIS SEL
TAK BERATURAN
TAK TERKOORDINASI
TAK ADA TUJUAN
TAK ADA GUNA
 ETIOLOGI
Multi faktor : - genetik
- virus
- kebiasaan buruk
- salah letak
 PENCEGAHAN

PAPs Smear
Mamografi
Operasi pengambilan bakal tumor
Colok dubur
Pemeriksaan dini setiap yg dicurigai tumor
 Beda tumor jinak & ganas
JINAK GANAS
============= =============
Lambat Cepat
Ekspansif Infiltratif
Berkapsul Tak berkapsul
Mudah sembuh Sukar sembuh
Selnya matang Selnya muda
Tak menyebar Menyebar
 ASAL SEL TUMOR
SEL EPITEL

SEL MESENKIM

SEL BENIH ( TOTIPOTEN )

 MEMBERI NAMA TUMOR
JINAK : NAMA SEL + OMA
misal : papiloma adenoma
fibroma lipoma
osteoma leyomyoma
teratoma
GANAS : NAMA SEL + CARCINOMA / SARCOMA
misal : squamus cell carcinoma adeno-carcinoma
fibro-sarcoma osteo-sarcoma
lipo-sarkoma leiomyosarcoma
teratocarcinoma
 BEDA KARSINOMA - SARKOMA
KARSINOMA SARKOMA
cepat Lebih cepat
Sel muda Lebih muda
Berkelompok Difus
Berbenjol-benjol Permukaan halus
Warna pucat kebiruan Warna kemerahan
Metastasis awal via Metastasis awal via
limfe darah
ganas Lebih ganas
 CIRI SEL GANAS
RATIO INTI : SITOPLASMA >> SATU
SEL PLEOMORFIK
INTI HIPERKROMATIK
KROMATIN KASAR
MITOSIS PATOLOGIK +
NUKLEOLI +
DISPLASIA KERAS
KANKER INVASIF
 Adenokarsinoma prostat

mitosis

tumor ganas padat

a. Biopsi otot ; Diagnosis ? Rhabdomyosarcoma
b. Bagaimana prognosisnya ?
Ginjal normal

Here is a normal adult

kidney. The capsule has
been removed and a
pattern of fetal
lobulations still persists,
as it sometimes does.
The hilum at the mid
left contains some
adipose tissue. At the
lower right is a smooth-
surfaced, small, clear
fluid-filled simple renal
cyst. Such cysts occur
either singly or scattered
around the renal
parenchyma and are not
uncommon in adults.
POTONGAN GINJAL NORMAL
CT SCAN GINJAL NORMAL
Rect abd
empedu
Antrum gaster
Jejunum

aorta

limpa

hati

Otot psoas
MIKROS GINJAL NORMAL
Kista ginjal sederhana
Here is a much
larger simple
renal cyst of the
upper pole.
Other smaller
cysts are also
scattered around
the kidney. The
ureter exits
south on the left.
Such a large
renal cyst would
be seen on a
radiographic
imaging
procedure, but
could probably
be distinguished
from a neoplasm
by its fluid
density.
CT SCAN KISTA SIMPLEK
MAKROS RENAL CELL CA
Karsinoma ginjal,makros.

Here is a renal cell carcinoma that on sectioning is mainly

cystic with extensive hemorrhage.
MAKROS RENAL CELL CA
 CT SCAN RENAL CELL CA

Tumor menyerang ginjal kiri (bintang), menginfasi vena renalis ,

juga menyerang vena kava anterior ( segitiga)
 Karsinoma ginjal

This is the classic histologic appearance of a renal cell carcinoma: the

neoplastic cells have clear cytoplasm and are arranged in nests with
intervening blood vessels. This appearance is why they are often called
MAKROS TU WHILM
Hipertrofi VU. ok.BPH.
The markedly enlarged
prostate seen here has not
only large lateral lobes, but
a very large median lobe as
well that obstructs the
prostatic urethra and led to
chronic urinary tract
obstruction. As a result, the
bladder became both
enlarged and hypertrophied
as it had to work against the
obstruction with every
episode of urination. That is
why the surface of the
bladder appears
trabeculated. Note also that
a yellowish-brown calculus
formed in the bladder.
Makros BPH
Mikros BPH
Makros adeno ca Prostat

Single nodule
ADENOCA MAKROS
 PIN
( Prostatic intra epithelial neoplasma )

PIN di bagian atas , epitel tampak

PIN bisa low atau high grade
Disini high grade
ADENO CA PROSTAT

Kelenjar kecil padat ireguler

Stroma sedikit
Grade : Gleason 1 5 berdasarkan
deferensiasi

ditambah
Grade berdasarkan pola

Jadi disini score menjadi 3 + 3 = 6

Pertanda tumor klinik ialah berupa

kenaikan PSA dlm darah.
Diagnosis dapat diperoleh dgn
Operasi,TURP, FNAB transrectal
 Adenokarsinoma prostat

mitosis

tumor ganas padat

Karsin. transisional VU,makros.

This bladder was removed surgically from a male who had a long history
of smoking. He had presented with hematuria. The opened bladder reveals
masses of a neoplasm that histologically proved to be transitional cell
carcinoma (TCC). TCC can arise anywhere in the urothelium, but is most
common in bladder. TCC is often multifocal and has a tendency to recur.
TUMOR UROTHELIAL
MEASTASIS CA PD GINJAL