PATOGENESIS NEOPLASMA

TRAKTUS GASTROINTESTINAL
dr. FAISAL, Sp. PA
 LEUKOPLAKIA AND ERYTHROPLAKIA
(candidiasis, lichen planus, or many other disorders )
 ESOFAGUS
• PJ : 10 – 11 CM (BAYI), 25 CM DEWASA

• Gejala Kelainan :
 Disfagia : kesulitan menelan
 Heartburn  pencerminan refluks isi lambung
 Hematemesis ( muntah darah)  inlamasi, ulserasi, atau ruptur
pembuluh darah
 Nyeri : Retrosternal, nonspesifik

• Anomali anatomik (jarang terjadi  ditemukan sgr stlh lahir

 Atresia
 Fistula : hub. Antara esofagus dng trakea / bronkus
ATRESIA & FISTULA
VARISES ESOVAGUS
BARRET ESOVAGUS
SQUAMOUS CELL CARCINOMA OESOPHAGUS
LAMBUNG (GASTER)
 GASTRITIS
•  INFLAMASI PADA MUCOSA LAMBUNG
• GASTRITIS AKUT  Paling sering berkaitan dgn
obat2an anti inflamasi nonsteroid (aspirin) dlm
waktu yg lama &dosis yg tinggi, konsumsi alkohol yg
berlebihan, dan perokok berat, stress berat (luka
bakar, pembedahan), iskemia ,syok, kemoterapi,
uremia, infeksi sistemik, terelan zat asam / alkali,
iridiasi lambung, trauma mekanik & gastrektomi.
• Gejala Klinik: dari keadaan asimtomatik, nyeri
abdomen yg ringan  akut dng hematemesis
• GASTRITIS KRONIK  TERDAPATNYA PERUBAHAN
INFLATORIK YG KRONIK PD MUKOSA LAMBUNG SHGG
TERJADINYA ATROPI MUKOSA LAMBUNG DAN METAPLASIA
EPITEL, KEADAAN INI MENJADI LATAR BELAKANG TERJADINYA
DISPLASIA DAN KARSINOMA.
• INFEKSI HELICOBACTER PYLORI MERUPAKAN PENYEBAB
UTAMA
Chronic gastritis, showing partial replacement of the gastric mucosal
epithelium by intestinal metaplasia (upper lef), and inflammation of
the lamina propria containing lymphocytes and plasma cells (right).
 Helicobacter pylori gastritis. A Steiner silver stain demonstrates the
numerous darkly stained Helicobacter organisms along the luminal surface of
the gastric epithelial cells. There is no tissue invasion by bacteria.
Multiple stress ulcers of the stomach, highlighted by
the dark digested blood in their bases
 Ulcerative gastric carcinoma. The ulcer is large with irregular, heaped-up
margins. There is extensive excavation of the gastric mucosa with a necrotic
gray area in the deepest portion. Compare with the benign peptic ulcer in
• USUS HALUS (INTESTINUM)
 Peptic ulcer of the duodenum. Note that the ulcer is small (2 cm) with a sharply
punched-out appearance. Unlike cancerous ulcers, the margins are not elevated. The
ulcer base is clean (compare with the ulcerated carcinoma
Normal small intestine. A: The surface of the small intestine is covered by
numerous regular folds (plicae circulares) with a submucosal core. B:
Convolutions of mucosa and submucosa are the histologic equivalent of
the folds of Kerckring
Diagram of duodenal arterial supply.
Diagram of the submucosal vascular plexus.
 Omphalocele. A: A large abdominal defect is covered by a thick white membrane extending into the base of the
umbilical cord (dark red structure with clamp across it). The organs inside the omphalocele cannot be seen. B: The
abdominal wall defect is smaller than that seen in A, and a clear sac covers the herniated intestines. A whitish membrane
is forming near the abdominal wall attachment. At the periphery of this whitish lesion and within the clear membranous
sac is an erythematous zone. The lesion continues into the umbilical cord, which has an umbilical clamp on it.
Infarcted small bowel, secondary to acute thrombotic
occlusion of the superior mesenteric artery.
•USUS BESAR ( COLON)
Major Causes of Intestinal Obstruction

Mechanical Obstruction

Hernias, internal or external

Adhesions

Intussusception

Volvulus

Other Less Frequent Conditions

Tumors

Inflammatory strictures

Obstructive gallstones, fecaliths, foreign bodies

Congenital stricture, atresias

Colonoskopi
Kronik Aktif
• Lesi kombinasi
radang aktif dan
proses penyembuhan
dgn regenerasi
mukosa

• Mikroabses ↓ (-),
limfoid ↑
 Gambaran Klinis collitis ulcerosa
Dominan
 .Sakit pada perut
 .Diarrhea dengan pendarahan
Selain itu dapat juga timbul :

1. Anemia
2. Kelelahan (mudah lelah)
3. Kehilangan berat badan
4. Perdarahan pd rektum
5. Kehilangan nafsu makan
6. Kehilangan cairan tubuh dan gizi
7. Skin lession
8. Radang sendi, mata, hati, dan
osteoporesis
9. Pertumbuhan yg terganggu, terutama
anak-anak
10. Demam
11. Rasa nyeri pd perut yg hebat
(periodik)
 Etiologi
• memfokuskan penyebab pada empat factor:
Genetik pada faktor predisposisi
,infeksi,gangguan immunologi dan
psikosomatik.
ADENOCARCINOMA COLON
 Adenokarsinoma kolorektal
PREDISPOSISI
 Diagnosa
• Pemeriksaan fisik
• Darah rutin  anemia, leukositosis
• Faeces leukosit
• Colonoskopi/sigmoidoskopi   biopsi 
HP rutin IHC
Formalin fixed paraffin embedded human colon carcinoma stained
with CEA antibody
( POSITIVE CONTROL SLIDE )
THANK YOU
ANY QUESTION?