Px Penunjang Lapkas Ipd Komuda CA Caput Pankreas

7/23/2019 Px Penunjang Lapkas Ipd Komuda CA Caput Pankreas

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III. PEMERIKSAAN PENUNJANG

A. Laboratorium

1. Pemeriksaan Laboratorium Kimia Klinik dan Koagulasi tanggal Se!tember "#1$

Pemeriksaan %asil Satuan Nilai Ru&ukan Keterangan

Kimia Klinik

SGOT 19 U/L 15-34

SGPT 23 U/L 15-60

Alkali Phosphatase 128 U/L 50-136

Gamma GT 138 U/L 5-55

!ili"#$i% Total 3&84 m'/(L 0&0-1&0

!ili"#$i% )i"ek 3&02 m'/(L 0&0-1&0

Total P"otei% 4&8 '/(L 6&4-8&2 L

Al$#mi% 2&3 '/(L 3&4-5&0 L

*lekt"olit +at"i#m 135 mmol/L 136-145 L

,ali#m 3&0 mmol/L 3&5-5&1 L

hlo"i(a 9. mmol/L 98-10. L

Koagulasi

Plasma P"oth"om$i%Time PPT

akt# P"oth"om$i% 13&3 )etik 9&4-11&3

PPT ,o%t"ol 10&. )etik

Pa"tial Th"om$oplasti%Time PTT,

akt# Th"om$oplasti% 45&3 )etik 23&4-36&8 APPT ,o%t"ol 34&1 )etik

'A(A(AN ) Serum Ikterik

". Pemeriksaan '( S*an Abdomen +RSU, Kota Semarang-

,esa%



• #ltipel %o(#l hipo(e%s oal te"se$a" (i lo$#s ka%a% (a%

ki"i hepa" (e%'a% ko%t"as te"lihat e%ha%eme%t

e%(e"#%' 'am$a"a% metastase (i hepa"&

• assa hipo(e%s $atas tak elas tepi i""e'#le" letak (i

ap#t pa%k"eas (a% mel#as ke a#m a$(ome% te%'ah7

a(a $a'ia% massa a%' melekat / s#lit (ipisahka% (e%'a%

ile#m T#mo" ap#t Pa%k"eas &

• !a'ia% a#(a pa%k"eas masih te"$e$as (a"i massa tetapi

pa"e%kim%a s#(ah i%homo'e% (a% tepi i""e'#le"&

• A(a pem$esa"a% limo%o(i pa"aao"ta&

•

. / 0oto M,

Tak tampak kelai%a% pa(a esoa'#s7 'aste"7 (a%

(#o(e%#m pa(a 'am$a" (i sampi%'&

. Pemeriksaan USG Abdomen



,esa%

• assa soli( $e%t#k lo$#late( $atas se$a'ia% tak te'as tepi i"e'#le" pa(a "e'io

epi'ast"i#m #k#"a% .795 : 6744 : 47.2 m → ))/ massa pa%k"eas7 lima(e%opati

• epatome'ali (e%'a% m#ltipel %o(#l $e%t#k $#lat $atas "elati te'as tepi se$a'ia% "e'#le"

pa(a ke(#a lo$#s #k#"a% te"$esa" pa(a 1765 : 1769 m pa(a se'me% . → #"i'a %o(#l

metastasis• Sl#('e pa(a esika elea&

• Asites

• *#si ple#"a (#pleks

• Tak tampak kelai%a% pa(a so%o'"ai o"'a%-o"'a% i%t"aa$(ome% lai%%a&

$. /20( (3ora4

,li%is A Pa%k"eas7 *#si7 Asites

,esa%

• !e%t#k a%t#%' s#lit (ieal#asi7 $atas ka%a% a%t#%'

te"t#t#p pe"sel#$#%'a% homo'e%7 $atas

ki"i a%t#%' $aik&

• *#si ple#"a ka%a%&

•

Tak tampak 'am$a"a% metastasis pa(a t#la%' a%'te"is#alisasi&

•

5. %asil 6io!si

,ete"a%'a% ,li%ik

Se(iaa% $iops (alam 2 ;a(ah7 ;a%ita 49 tah#%



ak"oskopik

<& etastasis epa"

2 poto%' a"i%'a% #k#"a% 1 : 075 : 075 m7 ;a"%a p#tih keoklata% pa(at7 ke%al

<<& T#mo" Pa%k"eas 1 poto%' a"i%'a% (iamete" 075 m7 ;a"%a p#tih keoklata% pa(at7 ke%al

ik"oskopik

Se(iaa% metastasis hepa" (a% t#mo" pa%"eas mem$e"ika% 'am$a"a% a%' se"#pa

Se(iaa% metastasis hepa" (a% t#mo" pa%"eas me%#%#kka% keepi%'-kepi%' a"i%'a% te"(i"i

atas $ek#a% (a"ah (a% kelompok-kelompok sel a%aplasti a%' t#m$#h mem$e%t#k st"#kt#"

ai%a" (a% t"a$e#lai"7 se$a'ia% te"se$a" i%(ii(#al7 $e$e"apa te"(isto"si (e%'a% i%ti sel $#lat7

oal hi%''a $i==a"e 7 pleiomo"ik7 hipe"k"omati%7 $e"k"omati% kasa"7 %#lei p"omi%e%7

sitoplasma l#as eosi%oilik7 mitosis a$%o"mal (apat (item#ka%7 me%'i%ilt"asi ke (alam

st"oma a"i%'a% ikat i$"o#s a%' sem$a$ hipe"emis7 $e"se$#ka% sel-sel "a(a%' limosit7

histiositGam$a"a% (i atas ses#ai (e%'a% etastasis A(e%oa"i%oma a%' (apat $e"asal (a"i hepa"

ata# tempat lai%

Sa"a%

,o%i"masi (ia'%osis (e%'a% imm#%ohistokimia , . (a% , 20

7. Imunoserologi

Immunoserologi %asil Satuan Nilai Ru&ukan Keterangan

a 19-9 >500700 U/ml ? 3.70

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Px Penunjang Lapkas Ipd Komuda CA Caput Pankreas