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II.
III.
RENAL CALCULI
URINARY OBSTRUCTION
NEOPLASMA
BLOK XV UROGENITAL
dr. JB Soebroto, Sp.PA
29 April 2013 Jam: 13.30 15.30
Stone
Calcium oxalate / phosphate
Idopathic hypercalciuria (50%)
Hypercalcemia & hypercalciuria (10%)
Hyperoxaluria (5%)
Enteric (4.5%)
Primary (0.5%)
Hyperuricosuria (20%)
No known metabolic abnormality (15-20%)
Struvite (Mg, Nh3, Ca, PO4)
Renal infection
Uric acid
Associated with hyperuricemia
Associated with hyperuricosuria
Idopathic (50% of uric acid stones)
Cystine
Others or unknown
Percentage
75
10-15
6
1-2
+/-10
Marked dilatation
of the pelvis and
calyces and
thinning of renal
parenchyma
Schematic
representation of
pathways of renal
infection
More common
CAUSES :
Most commonly infectious in origin: gram
negative bacteria (usually E. Coli) from patients
intestinal tract
Normal kidney is resistant to blood borne infection
Most common route of infection: bacterial
ascension from the urinary bladder
NefromaMesoblastik
PA : - Jinak Kongenital
- Tumor fibrosa + focus tulang rawan
dysplastik dan mesenkim embrional +
glomerulus + tubulus
I.
Tubulus glomerulus
mesenchymal
Variatif
variatif
( Karsino Sarkoma )
Typical crosssection of
yellowish,
spherical
neoplasm in one
pole of the kidney
Note the tumor in
the dilated,
thrombosed renal
vain
PA = - 95 % Urotelial = Papilloma
- Transisional Carcinoma
- Metaplasi Skuamosa
- Adeno Karsinoma
( Sistitis metaplastik glandular Brunn )
- Stadium P.TNM
PTIs = Insitu PT3b=Tembus
PT4b = dinding pelvis
Faktor
Hormonal : Testosteron
Estrogen
Potensi endogen jaringan ikat
~ Proses menua Fisiologis
Zone transisi / peri uretral
Hiperplasi fibromusculer acinus kel
Karsinoma prostat
zone Perifer Sub Capsuler = Kelenjar >< Orchidectomi
Peka Androgen
Gangguan BAB Colok Dubur / rectal toucher (+)
lanjut baru
sumbatan urin
Campuran BPH
MPH
Hemo spermia
TURP
Tetap
5% Prostatectomi klinis BPH
PA : Adenocarcinoma
Occult Carcinoma
metastase : Col.Vert, Pelvis,
Tulang panjang, Paru
PA : Adeno Ca (Acinus, Kribriform, Solid, tubuler)
WHO = grade 1,2,3
Gleason : Skor deferensiasi(baik, sedang, buruk)2 - 10