Prakt GIT Thyroid

8/18/2019 Prakt GIT Thyroid

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AMELOBLASTOMAAMELOBLASTOMA



DefnitionDefnition

► The most common epithelial The most common epithelial

odontogenic neoplasmodontogenic neoplasm



Clinical FeaturesClinical Features

►Comparatively rare:Comparatively rare: ≈≈1% o t!mors and cysts arising in "a#s1% o t!mors and cysts arising in "a#s

►Most common:Most common:

epithelial odontogenic t!morepithelial odontogenic t!mor in third to $th decades&'in third to $th decades&'

►(o gender or pop!lation preerence(o gender or pop!lation preerence►)*+% in mandi,le:)*+% in mandi,le:

-+% o these in molar.ram!s area-+% o these in molar.ram!s area►/!ration:/!ration:

e# #ee0s to + yearse# #ee0s to + years



M!ltiloc!larradiol!cency omore typical

character



Gross PathologyGross Pathology

► Traditional division into solid and Traditional division into solid and

2m!lti3cystic types ar,itrary2m!lti3cystic types ar,itrary

►

4s!ally some cystic4s!ally some cystic►Sometimes m!lticentricSometimes m!lticentric





Histopathology













5A6T78( T4MO65A6T78( T4MO6

SynonymsSynonyms: Cystadenoma: CystadenomaLymphomatos!m 9apillier!m&Lymphomatos!m 9apillier!m&Adenolymphoma&Adenolymphoma&

CystadenolymphomaCystadenolymphoma



DefnitionDefnition

►land!lar and cystic t!mor lined ,yland!lar and cystic t!mor lined ,y

,ilayered 2inner col!mnar oncocytic,ilayered 2inner col!mnar oncocytic

and o!ter ,asal3 epitheli!m #ithand o!ter ,asal3 epitheli!m #ith

lymphoid stroma;lymphoid stroma;



Clinical FeaturesClinical Features

►-+% o all ,ilateral salivary gland-+% o all ,ilateral salivary gland

neoplasmsneoplasms

►

Almost e<cl!sively in parotidAlmost e<cl!sively in parotid

►More common in malesMore common in males

►Statistical relationship #ith smo0ingStatistical relationship #ith smo0ing

►Oten m!lticentricOten m!lticentric►Bilateral in 1+=1% o casesBilateral in 1+=1% o cases



Gross PathologyGross Pathology

►Lo,!lated massLo,!lated mass

►May ,e $<ed to overlying s0in andMay ,e $<ed to overlying s0in and

sim!late a malignant neoplasmsim!late a malignant neoplasm

►On c!t sectionOn c!t section

typical m!lticystic appearance:typical m!lticystic appearance:

Occasionally entire t!mor !ndergoes necroticOccasionally entire t!mor !ndergoes necrotic

changes consistent #ith hemorrhagic inarct:changes consistent #ith hemorrhagic inarct:►spontaneo!s& ,!t more common ater $ne needlespontaneo!s& ,!t more common ater $ne needle

,iopsy,iopsy





HistopathologyHistopathology

►9rominent lymphoid tiss!e& oten #ith9rominent lymphoid tiss!e& oten #ith

germinalgerminal

►Large epithelial cells #ith oncocyticLarge epithelial cells #ith oncocytic

eat!res:eat!res:

cover s!race o lymphoid tiss!ecover s!race o lymphoid tiss!e

t#o layerst#o layers

some apical cells may ,e ciliatedsome apical cells may ,e ciliated

















>L8(8S>L8(8S

►Age: ) ?+ th& +% ter"adi pada !sia @ +Age: ) ?+ th& +% ter"adi pada !sia @ +

thth

►Male = emale ratio: 1; : 1Male = emale ratio: 1; : 1

►e"ala:e"ala: Sering 0ali asimptomati0 sampai tim,!lSering 0ali asimptomati0 sampai tim,!l

massa t!mor yang nyatamassa t!mor yang nyata

9er!,ahan ,o#el ha,it9er!,ahan ,o#el ha,it AnemiaAnemia

5eight loss5eight loss



6OSS6OSS

► T!mor solid dan rap!h; T!mor solid dan rap!h;

► Tida0 ,er,atas "elas ma!p!n Tida0 ,er,atas "elas ma!p!n

,er0aps!l;,er0aps!l;

►/apat t!m,!h:/apat t!m,!h:

E<ophytic . !ngatingE<ophytic . !ngating

!lcerati !lcerati







A/E(OCA6C8(OMA CAEC4MA/E(OCA6C8(OMA CAEC4M



M8>6OS>O98SM8>6OS>O98S

► T!mor terdiri dari prolierasi sel epitel T!mor terdiri dari prolierasi sel epitel

anaplasti0& dengan ciri:anaplasti0& dengan ciri: 8nti pleomor$08nti pleomor$0

(.C ratio )& inti hiper0romati0& 0romatin inti(.C ratio )& inti hiper0romati0& 0romatin inti0asar& n!0leoli prominent;0asar& n!0leoli prominent;

Banya0 mitosisBanya0 mitosis

► Ters!s!n mem,ent!0 str!0t!r 0elen"ar . Ters!s!n mem,ent!0 str!0t!r 0elen"ar .acini;acini;

► T!m,!h in$ltrati T!m,!h in$ltrati











A/E(OMATO4S O8TE6A/E(OMATO4S O8TE6

2Str!ma Colloides32Str!ma Colloides3





M4LT8(O/4LA6 O8TE6M4LT8(O/4LA6 O8TE6











>L8(8S>L8(8S

► Masa pada thyroid& !nilateral Masa pada thyroid& !nilateral

Str!ma 4ninodosa;Str!ma 4ninodosa;

►9alpasi: tida0 nyeri;9alpasi: tida0 nyeri;

► i0a massa sangat ,esar dapat i0a massa sangat ,esar dapat

menye,a,0an gangg!an menelan;menye,a,0an gangg!an menelan;

►

>e,anya0an cold nod!le& hot nod!le>e,anya0an cold nod!le& hot nod!le

se0itar 1+ %;se0itar 1+ %;

►Le,ih sering ter"adi pada #anita;Le,ih sering ter"adi pada #anita;



6OSS6OSS►(od!l ,!lat . ,!lat(od!l ,!lat . ,!lat

lon"onglon"ong► soliter 2single nod!le3soliter 2single nod!le3

► SolidSolid

►Ber0aps!lBer0aps!l► Terdapat per,edaan Terdapat per,edaan

#arna dengan "aringan#arna dengan "aringan

normal se0itarnya;normal se0itarnya;



M8>6OS>O98SM8>6OS>O98S









►9rolierasi oli0el& seperti oli0el normal9rolierasi oli0el& seperti oli0el normal

thyroid& ,erisi 0oloid& dilapisi sel epitelthyroid& ,erisi 0oloid& dilapisi sel epitel

0!,is;0!,is;

►Memp!nyai 0aps!lMemp!nyai 0aps!l

► Terdapat tanda 0ompresi "aringan Terdapat tanda 0ompresi "aringan

normal dil!ar nod!l;normal dil!ar nod!l;

► Tida0 ada tanda anaplasia Tida0 ada tanda anaplasia



9A98LLA6 CA6C8(OMA9A98LLA6 CA6C8(OMA

T76O8/ T76O8/



AMBA6A( >L8(8SAMBA6A( >L8(8S

► E(8S A( 9AL8( SE68( /84M9A8 E(8S A( 9AL8( SE68( /84M9A8

►5A(8TA: 968A D ':15A(8TA: 968A D ':1

►

4S8A A( TE6SE68( : 1' T7(4S8A A( TE6SE68( : 1' T7(►1+ % >AS4S : A 78STO6 O1+ % >AS4S : A 78STO6 O

866A/8AT8O( EF9OS46E TO T7' (EC>;866A/8AT8O( EF9OS46E TO T7' (EC>;

MA>6OS>O98>MA>6OS>O98>



MA>6OS>O98>MA>6OS>O98>

►4>46A( : /A68 LES8 A( BE64>46A(4>46A( : /A68 LES8 A( BE64>46A(M8>6OS>O98> 78(A MASSA BESA6 : 1+M8>6OS>O98> 78(A MASSA BESA6 : 1+CM;CM;

► >EBA(A>A( T4MO6 9A/AT&94T87>EBA(A>A( T4MO6 9A/AT&94T87

>OTO6&>E(AL GB8ASA(A ME649A>A(>OTO6&>E(AL GB8ASA(A ME649A>A(LES8 8(8LT6AT8&1+ % /E(A( >A9S4LLES8 8(8LT6AT8&1+ % /E(A( >A9S4L

A( >OM9L8T G 1+ % /E(A( 9E64BA7A( A( >OM9L8T G 1+ % /E(A( 9E64BA7A(>8ST8>;>8ST8>;

►

>A/A( 9EMBE(T4>A( 9A98LE6 B8SA>A/A( 9EMBE(T4>A( 9A98LE6 B8SA/8L87AT SECA6A MA>6OS>O98>;/8L87AT SECA6A MA>6OS>O98>;





M8>6OS>O98>M8>6OS>O98>



M8>6OS>O98> M8>6OS>O98>

► S4S4(A( SEL /ALAM ST64>T46 9A98LE6S4S4(A( SEL /ALAM ST64>T46 9A98LE6

► 8(T8 SEL >OSO(&TA(9A A(A>8(T8 SEL >OSO(&TA(9A A(A>

8(T8&789O>6OMAT8>2HO697A( A((8E EESI38(T8&789O>6OMAT8>2HO697A( A((8E EESI3

►(4CLEA6 6OOJES.9A68T 8(T8(4CLEA6 6OOJES.9A68T 8(T8► 8(>L4S8 8(T6A(4LE4S EOS8(O8L8> 8(>L4S8 8(T6A(4LE4S EOS8(O8L8>

►BA/A( 9SAMOMA;BA/A( 9SAMOMA;







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Prakt GIT Thyroid