Tumor pada paru dan Tumor pada Mediastinum

Tumor pada paru dan Tumor pada Mediastinum

1. Presentasi Kasus Tumor Paru & Mediastinum Guruh Tri Mukti Setyawan – Koas FK UIN Jakarta Pembimbing : dr. Priska DP, Sp.P (K)

2. Identitas Pasien Nama Tn. B Jenis Kelamin Laki-laki Usia 54 Tahun No Rekam Medis 2025362942

3. KU: Nyeri dada kiri sejak 1 hari SMRS RPS: Nyeri menjalar hingga ke leher dan tangan kiri, keluhan disertai sesak napas, terutama saat aktivitas. Batuk berdahak, demam, dan keringat dingin disangkal. 2 minggu lalu telah dirawat inap di RSPG dengan diagnosa Ca paru, T4N3M1a pleura; left atrium myxoma. Pasien akan dirujuk ke RS Jantung Harapan Kita .. Pasien kembali ke RSPG karena nyeri dada dan sesak napas. RPD: Riwayat DMT2, hipertensi, alergi, penyakit jantung dan paru disangkal. KU, RPS dan RPD

4. KU: Nyeri dada kiri sejak 1 hari SMRS RPS: Nyeri menjalar hingga ke leher dan tangan kiri, keluhan disertai sesak napas, terutama saat aktivitas. Batuk berdahak, demam, dan keringat dingin disangkal. 2 minggu lalu telah dirawat inap di RSPG dengan diagnosa Ca paru, T4N3M1a pleura; left atrium myxoma. Pasien akan dirujuk ke RS Jantung Harapan Kita .. Pasien kembali ke RSPG karena nyeri dada dan sesak napas. RPD: Riwayat DMT2, hipertensi, alergi, penyakit jantung dan paru disangkal. KU, RPS dan RPD

5. RPK : Tidak ada riwayat keluarga dengan keluhan serupa. Tidak ada Riwayat keganasan di keluarga Riwayat Sosial Merokok dari tahun 1975 sampai 2025, sebanyak sehari 3 bungkus (IB = perokok berat). Pekerjaan : Supir angkot. RPK dan Rsos

6. TD: 153/95 HR : 116 RR = 20x/menit Suhu= 36.5 SpO2 = 97% on NK 5lpm Tanda-tanda Vital (TTV) Mata: Konjungtiva anemis (-/-). sklera ikterik (-/-) Leher: KGB tidak teraba membesar, tiroid tidak teraba membesar, trakea di tengah. Pemeriksaan Fisik

7. Paru : I : Asimetris kiri tertinggal P : Fremitus kiri menurun P : Sonor/redup A : Vesikuler menurun di hemithoraks kiri, ronkhi (-/-), wheezing -/- Pemeriksaan Fisik Jantung : S1S2 regular, murmur -, gallop – Abdomen : Supel, BU (+) normal, nyeri tekan (-) Ekstremitas: akral hangat, CRT<2s, pitting edema (+) di regio manus dextra

8. DPL Elektrolit Fungsi hati TCM & HIV Hasil Bronkoskopi (24/3/25) : Massa infiltrative menutup BUKi Pemeriksaan Penunjang

9. Lab 18/3/25 GDS :91 DPL : 13,1/38,8/11.350/405.000 Hitung Jenis : 0/2/72/16/10 Lab 20/3/25 Elektrolit : Na/K/Cl 132/4.4/96 Fungsi hati : OT/PT 35/15 Fungsi ginjal : Ur/Cr 44/0.9 Hasil Bronkoskopi (24/3/25) : Massa infiltrative menutup BUKi Pemeriksaan Penunjang CT Scan toraks kontras (22/3/25) : Massa segmen 1,2,3 paru kiri dengan infiltrasi ke dinding dada apikal kiri disertai trombus a. pulmonalis kiri dan limfadenopati multipel mediastinum anterior kiri, paratrakea bilateral dan subcarina, sugestif malignancy DD/ca paru; Efusi pleura kiri (T4N3M1a)

10. Rontgen Thorax Pemeriksaan Penunjang Bronkoskopi

11. Diagnosis Kanker paru kiri jenis(?) T4N3M1a (pleura) stage IVA PS 2 LA myxoma DVT arteri pulmonalis Bronkospasme Hemoptisis perbaikan Hiponatremia dan hiperkalemi perbaikan SVKS grade II dd/DVT antebrachia sinistra Asesmen

12. 25/03/25 Jadwal MRI cardiac Harapan Kita 30/4/2025 anticoagulant - bila spp acc -> diviti 1x2,5 mg sc 3 hari lanjut warfarin 1x2 mg ator 1x40 mg recolfar 1x0,5 mg candesartan 1x8 mg amlodipin 1x5 mg spiro 1x25 mg Perencanaan

13. Tinjauan Pustaka You can describe the topic of the section here 01 Tumor Paru You can describe the topic of the section here 02 Name of the section You can describe the topic of the section here 03 Name of the section

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17. Do you need a longer text? Speaking of craters, many of them were named after artists or authors who made significant contributions to their respective fields. Mercury takes a little more than 58 days to complete its rotation, so try to imagine how long days must be there! Since the temperatures are so extreme, albeit not as extreme as on Venus, and the solar radiation is so high, Mercury has been deemed to be non-habitable for humans Mercury is the closest planet to the Sun and the smallest one in the entire Solar System. This planet’s name has nothing to do with the liquid metal, since Mercury was named after the Roman messenger god. Despite being closer to the Sun than Venus, its temperatures aren’t as terribly hot as that planet’s. Its surface is quite similar to that of Earth’s Moon, which means there are a lot of craters and plains

18. The slide title goes here! Do you know what helps you make your point crystal clear? Lists like this one: They’re simple You can organize your ideas clearly You’ll never forget to buy milk! And the most important thing: the audience won’t miss the point of your presentation

19. Maybe you need to divide the content Venus has a beautiful name and is the second planet from the Sun. It’s hot and has a poisonous atmosphere Mercury is the closest planet to the Sun and the smallest one in the Solar System—it’s only a bit larger than the Moon Mercury Venus

20. Name of the section 02 You can enter a subtitle here if you need it

21. Here are three important ideas Mercury is the closest planet to the Sun and the smallest of them all Venus has a beautiful name and is the second planet from the Sun Despite being red, Mars is actually a cold place. It’s full of iron oxide dust Mercury Venus Mars

22. Divide the content in four ideas Mars is actually a very cold place Venus has extremely high temperatures Jupiter is the biggest planet of them all Saturn is a gas giant and has several rings Mars Jupiter Venus Saturn

23. Venus has extremely high temperatures Neptune is the farthest planet from the Sun Reviewing concepts is a good idea Despite being red, Mars is actually cold Mercury is the closest planet to the Sun Saturn is a gas giant with several rings Jupiter is the biggest planet of them all Mars Venus Neptune Mercury Saturn Jupiter

24. Awesome words

25. “This is a quote, words full of wisdom that someone important said and can make the reader get inspired” —Someone Famous

26. A picture is worth a thousand words

27. About body cells Cells Mercury is small Normal Mars is very cold Cancerous Venus is very hot Size Small About We all live on Earth Size Big About Neptune is far from us

28. Name of the section 03 You can enter a subtitle here if you need it

29. A picture reinforces the concept Images reveal large amounts of data, so remember: use an image instead of a long text. Your audience will appreciate it

30. 4,498,300,000 Big numbers catch your audience’s attention

31. What to do on this day Location Time Requirements Workshop Earth 14:30 We all live on Earth Fundraising Mars 16:30 Mars is very cold Conference Mercury 17:30 Mercury is small Social media Venus 11:30 Venus is very hot

32. Jupiter’s rotation period 9h 55m 23s 333,000 The Sun’s mass compared to Earth’s 386,000 km Distance between Earth and the Moon

33. Mercury is the closest planet to the Sun and the smallest of them all Mercury Venus has a beautiful name and is the second planet from the Sun Venus Despite being red, Mars is actually a cold place. It’s full of iron oxide dust Mars Let’s use some percentages 50% 75% 25%

34. Infographics are useful Earth is the third planet from the Sun and the only one that harbors life in the Solar System. We all live on this planet Information Inspire Jupiter is an enormous planet Expire Mercury is quite a small planet Venus has high temperatures Saturn is a gas giant with rings Mars is actually a very cold place Neptune is very far from the Sun Pluto is considered a dwarf planet Ceres is located in the asteroid belt Steps

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38. Venus Mars Mercury This is a map Venus has a beautiful name Mars is a very cold place Mercury is a small planet

39. 01 A timeline always works well Saturn It’s a gas giant and has several rings 02 Mars Mars is actually a very cold place 03 Venus It has extremely high temperatures 04 Mercury It’s the closest planet to the Sun

40. What can you do to reduce the risk? Mercury is quite a small planet Venus has very high temperatures Jupiter is an enormous planet Saturn is a gas giant with rings Mars is actually a very cold place Neptune is very far from the Sun Mercury Venus Mars Jupiter Saturn Neptune

41. Venus Venus has extremely high temperatures Mercury Mars is actually a very cold place Mercury is the closest planet to the Sun Mars Some infographics

42. Tables represent your data Carcinoma Angiogenesis Cancer Prevalence 25% 45% 65% Incidence Saturn has rings Neptune is far from us Mars is very cold Location Jupiter is big We all live on Earth The Sun is a star Risk factors Venus Mars Jupiter Earth Saturn The Moon Mercury Neptune Pluto

43. You can use this graph Follow the link in the graph to modify its data and then paste the new one here. For more info, click here Mercury Mercury is quite a small planet Jupiter Jupiter is an enormous planet Venus Venus has very high temperatures Saturn Saturn is a gas giant with rings 20% 15% 35% 30%

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