ILMU PENYAKIT DALAM NON HODGKINS LYMPHOMA Keganasan pd sel limfosit; kena sel B (dominan),T,NK; plg sering diffuse

large B-cell lymphoma KARSINOMA SEL RENAL Keganasan pd Ginjal Massa cpt m> di leher ATAU abdomen B symptom demam > 38, keringat malam, BB turun >10kg dlm <6bulan Darah lengkap : LDH + as.urat CT scan sesuai lokasi Biopsy eksisional Limfosit m>, inti 2x >, sitop. Basofilik ; biopso jarum halus adekuat Stage I 1 region/ 1 extralimfatic organ (IE) Stage II 2/> region / involvement extralimfatic (IIE) Stage III Involv.region ->spleen (IIIS) / involv. Extralimfatic (IIIE) / both (IIIES) Stage IV diffuse 1/> extralimfatic organ *) A = B symptom ; B = B symptom *)S = splenic involve ; H = Hepatic involve *)X = Bulky disease > 10cm Kemo; radiasi resisten R-CHOP cyclophosphamide, adryamicin(hydroxidaunorubicin), vincristine(oncovin), prednisone 1 low risk 2 low-intermediate risk 3 high-intermediate risk 4-5 high risk Ling rokok,obes, HT, asbestos, peny.ginjal, tricloroetilen Herediter von hippel landau disease, family, birth hogg dube, herediter paraganglion,dll Asimptomatik TRIAS hematuria, nyeri abdomen, massa di abdomen

DEFINISI+EPID ETIOLOGI

MAN.KLINIS

PEM.PENUNJANG

PROGRESIFITAS

USG ginjal masa pd parenkim Biopsy MRI/PET gantiin pyelogram IV X-thorax lihat metas. Ke paru Tabel lain *) metas. Tersering ke PARU-PARU

TERAPI

PROGNOSIS

Operatif nefrektomi Terapi ablasi Kemo Terapi adjuvant immunoterapi Terapi sel target T1 95 %; T2 88; T3 59; T4 20; M1 10-20