ppt limfoma

7/21/2019 ppt limfoma

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TUGAS PAKAR SISTEM IMUN DANHEMATOLOGI

“LIMFOMA”OLEH KELOMPOK 4

DOSEN PAKAR

ELMI. M. KES

DOSEN PEMBIMBINGNS.SISKA DAMAIYANTI, S.KEP

SEKOLAH TINGGI ILMU KESEHATAN YARSISUMATERA BARAT BUKITTINGGI

PRODI S1 KEPERAWATAN2014/2015



Anggot K!"o#$o%

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ANATOMI FISIOLOGI SITEM LIMFATIK

Pengertian

S&'t!# L&#t&% )"( ',t, '&'t!# '&*%,"'& '!%,n)!* ng!*,ng'& #!ng"&*%n "&# t, g!t( !n&ng )& )"# t,,(7L&# 8,%n "&#$9 !*'" )*& $"'# )*( ng %!",* )*&'&'t!# %*)&o'%,"* %! )"# :*&ngn '!%&t*n7 .&*n &n&

%!#,)&n )&%,#$,"%n o"!( '&'t&# "&# #!"",& $*o'!' )&,'& %!)"# %!"!n:* "&# )n )&%!#"&%n %!#"& %! )"# '&'t!#'&*%,"'&7 S&'t!# '",*n "&#! !*(,,ngn !*t )!ngn '&'t!#'&*%,"'& )*(7 D*( #!n&ngg"%n :nt,ng #!"",& *t!*& )n)&%!#"&%n #!"",& !n7 S!g&n &*n ng #!n&ngg"%n

'&*%,"'& )&%!#"&%n #!"",& '",*n "&#!; ng #!*!#!' )"#*,ng *,ng :*&ngn7 H#$&* '!",*,( :*&ngn t,,( #!#$,n&'",*n "&#t&% ng #!ng"&*%n %!"!&(n &*n '!*"ng',ng )*& *,ng &nt!*'t&'&"7 B!!*$ $!ng!,"&n nt* "&ng&n $!*#,%n %,"&t;'&'t!# '* $,'t ;g&n )"# )*&'* $!*&!* ;!n)o#&'&,# otot; )n t,"ng7



S,',nn Dn F,ng'& S&'t!# L&#t&%

7 S,',nn

L&#! #&*&$ )!ngn $"'#t!t$& )!ngn %)* $*ot!&nng "!&( %!&"7 K!"!n:*"&#! #!n#(%n "&#o'&t$) "&#! '!(&ngg :,#"('!" &t, 'ngt !'* )"#'",*n "&#!7 D& )"# "&#!t&)% t!*)$t '!" "&n7L&#!)"# '",*nn )&g!*%n

o"!( %ont*%'& otot )&'!%&t*n )n )"#!!*$ '",*n "&#! ngg!*%nn !'* &t, )&nt,o"!( %t,$7

7 F,ng'&

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M!ng!#"&%n &*n )n $*ot!&n )*& :*&ngn %! )"# '&*%,"'& )*(

M!ngng%,t "&#o'&t )*& %!"!n:* "&#! %!

'&*%,"'& )*(7

Unt,% #!#- "!#% ng ',)(

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&n& &"( '",*n "%t!"7

K!"!n:* "&#! #!n*&ng )n#!ng(n,*%n #&%*oo*gn&'#! ,nt,%

#!ng(&n)*%n $!n!*%n o*gn&'#!&t, )*& t!#$t #',%n %! )"#

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#!"&n),ng& t,,( t!*()$ %!"n:,tn&n!%'&7



P!#,",( "&# !*,ng'&#!ngng%,t &*n ,nt,% %!#"&%! $!*!)*n )*(7 L&#'!!n*n #!*,$%n &*n

$"'# )*( ng #!*!#!'%!",* )*& $!#,",( %$&"!* )&'&'t!# $!*!)*n )*( )n%!#,)&n #!n:)& &*n &nt!*'&'&"*,ng nt*'!" $) :*&ngn7P!#,",( "&# )&!)%n

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7 K$&"!* "&#t&%

K$&"!* "&#t&% )"($!#,",( "&#t&% t!*%!&" ng!*,ng'& '!g& $!n!*&#

&*n "&#! ,nt,% $!*t#%"&n7 D&)"# t,,(; )',t, $!#,",( %$&"!* "&#t&%ng !*,ng'& ,nt,% $!n!*$n"!#%; $!#,",( %$&"!* &n&)&'!,t lacteal

St*,%t,* )n "o%'& $!#,",( %$&"!*



7P!#,",( L&#t&%P!ng,#$,"

P!#,",( "&#t&%$!ng,#$," !*,ng'&'!g& $!n!*&# &*n"&#! ng !*'" )*&%$&"!* "&#t&%7

7 L&#$(ono),'

L&#$(ono),' &n&!*!nt,% ,"t>o";!n '($! )n !*))& '!$n:ng $!#,",(

"&#! ng !*,ng'&,nt,% #!n!*&# &*n"&#! ,nt,% %!#,)&n)&'*&ng;#!ng(n,*%n %t!*&; $*'&t )n#&%*oo*gn&'#! ng!*( g& t,,(7



)7 T*,n%,' L&#t&%,'

A) "&# T*,n%,' L&#t&%,' !'* ng ) )& t,,( 7

Lumbar Trunk ; !*,ng'& '!g& '",*n )*& &*n

"&#! ng !*'" )*& o*gn $!"&; o*&,#; t!'t&';g&n:"; %!"!n:* )*!n"; !%'t*!#&t' -(; $!"&)n )&n)&ng )o#&n"7

Intestinal Trunk ;'!g& '",*n "&#! ng !*'")*& o*gn ?o*gn $!n!*nn &t, "#,ng;$n*!'; "&#$ )n (t&

Bronchomediastinal Trunk ; #!ng,#$,"%n &*n"&#! ng !*'" )*& o*gn>o*gn ng !*) )&to*%' )n )&n)&ng t(o*%'

Jugularis Trunk ; '",*n )*&n'! ,nt,% %!$" )n"!(!*

Subclavian Trunk ; '",*n "&#! )*& !%'t*!#&t' t';)&n)&ng to*%' ng ',$!*$&'&"; )n )*& %!"!n:*##!



T*,n%,' L&#t&%,'



!7 D,t,' L&#t&,'

T*,n%,'>t*,n%,' ng ) %!#,)&n t!*(,,ng )!ngn !n!'* ng !*) )& )!*( t(o*%' t, !*g,ng $)

$!#$,",( "&#t&% ng "!&( !'* ng )&'!,t ),t,' "&#t&%,'D,t,' "&#t&,' t!*)&*& t'<

Sisterna Chyle

S,t, ),t,' ng t!*"!t% )& g&n ,n&on )*& ",#* t*,n% )n#!)&'t&n" t*,n% !*!nt,% g!"!#,ng ng % %n "!#%7

Thoracic Duct D,t,' &n& !*:"n n&% )&'!$n:ng !*t!* )n !*,ng'& ,nt,%#!ngo'ong%n &*n "&#! %! $!#,",( !n7 D,t,' &n&

#!n)*&n'! '!%&t* t&g $!*!#$t )*& '&'t!# "&#&% t,,(7 T*,n%,' ng "&*n "&#!n #!n,:, ),t,' &n& )"( T*,n,' :,g,"*&' %&*& )n t*,n%,' ',"&n %&*&

Ductus Limfatikus Dextra

T*,n,' :,g,"*&' %nn; ',"&; *on(o#!)&'t&n"#!#!nt,% ),t,' "&#t&,' )!@t* ng !*g,ng )!ngn!n t(o*& ng #!n,$"& %!$" %nn; !%'t*#&t' t'g&n %nn; )n t(o*@ %nn



B7 *&ngn / O*gn L&#t&%



O*gn "&#t&% t!*)&*& t'<

17 Organ Li!ati" Prier

S,#',# t,"ng #!*( <#!*,$%n :*&ngn $!ng('&"

"&#o'&t 7S!" '!" ng )&('&"%nt!*'!,t %n #!ng"#& $!*%!#ngn7L&#o'&t ng!*%!#ng )& ')"# ',#',# t,"ng %n #!n:)&"&#o'&t B7 S!)ng%n "&#o'&t ng !*%!#ng )&)"# %!"!n:* t&#,' %n #!n:)& "&#o'&t T 7"&#o'&t

"&#o'&t In& !*$!*n $!nt&ng ,nt,% #!"-n $!n%&t7

K!"!n:* t&#,' <#!#&"&%& ,ng'& '$!'&% ;&t, t!#$t$!*%!#ngn "&#o'&t ng )&('&"%n )*& ',#',#

#!*( ,nt,% #!n:)& "&#o'&t T7 T&#,' t&)% !*$!*n)"# #!#!*ng& nt&g!n '!* "ng,ng '!$!*t& $)o*gn>o*gn "&#o&) ng "&n 7Unt,% #!#!*&%n%!%!"n $) "&#o'&t T &n&; #% t&#,' #!n'!%*!'&%n(o*#on t&$o$o&!t&n7



#. Organ Li!ati" Se"$n%er

Limpa< "&#$ #!*,$%n o*gn "&#o&) ng $"&ng!'*7 K!"!n:* ng )&('&"%n )*& "&#$ !*-*n ,ng,

t,7L &# t!*"!t% )& !"%ng "#,ng7 F,ng'& "&#$ nt*"&n< #!#,n,( %,#n $!n%&t; #!#,n,( '!" )*($,t&( 8"!,%o'&t9 )n nt&o)& ; #!ng(n,*%n '!" )*(#!*( ng ',)( t,7

odus limfe< !*!nt,% %!&" "on:ong t, '!$!*t&%ng )n t!*)$t )& '!$n:ng $!#,",( "&#!7 No),'"&# t!*g& #!n:)& *,ngn ng "!&( %!&" ng)&'!,t no),",'7 No),",' t!*g& #!n:)& *,ngn ng"!&( %!&" "g& ng )&'!,t '&n,'7D& )"# '&n,' t!*)$t

"&#o'&t )n #g*o%7 F,ng'& no),' "&# )"( ,nt,%#!n*&ng& #&%*oo*gn&'#! ng ) )& )"#"&#7K!"o#$o%> %!"o#$o% ,t# t!*)$t )& )"#"!(!*;@&";t(o*@;)o#!n; )n "&$tn $(7



odulus limfatikus <#!*,$%n'!%,#$,"n :*&ngn "&#t&% ngt!*'!* )& '!$n:ng :*&ngn &%tng t!*)$t $) #!#*n#,%,' ng #!#t'& )&n)&ng'",*n $!n!*nn; '",*n*!$*o),%'&; '",*n ,*&n; )n'",*n *!'$&*'&7 B!!*$ !nt,%no),",' "&#t&%,' &t, ton'&" )no"&%!" "&#t&%7Ton'&" t!*)$t )&t!nggo*o%n7 Fo"&%!" "&#t&%t!*)$t )& $!*#,%n )&n)&ng

,',' (",'7 L!t% no),",'"&#t&%,' 'ngt 't*t!g&' ,nt,%!*$!*n )"# *!'$on &#,n#!"-n =t '&ng ng #',%)"# t,,( #!"",& $!n!*nnt, $!*n$'n7



&i'i()(gi Si'te Li!a'iti"

S&*%,"'& "&#! #!*,$%n $*o'!' ng *,#&t )n',"&t )&$(#&7St, ,ng'& ,t# '&'t!# "&#! )"(

,nt,% !*$*t&'&$'& )"# $!*t,%*n %&nt&n&, &*n&nt!*'t&" "t*t $"'# ng #!n&"ng )&n)&ng %$&"!*)n %!!$tn $!#!nt,%nn t!*gnt,ng $)$!*!)n t!%nn )& t*n #!#*n &n&7

P$$!n(&#!* )n 'oto *&!* #!n),%,ng %on'!$(- $o*& $o*& %$&"!* )"( %!&" )n (n$!*#!!" '!g&n g& #o"!%," !'* '!$!*t&$*ot!&n $"'#7 Mo"!%," !'* &n& ng t!*tng%$ )&)"# %$&"!* #!n&#,"%n !!% o'#ot&% ng!n)!*,ng #!n:g o",#! &*n )& )"# *,ng%$&"!*7

A) "&*n !*'&( &*n %!",* )*& %$&"!* %! *,ng&nt!*'t&'&" $) ,:,ng *t!*&o" ng !*t!%n t&ngg&)*& ',t, %$&"!*; )n "&*n !*'&( %! )"# ,:,ng



Ln:,tnC

A"&*n "&#! no*#" 2 '#$& 4 "&t!* $!* (*& 7K!!$tn "&*n

'ngt )&$!ng*,(& o"!( '!:,#"( %to* "o%" )n '&'t!#&%;ng#!n%,$ %on'!nt*'& $*ot!&n )"# $"'# )n &*n&nt!*'t&'&" ;(,,ngn t!%nn *t!*& )n !n "o%";'!*t ,%,*n$o*& )n %!,t,(n %$&"!*7T!ng $!n)o*ong "&#! :,g#!*,$%n $*o'!' ng *,#&t7

St &'t&*(t ;%ont*%'& &nt*&n'&% ng *&*# )*& )&n)&ng),%t,' $!ng,#$," )&ngg$ #!n)o*ong "&#! %! *( ),%t,'to*'&,' )"# !nt,% $!*&'t!"t&%7Kont*%'& otot *ng% %t&;#!n!%n '",*n "&#! )n %*!n )n %t,$ ng %o#$!t!n)"# '",*n "&#! ;#% "&#! )& )o*ong %! *(%!$"7P!n&ng%tn t!%n &nt* )o#!n %&t t,% t,

#!ng!:n;:,g #!n!%n $!#,", "&#! ;#!#$!*!$t "&*n"&#! %! t'7P!*,(n '&% )"# t!%nn &nt*to*%' ng!*(,,ngn )!ngn $!*n$'n ;#!#!nt,% #!%n&'#!$o#$ "&n ,nt,% #!"",& #!)&'t&t&n,#7A"&*n )*( ng !$t)"# !n ',%"& &' #!n&#,"%n !!% '&$(on $) ),%t,'to*'&%,'7



F&'&o"og& '&'t!# "&#t&%



L I M FO MA



Pengertian Li!(a

M!n,*,t Dn&!""!; 819 (- "&#o# )"( #"&gnn'& ngt&#," )*& '&'t!# "&#t&%7

P!ng!*t&n "&n t!ntng "&#o# #"&gn #!n,*,t S,'n M*t&n T,%!*; 819 )"( ',t, %!"o#$o% n!o$"'# ng !*'" )*& :*&ngn "&#o&)7

S!)ng%n #!n,*,t S,=nn! .7 S#!"t=!*; 8 20019; #!ng!#,%%n(- "&#o# #"&gn )"( %!gn'n '!" ng !*'" )*& '!""&#o&)7

P!ng!*t&n "&n t!ntng "&#o# #"&gn #!n,*,t Do!ng!'; 819)"( %n%!* %!"!n:* "&#o&)7

L&#o# )"( '"( 't, :!n&' %n%!* )*( ng t!*:)&%!t&% "&#o'&t B t, T; &t, '!" )*( $,t&( ng #!n:g )t(n t,,( #!n:)& no*#" )!ngn #!#!"( "!&( !$t )*& '!"

&' t, (&),$ "!&( "# )*& &'n7 L&#o# )$t #,n," )&!*g& g&n t,,(; '!$!*t& no),' "&#; "&#; ',#',# t,"ng;

)*(; t, o*gn "&nn; ng $) %(&*n %n#!#!nt,% t,#o*; ng t,#,( )n #!ng#&" *,ng :*&ngn )no*gn )& '!%&t*n; '!(&ngg #!ng(!nt&%n ',$n o%'&g!n )nn,t*&!n ,nt,% :*&ngn t, o*gn t!*'!,t7 86&%&$!)&; 20149



K)a'i*"a'i Li!(a

L&#o# t!*g& #!n:)& ), g&n

17 L&#o# Ho)g%&n

27 L&#o# Non Ho)g%&n



LIMFOMA HODGKIN



17 P!ng!*t&n

L&#o# Ho)g%&n )"( '!,( %!gn'n )& '&'t!# "&#t&%ng )&!)%n )*& "&#o# non>Ho)g%&n o"!( %!!*)n '!"R!!)>St!*n!*g7 ,g )&%!n" '!g& $!n%&t Ho)g%&n786&%&$!)&;20149

P!n%&t Ho)g%&n )"( %!gn'n ''t!# "&#o*!t&%,"!* )n :*&ngn $!n),%,ngn ng '!*&ng #!n!*ng %!"!n:* g!t(!n&ng )n )&'!*t& g#*n (&'to$to"og& ng %('7 .&*&(&'to$to"og&' ng )&ngg$ %(' )"( )n '!" R!!) ?St!&n!*g t, *&nn ng )&'!,t '!" Ho)g%&n )ng#*n $"!&#o*% %!"!n:* g!t( !n&ng

P!n%&t Ho)g%&n )"( %n%!* ng !*-" )*& '!">'!"'&'t!# &#,n7 P!n%&t Ho)g%&n !*-" 't '!" "&#o'&t ng&'n )"( '!" B 8'!" T 'ngt :*ng9 #!n:)& no*#"7S!" "&#o'&t ng no*#" t!*'!,t )&n#%n '!" R!!)St!*n!*g7



27 K"'&%'& L&#o# Ho)g%&n

K"'&%'& $to"og&' ng '!*&ng )&$%& '!%*ng &n& )"(#!n,*,t L,%' )n B,t"!* '!',& %!$,t,'n '#$o'&,#$!n%&t Ho)g%&n )n Ann A*o*7 M!n,*,t %"'&%'& &n&$!n%&t Ho)g%&n )&g& #!n:)& 4 t&$!; &t, <

a! Tipe Lymphocyte "redominant

P) t&$! &n& g#*n $to"og&' %!"!n:* g!t( !n&ng

t!*,t# t!*)&*& )*& '!">'!" "&#o'&t ng )!-';!!*$ '!" R!!)>St!*n!*g7 B&'n )&)$t%n $)n% #,)7 P*ogno'&'n &%7

b! Tipe #ixed Cellularity

M!#$,n& g#*n $to"og&' ng $"!&#o*% )!ngn

'!" $"'#; !o'&no"; n!,t*o"; "&#o'&t )n n%)&)$t%n '!" R!!)>St!*n!*g7 Dn #!*,$%n $!n%&tng ",' )n #!ng!n& o*gn !%'t*no),"7 S!*&ng $,")&'!*t& g!:" '&'t!#&% '!$!*t& )!##; !*t )n#!n,*,n )n !*%!*&ngt7 P*ogno'&'n "!&( ,*,%7



Ln:,tnC

c! Tipe Lymphocyte Depleted

G#*n $to"og&' #&*&$ )&,'! (&'t&ot&"#$(o#; '!" R!!)>St!*n!*g n% '!%"& )n(n ) '!)&%&t '!" :!n&' "&n7 B&'n $) o*ng

t, )n !n)!*,ng #!*,$%n $*o'!' ng ",'8g*!'&9 )!ngn g!:" '&'t!#&%7 P*ogno'&' ,*,%7

d! Tipe odular Sclerosis

K!"!n:* #!ngn),ng no),">no)," ng )&$&'(%n

o"!( '!*t %o"g!n7 S!*&ng )&"$o*%n '!" R!!)>St!*n!*g ng t&% ng )&'!,t '!" Ho)g%&n7 S!*&ng)&)$t%n $) -n&t #,) / *!#:7 S!*&ng

#!n!*ng %!"!n:* #!)&'t&n,#7

+eni' en-a"it H(%g"in er%a'ar"an /aringan



+eni' en-a"it H(%g"in er%a'ar"an /aringan-ang ter)i0at %i aa0 i"r('"(

+eni' Gaaran i"r('"(i" Per/a)anan

Pen-a"itLi!('it

Pre%(inan

S!" R!!) St!n!*g 'ngt

'!)&%&t t$& ) n%

"&#o'&t

L#t

S2)er('i'N(%$)er

S!:,#"( %!&" '!" R!!)St!n!*g )n #$,*n '!"

)*( o,t&( "&nn )!*(

:*&ngn &%t *o'

S!)ng

Se)$)arita'

3a$ran

S!" R!!) St!n!*g )"#

:,#"( ng '!)ng )n

#$,*n '!" )*( $,t&(

"&nn

Ag% !$t

De)e'i

Li!('it

Bn% '!" R!!g St!n!*g

)n '!)&%&t "&#o'&t :*&ngn

.!$t



7 Et&o"og&

P!n! )*& $!n%&t "&#o##"&gn #'&( !",# )&%!t(,& )!ngn$'t&7 A) 4 %!#,ng%&nn $!n!n;

&t, < %to* %!t,*,nn; %!"&nn '&'t!#%!%!"n; &n!%'& &*,' 8HI39 t, %t!*&8$elicobacter "ilori9; &*,' (,#n T>!"""!,%!#&/"#$(o# 8HTL39; E$'t!&n>B**

&*,' 8EB39; )n to%'&n "&ng%,ngn8(!*&'&); $!ng-!t )n $!-*n %&#&97

L : t



Ln:,tnCA) !!*$ %to* $!#&, &t,<

3&*,' <#&'" HTL3;HI3

G!n!t&% < )n #,t'& g!n I#,no)!'&!'& < 25 %!"&nn (!*!)&t!* "ng% ng

!*(,,ngn )!ngn t!*:)&n($og##g"o,"&n!#&;o##on *&"!&##,no)!&!n; -&'%ot ")*&( 'n)*o#! )n t@>t!"ng&!t'&7

Ag!n &n!%'&,' < EB3 DNA )&t!#,%n $) "&#o# B,*%&t'$o*)&7%*!n t&)% $) '!#, %',' "&#o# B,*%&t)&t!#,%n EB3; (,,ngn )n #!%n&'#! EB3 t!*()$

t!*:)&n "&#o# B,*%&t !",# )&%!t(,&7 P$*n "&ng%,ngn )n $!%!*:n < !!*$ $!%!*:n

ng '!*&ng )&(,,ng%n )!ngn *!'&%o t&ngg& )"( <$!t!*n% '!*t $!%!*: (,tn )n $!*tn&n7 H" &n&)&'!%n o"!( )n $$*n (!*&'&) )n $!"*,t

o*gn&%7



47 F%to* R!'&%o

3&*,' t!*t!nt,

T!*&n!%'& &*,' E$'t!&n B** 8EB39 t, (,#n&##,no)!&!n &*,' 8HI39 )$t #!n&ng%t%n *&'&%o$!n%&t Ho)g%&n7 Bg&#n$,n :,g; "&#o# t&)%#!n,"*; '!(&ngg t&)% #,ng%&n #!n)$t%n "&#o# )*&o*ng "&n7

S&'t!# &#,n "!#(R&'&%o #!ng&)$ $!n%&t Ho)g%&n #!n&ng%t )!ngn

'&'t!# &#,n ng "!#( 8'!$!*t& %!)n '!)ng#!ng%on',#'& ot>otn $!n!%n &#,n $'t*n'$"nt'& o*gn97

U'&

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P!n%&t "&#o# #"&gn "!&( n% )& )!*&to"!( $*& )&n)&ng%n -n&t7 G (&),$ ng t&)% '!(t

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B!!*$ $!%!*:n ng )&(,,ng%n )!ngn*!'&%o t&ngg& "&#o# #"&gn )"( $!t!*n% '!*t$!%!*: (,tn )n $'!*tn&n7H" &n& )&'!%n)n $$*n (!*&'&) )n $!"*,t o*gn&%7



57 Pto'&o"og&

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B!!*$ $!*,(n ng t!*:)& $) "&#o'&tt, nt* "&n<

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N!%"!o"&n t!*"&(t7

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B!!*$ %to* *!'&%o ng )&$!*%&*%n )$t#!n!%n t!*:)&n "&#o# (o)%&n '!$!*t& &*,'>&*,'

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%!"!n:* "&#! #% %n t!*:)& "&#$()!no$(t7D#$% )*& $o"&!*'& '!" )*( $,t&( ng t&)%

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7 Mn&!'t'& %"&n&'

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'tg&ng #!n,*,t Ann A*o* ng )& #o)&%'& '!',&%on!*!n'& .ot'-")7

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ng%; #&'" < II2; II; )'7

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Staging menurut Ann Arbor berdasarkan anatomis.I Pee'aran "e)en/ar )i!e regi(na) t$ngga) ata$

ee'aran (rgan e"'tra )i!ati" t$ngga) ata$ 'e'i'i.

II P!#!'*n %!"!n:* "&#! *!g&on" ), t, "!&( ng #'&(

'!'&'& )!ngn )&*g# t, $!#!'*n o*gn !%'t*"&#t&%

't, '&'& t, "!&( ng #'&( '!'&'& )!ngn )&*g#

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)!ngn $!#!'*n "&#$ t, $!#!'*n o*gn !%'t*

"&#t&% '!'&'& t, %!), '&'&

I4 P!#!'*n o*gn !%'t* "&#t&% )!ngn t, tn$

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M!n,*,t .ot'-o")' 8109 ng #!*,$%n #o)&%'& )n%"'&%'& Ann A*o* 8119; L&#o# Ho)g%&n )&%"'&%'%n

#!n:)& 4 't)&,# #!n,*,t t&ng%t %!$*(nn <Sta%i$ Meta'ta'e

Sta%i$ I P!n!*n L&#o# (n t!*)$t $) 't,

%!"o#$o% &t, %!"!n:* g!t( !n&ng

Sta%i$ II P!n!*n "&#o# #!n!*ng ), t, "!&(

%!"o#$o% %!"!n:* g!t( !n&ng; t!t$& (n $) 't,

'&'& )&*g#; '!*t $) '!",*,( )) t, $!*,t

Sta%i$ III P!n!*n "&#o# #!n!*ng ), t, "!&(

%!"o#$o% %!"!n:* g!t( !n&ng; '!*t $) )) )n

$!*,tSta%i$ I4 P!n!*n "&#o# '!"&n $) %!"!n:* g!t( !n&ng

'!t&)%n $) 't, o*gn "&n :,g '!$!*t& ',#',#

t,"ng; (t&;$*,>$*,; t, ot%



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L&#o# Ho)g%&n :,g )&%t!go*&%n #!n:)& ”A”t, ”B” )n “” )n “S”

A < &% $'&!n t&)% #!ng"#& g!:" )!##;n% !*%!*&ngt; t,$,n #!n,*,nn !*t

)n

B < &% $'&!n #!ng"#& g!:" )!##;

n% !*%!&*ngt; t,$,n #!n,*,nn !*t)n7

< &" ) bulky mass 8J 1/ "!* t(o*@ )nJ 10 # ,nt,% ,%,*n %!"!n:*97

S < &" "&#$ 8'$"!!n9t!*%!n

Tn) )n G!:"



7 Tn) )n G!:"

L#$()!no$t( t% '%&t )&'t, '&'& "!(!*7$)

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ng !",# )&%!t(,& $!n!n ;!*%!*&ngt )&#"# (*&;*' "!"( ng t!*,' #!n!*,' ;*'gt" ng !*"!&(n ;$!n,*,nn !*t)n;t!%nn )*( t,*,n7

G!:" "&nn t&#," !*)'*%n "o%'&$!*t,#,(n '!">'!" "&#o#7 T!*)$t g!:"'$!'&% $) "&#o# nt* "&n <

D!## !*%!$n:ngn )!ngn ',(, "!&( )*&

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Ln:,tnCGe/a)a Pen-ea

Ber"$rangn-a /$)a0

eritr('it

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',#',# t,"ng

Hi)angn-a "e"$atan (t(t,

'$ara 'era"

P!#!'*n %!"!n:* g!t( !n&ng

#!n!%n '* )& t,"ng !"%ng

t, '* $&t ',*Sa"it "$ning 5/a$n%i2e6 L&#o# #!n,#t "&*n !#$!),

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7 Ko#$"&%'& P!n%&t

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T*n','& "!,%!#& &"!,'

Gg" ,ng'& (t&

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K!t&)%##$,n #!#$,n& %!t,*,nn 8&n!*t&"&t'9 E!% '#$&ng )*& *)&'&

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T!*:)& &n!%'&

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7 E$&)!#&o"og&

Ang% %!:)&n P!n%&t Ho)g%&n ng !*)'*%n$o$,"'& )& In)on!'& !",# )7 P) KOPAPDI II )&S,* t(,n 1 )&"$o*%n (- )& g&n$!n%&t )"# RS7 D*7S,to#o S,* nt* t(,n1>12 8 t(,n9 t!"( )&*-t 2715 $'&!n; )&#n1 )&nt*n )"( "&#o# #"&gn,# )n 12 o*ng)"( $!n%&t Ho)g%&n7 P) KOPAPDI 3III t(,n 10)& +og )&"$o*%n (- '!"# 1 t(,n )& g&n$!n%&t )"# RSUP D*7 S*):&to )&*-t 224 $'&!n; 2)& nt*n )"( "&#o# #"&gn,# )n '!#,n)"( "&#o# Ho)g%&n7 D*& "$o*n>"$o*n t!*'!,t )&t' t!*"&(t (- )& In)on!'& "&#o# non>Ho)g%&n"!&( n% )*& $!n%&t Ho)g%&n; )n $*& '!"", "!&(n% )*&$) -n&t7

10 G K"& &



107 G#*n K"&n&'

P!n%&t Ho)g%&n &'n t&#," '!g& $!n%&t

"o" )n %!#,)&n #!n!* %! 't*,%t,* "&#o&))&)!%tn )n %(&*n #!",' %! :*&ngn non "&#o&))!ngn %!#,ng%&nn %!#t&n $'&!n7 P'&!n $!n%&tHo)g%&n ,#,#n )tng )!ngn )n #'' t,%!"o#$o% %!"!n:* "&#! ng $)t; #,)( )&g!*%%n

)n &'n t&)% n!*& t!%n7 S!%&t* '!$*,( $'&!n)tng )!ngn )!no$t& )& "!(!* t, )!*(',$*%"&%," )n "!&( )*& 0 $!*'!n $'&!n )tng)!ngn $!#!'*n %!"!n:* g!t( !n&ng ',$!*'&"7

K*!n %!"!n:* t!*'!,t ,#,#n t&)% n!*&; #%)!t!%'& o"!( $'&!n #,ng%&n t!*"#t '#$& %!"!n:*"&#! ,%,$ !'*7 S!%&t* 0 $!*'!n $'&!n )tng)!ngn )!no$t& #!)&'t&n,#7

L :



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Ho)g%&n t&)% t, '!)&%&t

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"!&( )*& 10 $!*'!n )"# ,"nt, %,*ng tn$ '! ng

:!"'7 G!:" "&n ng '!*&ng)&t!#,%n )"( *' "!#(;#"&'! )n !$t "!"(7 P*,*&t,'t!*)$t $) '!%&t* 10n $!*'!n

$'&!n $) 't )&gno'&'; g!:"&n& &'n g!n!*"&'t )n#,ng%&n !*%&tn )!ngn *,#%,"&t t, -",$,n :*ng#!*,$%n 't,>'t,n g!:"$!n%&t7



117 P*ogno'&'

P*ogno'&' $!n%&t Ho)g%&n &n& *!"t& &%7 P!n%&t&n& )$t '!#,( t, (&),$ "# )!ngn $!ngotn#!'%&$,n t&)% 1007 T!t$& o"!( %*!n )$t (&),$"#; %!#,ng%&nn #!n)$t%n "t! o#$"&t&on

#%&n !'*7 Lt! o#$"&t&on &t, nt* "&n < T&#,"n %!gn'n %!), t, '!%,n)!*

D&',ng'& !n)o%*&n ng %!n%n )"( t&*o&))n gon)"

P!n%&t ' t!*,t# #!*!% ng #!n)$t%o#&n'& *)&'& )n $!#!*&n nt*'&%"&nt!*,t# ng )o'&'n n% 8)o'! *!"t!)9

P!n%&t $) $*, $) #!*!% ng #!n)$t

*)&'& )n "!o#&'&n ng :,g )o'! *!"t!) $)>



LIMFOMA NON HODGKIN

1 P t&



17 P!ng!*t&n

L&#o# Non>Ho)g%&n 8LNH9 )"( %!"o#$o% %!gn'n$*&*n!* "&#o'&t ng )$t !*'" )*& "&#o'&t B; "&#o'&t

T; )n 'ngt :*ng !*'" )*& '!" NK 8nt,*" %&""!*9ng !*) )"# '&'t!# "&#! ng 'ngt (!t!*og!n;&% t&$! (&'to"og&'; g!:"; $!*:"nn %"&n&'; *!'$ont!*()$ $!ngotn; #,$,n $*ogno'&'7

L&#o# non>Ho)g%&n 8LNH9 t, non>Ho)g%&nL#$(o#' #!*,$%n $!n%&t ng 'ngt (!t!*og!n)&"&(t )*& '!g& $to"og& )n %"&n&'n7 P!n!*nn

:,g t&)% '!t!*t,* $!n%&t Ho)g%&n '!*t !nt,% !%'t*>no)" :,( "!&( '!*&ng )&:,#$&7

L&#o# non Ho)g%&n #!*,$%n $!n%&t ng(!t!*og!n; t!*gnt,ng )*& g#*n %"&n&%;imunofenotiping )n *!'$on' t!*()$ t!*$&7



27 Et&o"og&

P!n! $'t& "&#o# non Ho)g%&n t&)%)&%!t(,&; n#,n LNH )$t )&'!%n o"!(no#"&t' '&tog!n&%; '!$!*t& t*n'"o%'& %*o#o'o#)n &n!%'& &*,'7 T*n'"o%'& %*o#o'o# )n

$!*,(n #o"!%,"* 'ngt !*$!*n $!nt&ng )"#$tog!n!'&' "&#o#; )n !*(,,ngn )!ngn(&'to"og& )n &#,no!not&$&ng7 T*n'"o%'& %*o#o'o#)"( t*n'"o%'& %*o#o'o#" no*#" ng $"&ng'!*&ng )&(,,ng%n )!ngn LNH7 B!!*$ &n!%'&&*,' !*$!*n )"# $tog!n!'&' LNH; '!$!*t& &*,'E$'t!&n B** ng #!*,$%n $!n! $"&ng '!*&ng$) "&#o# B,*%&tt;"&#o# $) $'&!n )!ngnimunocompremised )n $!n%&t Ho)g%&n7

F%to* R!'&%o



7 F%to* R!'&%o

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b!"enatalaksanaan secara +husus

Limfoma Hodgkin



Limfoma Hodgkin T(!*$ M!)&%; Kon',"t'& %! ("& on%o"og& #!)&% 8&'n RS t$! A

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(!$*; " g&n:"; LDH7

"emerikasaan Ideal

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ASUHAN KEPERAWATAN



A. PENGKA+IAN

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Mengenai Keti%a"e!e"ti!an



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