DAFTAR ISI

BAB I PENDAHULUAN .

BAB II TINJAUAN PUSTAKA . 4

2.1 Anatomi Paru ..... 8
2.2 Histologi paru...................................................................................

2.3 Definisi metastasis.... 11

2.4 Mekanisme penyebaran metastasis.....

12

2.4.1 Penyebaran secara langsung dari tumor primer............................

12

2.4.2 Penyebaran secara hematogen... 12

2.4.3 Penyebaran melalui saluran limfe.................................................

13

2.4.4 Penyebaran ke rongga pleura........................................................

13

2.4.5 Penyebaran melalui endobronkhial...............................................

13

2.5 Patofisiologi dan patomekanisme.................................................... 13

2.5.1 Patomekanisme penyebaran secara hematogen............................. 15
2.5.2 Patomekanisme pulmonary limfangitis carsinomatosis................

16

2.6 Gejala....................................... 17
2.7 Modalitas radiologi....................... 18
2.7.1 Foto konvensional torak

18

2.7.2 Computed Tomography....................................

21

2.7.2.1 Gambaran khas (typical) metastasis intrapulmonal........ 21

2.7.2.1.1 Penyebaran tumor melalui hematogen....................

21

2.7.2.1.2 Penyebaran pulmonary lymphangitic carcinomatosis..............

26

2.7.2.2 Gambaran yang tidak khas (atypical)..... 28

2.7.2.2.1 Kalsifikasi............................................ 28
2.7.2.2.2 Kavitas................. 30
2.7.2.2.3 Perdarahan di sekitar nodul metastasis.................................... 30
2.7.2.2.4 Pneumothorax.............................. 31
2.7.2.2.5 Air space pattern...................................................................... 32
2.8 Diagnosis banding............................................................................

33

2.8.1.1 Tuberkulosis (TB) milier............................................................ 33

2.8.1.2 Tuberkulosis dengan penyebaran secara endobronkial..............

36

2.8.2 Sarkoidosis....................................................................................

36

2.8.3 Edema pulmo kardiogenik............................................................. 37

2.8.4 Bronkoalveolar cell carcinoma...................................................... 38
2.9 Penatalaksanaan................................................................................ 39
BAB III RINGKASAN

40

DAFTAR PUSTAKA ... 41