DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT...
Transcript of DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT...
![Page 1: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/1.jpg)
DermatopathologyKuliah-3 / Blok DMSKuliah-3 / Blok DMS
Dr. H. Soekimin, SpPADr T Ibnu Alferraly SpPADr. T. Ibnu Alferraly, SpPA
Departemen Patologi Anatomi FK USUDepartemen Patologi Anatomi FK USU
![Page 2: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/2.jpg)
NEOPLASMA KULIT
TABEL 61-4
![Page 3: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/3.jpg)
NEOPLASMA KERATINOSIT
> Neoplasa Jinak Keratinosit
Veruca Vulgaris ( common wart )
- Ok papilomavirus : direct contact- dapat muncul disemua tempat di kulit : paling sering jari- HTPL : squamous papilloma, keratinisasi, granul keratohialin (+)- Pewarnaan khusus : proliferasi squamous epithelium, vacuolated cell (+)
![Page 4: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/4.jpg)
Veruca Vulgaris
Ep : Epidermis
Veruca Vulgaris
p p de s
H : Hyperkeratosis
P : ParakeratotikP : Parakeratotik
D : Dermis
![Page 5: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/5.jpg)
Moloscum Contangiosum
Ok gol poxvirus grup- Ok gol poxvirus grup- Lesi : berpapul- Htpl : epidermis menyusup ke dermis, pada sel epidermal : “ intracytoplasmic –
inclusions bodies “
![Page 6: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/6.jpg)
Molluscum Contangiosum
V : viral Inclusion Bodies
K : KeratinK : Keratin
![Page 7: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/7.jpg)
Seborheic Keratosis
S i d t l h j h t it- Sering pada orang tua : leher, wajah, extremitas- Lesi : datar, kecoklatan, - Jinak, kemungkinan bukan neoplasma- HTPL : proliferasi epitel, kista berisi keratin (+); horn cystp p , ( ); y
KeratoacanthomaKeratoacanthoma
- Banyak pada usia menengah : wajah, extremitas atas- ciri khas : fase pertumbuhan cepat ( bbrp minggu ) + fase statis ( 1 tahun )ciri khas : fase pertumbuhan cepat ( bbrp minggu ) fase statis ( 1 tahun )- HTPL : lesi2 bentuk bulat dgn keratin dibahagian tengah, sering ditemukan gambaran
atipia sedang, aktifitas mitotik (+), diskeratosis : sulit bedakan dgn squamouscarcinoma
![Page 8: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/8.jpg)
Seborrhoeic Keratosis
K : keratin nest
![Page 9: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/9.jpg)
Keratoacanthoma
K : keratin S : squamous cell D : dermis K : keratinK : keratin S : squamous cell D : dermis K : keratin
![Page 10: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/10.jpg)
> Lesi Kulit Premaligna
Actinic KeratosisActinic Keratosis
- Akibat ultraviolet- Lesi eritomatous kasar, atau papula2 kecil- HTPL : displasia dermis, degenerasi kolagen dermis ( solar elastosis )
kecendrungan menjadi ganas tergantung : tingkat displasia epitel
> Neoplasma Maligna
Bowen’s Disease ( carcinoma in situ )Bowen s Disease ( carcinoma in situ )
- Dapat pada kulit yg terkena matahari atau vulva, mukosa mulut, glans penis- Lesi : bercak eritema yg tumbuh lambatyg- HTPL : perubahan displastik ( carcinoma in situ ), invasi membrana basalis (-)
![Page 11: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/11.jpg)
Basal Cell Carcinoma ( Basal Cell Epithelioma )
- Sering terjadi usia > 40 thn daerah kulit yg terpapar sinar matahari ( wajah )Sering terjadi, usia > 40 thn, daerah kulit yg terpapar sinar matahari ( wajah ).- Jarang : Multiple Basal Cell Carcinoma ; pada bayi, congenital, dgn abnormalitas pd
tulang, syaraf, mata.- Lesi : papula ber”lilin”, telengiectasis pblh darah pd permukaan, nekrosis pd bagian
t h ( R d t Ul )tengah ( Rodent Ulcer )- HTPL : berasal dari lapisan basal epidermis yg menyusup ke dermis membentuk
gambaran seperti sarang. Sel2 basal membentu palisade pd bagian tepi tumor
- Bersifat agresif, dapat invasi lebih dalam ke tulang dan otot, metastasis (-)- Diperlukan operasi lesi meluas, batas operasi dengan “Frozen Section”
![Page 12: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/12.jpg)
Basal Cell Carcinoma
N : nodularT T b lT : TrabecularC : cystic
![Page 13: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/13.jpg)
Squamous Carcinoma
- Sering pd orang tua, akibat terpapar sinar matahari- agresif, matatasis 1%- sering bersamaan dengan chronic ulcers, burn scars, infeksi sinus - lesi : dengan batas yang meninggilesi : dengan batas yang meninggi- HTPL : sel2 poligonal besar (+) dengan sitoplasma berwarna pink
gambaran atipia, pleomorfik, dan mitotik bervariasi antara “well differentiated”ke “poor differentiated”
Bil d t t tik l di k i l h d- Bila dgn metastatik : perlu diseksi lymph node
![Page 14: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/14.jpg)
Squamous Cell carcinomaK : KeratinD : DermisD : DermisC : Cartilage
![Page 15: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/15.jpg)
NEOPLASMA MELANOSIT
Dua katagori utama : NEVUS dan MALIGNANT MELANOMASNevus : ok terkumpulnya sel2 nevus ( melanocyte precursor cell ) yg berhenti saat
perpindahan dari ‘neural crest’ ke epidermis dan membentuk melanositTerbentuk pada anak2 dan menetap hingga dewasaTerbentuk pada anak2 dan menetap hingga dewasa
Malinant Melanomas : transformasi neoplasktik melanosit pada epidermis yg kmdnmelibatkan dermis.Umumnya pada orang dewasa
Melanocytic Nevus ( Nevocellular Nevus )
- Tidak muncul pd saat lahir, tetapi setelah anak2, berhenti tumbh setelah pubertas- Bersifat jinak, lesi : rata, papula, pigmented ( hitam/kecoklatan ), papilomatous- Bila terjadi perubahan bentuk : suspect malignant
HTPL k l k l2 l i d d i ( i d l ) b d i- HTPL : kelompokan sel2 melanosit pd dermis ( intradermal nevus ), batas dermis-epidermis ( junctional nevus ), atau pd ke-dua lokasi ( compound nevus )
![Page 16: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/16.jpg)
![Page 17: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/17.jpg)
Intradermal MelanomaIntradermal Melanoma
N : sel2 Nevus
![Page 18: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/18.jpg)
Junctional MelanomaJunctional Melanoma
![Page 19: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/19.jpg)
Compound Melanoma
![Page 20: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/20.jpg)
COMPOUNDMELANOMA
CONGENITAL MELANOMA DYSPLASTIC
MELANOMA
![Page 21: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/21.jpg)
HYPERPLASIA MELANOSIT
NODULAR MELANOMA
LENTIGO MELANOMA
![Page 22: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/22.jpg)
Melanocytic melanoma
![Page 23: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/23.jpg)
Malignant melanoma
U : Ulcerasi
Ep : Epiteliump p
T : sel tumor
![Page 24: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/24.jpg)
Dermatofibroma
![Page 25: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/25.jpg)
Dermatofibrosarcoma
![Page 26: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/26.jpg)
Epydermal Cyst
![Page 27: DMS-K16 - Dermatopathology.ppt Blok DMS Kul 3 KULIT ...ocw.usu.ac.id/course/download/1110000112-dermatomusculoskeletal... · - Diperlukan operasi lesi meluas, ... - Bil d t t tik](https://reader031.fdocuments.in/reader031/viewer/2022022117/5c9bdc6b09d3f28d6a8c85ed/html5/thumbnails/27.jpg)