Professional Documents
Culture Documents
1. Soliter
a. Small (d: 0,5-3 cm coin lesion)
Malignancy primer atau sekunder
Adenoma
Hamartoma
Granuloma
Exudat
Arteri-Venous aneurysma
b. Large (d: >3 cm)
- Berbatas tegas
Kista dengan cairan penuh
Tumor-tumor dari pleura
- Berbatas tidak tegas dan tidak teratur
Abses, granuloma
Infark
KLASIFIKASI
2. Multiple
Multiple pulmonary metastasis tumor
Pneumoconiosis
Caplans syndrome (Rheumatoid pneumoconiosis)
Silo-fillers disease
KLASIFIKASI (2)
Large Nodule
Granular Nodule
A.
Large nodular
1. Abses Paru
Supurasi dan nekrosis jaringan paru-paru
Etiologi:
Tuberkulosis
Staphylococcal & Klebsiella pneumonia
Infeksi fungi
Tumor malignan
Infected cyst
SOLITER NODULAR
Kebanyakan
berjumlah 1
Homogenous opak
Terdapat lesi pneumonic disekelilingnya
Round cavity, distinct border with wall consist of
granulation tissue
Biasanya terdapat pada segmen posterior lobus
superior (kanan>kiri)
Biasanya subpleura dan dapat ruptur menuju
pleura, menyebabkan fistula bronkopleural
air-fluid level (+)
DD Lung Abscess :
1. Cavernae TBC
Mostly in apex/subapical
Irregular cavity, distinct border with TBC
lesion around them
3. Pulmonary cyst
- Thin walled
- Solitary/multiple
- Sometimes accompanied by emphysema
A large Aspergillus
mycetoma (fungus ball)
within a cavity
2. Carcinoma Paru
a. Bronchogenic Ca
- sering
- pria > wanita
- kanan > kiri
- Usia: 50 60 thn
- FR : merokok, radioaktif/material industri, TBC
- gambaran radiologi: massa di paru sebsear
4-12 cm, bentuk bulat atau oval yang
berbenjol (lobulated)
b. Pancoasts tumor
BRONCHOGENIC CA
PANCOAST TUMOR
4. Hamartoma
Pertumbuhan berlebih beberapa jaringan seperti
smooth muscle fibrous cartilage tissue and vascular
Radiologi :
Tumor bulat atau bergelombang (lobulated)
dengan batas tegas
Ukuran <4 cm
Calsification inside : pop corn calcification
HAMARTOMA
Multiple Nodular
2. Pneumoconiosis
Occupational disease
Penyakit paru-paru akibat menginhalai
substansi asing
Lung reaction if invaded by foreign substance
Fibrosis : Silicate
No reaction : Siderosis
Pneumonitis & fibrosis : Beryllium, Mangan, Gas
Fibrosis / allergy : Cotton linen
Carcinogen : Radioactive, Asbestosis, Arsenic
3. Silikosis
tahun
Radiologi :
Gambaran fibrotik tipis sekitar
bronkovaskular
Proses lanjut: gambaran noduler pada kedua
lapang paru
Kelenjar hilus membesar dengan kalsifikasi
tipis, dikenal sebagai gambaran kulit telur
SILIKOSIS
The chest x-ray (A) shows significant parenchymal disease, predominant in the upper lobes, as
a result of progressive massive fibrosis. The regular (B) and high-resolution (C)
computedomography scans show both coarse interstitial and nodular changes.
4. Asbetosis
-penebalan pleura disertai fibrosis paru
-Pada lapangan paru bawah, terutama paru
kiri sekitar parakardial yang menutupi jantung
kiri
-Kadang teradpat pembesaran hilus
ASBESTOSIS
5. Siderosis
- Deposisi endapan debu besi
Bayangan noduler dengan densitas lebih tinggi
disertai jaringan fibrotik
Tidak mempunyai batas tegas
Tidak ada pembesaran hilus
6. Berrylosis
Stadium akut: pneumonitis kimiawi dengan
gambaran edema dan perdarahan berupa
bayangan suram paru dengan pembesaran
hilus
Stadium kronik: granuler atau noduler fibrotik
yang mencapai ukuran 1 cm
- stadium lanjut: garis fibrotik atau ateletaksis
SIDEROSIS - BERRYLOSIS
Depending on position:
Apex : Pulmonary TBC
Undefined:
TBC
Mycosis
Bronchopneumonia
Basis
Bronchiectasis + Secondary infection
Hypostatic pneumonia
Aspiration pneumonia
Small Nodule
TBC
The classic appearance of reactivation tuberculosis is that of an upper lobe infiltrate with cavities (A). Over time,
healing and fibrosis will occur, which will pull the hilum up on the affected side. If any question remains about
whether the infiltrate is cavitated, a computed tomography scan (B) may be useful.
MYCOSIS
Fungal infections of the lung may initially be seen as an alveolar infiltrate (A), but several days later (B), they
may show cavitation (arrows), with a central loose mass representing a fungus ball.
Bronchopneumonia
Small nodular, poorly defined,
irregular confluent
In middle and basis (ussually)
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BRONCHIECTASIS
A posteroanterior chest x-ray in a patient with bronchiectasis demonstrates bronchial wall thickening, most
pronounced at the lung bases(A). This is often referred to as tram tracking or linear parallel lines that
represent thickened bronchial walls (arrows). In advanced bronchiectasis (B), coarse basilar
lung infiltrates may appear cavitary. Bronchiectasis is much better seen on a computed tomography scan (C)
than on a chest x-ray. The findings are of dilated bronchiwith thickened bronchial walls (arrow).
A chest x-ray obtained immediately after aspiration may be quite normal (A). The chemical
pneumonia takes 6 or 12 hours (B) to cause an alveolar infiltrate (arrow).
Pulmonary oedema
Infusion overload
Renal failure oedema
Heart failure oedema
CNS disease : cerebral tumor / post op
Collagen disease
Rheumatoid arthritis
Periarthritis nodosa
Scleroderma
Gas / fluid inhalation
Radiologi :
Smooth / small noduler in medial
Ussualy >> cor
34
Milliary TBC
Milliary carcinoma
Pneumoconiosis
Bronchiolitis
Alveolar cell Ca
Sarcoidosis
Milliary mycosis
Pulmonary amyloidosis
Bronchiectasy with secondary infection
Interstitial bronchopneumonia
Rheumatic bronchopneumonia
Pulmonary congestion
GRANULAR NODULAR
Milliary TBC
Milliary carcinoma
(Papillary thyroid carcinoma with miliary metastases)
Pulmonary cyst
Spherical cavity, thin walled, non-granulomatous, filled
with air / fluid.
Klasifikasi :
A. Solitary
Congenital cyst
Infection cyst
Neoplastic cyst
B. Multiple
Apex:
Bleb
Bulla
Basal
Bronchiectasis cyst
Pneumatocele cyst
38
Infection Cyst
INFECTION CYST
Congenital cyst
Origin
Embryonal primary lobe
Endoderm disorder mucosa like gaster
Connected / not connected with digestive tract
Solitary thin walled with fluid
Connected with bronchus air fluid level
CONGENITAL CYST
Bilateral
bullae
44
Giant Bulla
Solitary, unilateral asym. lung
Bulla will pushes mediastinum & diaphragma
DD: Pneumothorax
If very large pneumothorax
45
Pneumatocele
PNEUMATOCELE
TERIMA KASIH