Saran - KESIMPULAN DAN SARAN - Konfirmasi Diagnostik Sitologi Imprint, Potong Beku dan Histopat

BAB V KESIMPULAN DAN SARAN

5.2. Saran

5.2.1. Saran Kepada Klinisi

Pada penelitian ini diketahui tidak semua lesi tiroid yang dilakukan operasi mengalami pemeriksaan sitologi imprint dan potong beku dengan indikasi yang sesuai, di mana masih dijumpai lesi tiroid yang tidak memerlukan tindakan operatif dalam penanganannya, dengan demikian diharapkan dapat ditentukan lesi tiroid yang memiliki indikasi pemeriksaan intra-operatif (sitologi imprint dan potong

beku) sehingga penatalaksanaan lesi tiroid dapat lebih optimal. Hal ini dapat diperoleh dengan melakukan biopsi aspirasi jarum halus sebagai tindakan pre- operatif rutin terhadap lesi tiroid.

5.2.2. Saran Kepada Ahli Patologi

Keterbatasan pemeriksaan sitologi imprint dan potong beku lebih disebabkan cara pengambilan dan pengolahan sediaan yang belum maksimal, diharapkan teknik pengambilan sediaan sitologi imprint dapat lebih baik lagi (lege artis) dan pengambilan sampel jaringan untuk potong beku lebih representatif dan prosedur pengolahan jaringan yang lebih baik lagi untuk meningkatkan nilai sensitivitas dan akurasi pemeriksaan.

5.2.3. Saran Kepada Rumah Sakit

Pemeriksaan intra-operatif yang baik (sitologi imprint dan potong beku) sangat bermanfaat dalam membantu penatalaksanaan lesi- lesi tiroid maupun lesi- lesi lainnya, karena mempunyai nilai sensitivitas dan spesifisitas yang tinggi, sehingga jenis tindakan operasi dapat dilakukan tanpa menunggu hasil pemeriksaan histopatologik, dengan demikian sangat baik apabila rumah sakit yang memiliki pelayanan operatif juga memiliki pemeriksaan intra-operatif (sitologi imprint dan potong beku).

5.2.4. Saran Kepada Peneliti Lain

Pemeriksaan intra-operatif pada lesi tiroid sangat berguna dalam penatalaksanaan lesi tiroid, diharapkan penelitian terhadap pemeriksaan sitologi imprint dan potong beku dilakukan juga untuk lesi-lesi lainnya di RSUP Haji Adam Malik Medan maupun di rumah sakit lainnya.

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NO REK MEDIS NAMA PASIEN L/P

UMUR

(THN)

IMPRINT

FS

HISTOPAT

KET

1 460643 DA P 45 THY 5,KPT (GANAS) KPT (GANAS) KPT (GANAS)

2 465290 SA P 32 THY 5, KPT (GANAS) KPT (GANAS) KPT (GANAS)

3 282126 RE P 40 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

4 471185 BK L 46 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

5 477842 KG L 53 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

6 480736 RH P 52 THY 5, KPT (GANAS) KPT (GANAS) KPT (GANAS) VARIAN FOLIKULAR

7 486671 RK P 53 THY 3 (JINAK) KFT (GANAS) KFT (GANAS)

8 488179 SM L 64 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

9 484364 MG P 51 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

10 489158 EL P 49 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

11 996681 ME P 20 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

12 498452 SU P 38 THY 3 (JINAK) FN (JINAK) KPT (GANAS) VARIAN FOLIKULAR

13 504501 RO P 30 THY 5,SCC (GANAS) LESI GANAS (GANAS) KAT (GANAS)

14 502620 KC P 52 THY 5,KAT (GANAS) LESI GANAS (GANAS) KAT (GANAS)

15 492155 SBT L 31 THY 5, KPT (GANAS) KPT (GANAS) KPT (GANAS)

16 491902 DAH P 38 THY 5,KPT (GANAS) KPT (GANAS) KPT (GANAS)

17 514881 DAS P 53 THY 4,SUSP KPT (GANAS) CG (JINAK) CG (JINAK) PAPILLARY HYPERPLASIA

NO NO REK MEDIS NAMA PASIEN L/P

UMUR

(THN)

IMPRINT

FS

HISTOPAT

KET

18 512135 NUR P 35 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

19 506701 CS P 54 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

20 505082 ROM P 51 THY 3 (JINAK) FN (JINAK) FA (JINAK)

21 510755 ER P 60 THY 3 (JINAK) FN (JINAK) FA (JINAK)

22 512879 MER P 30 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

23 513212 CG P 49 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

24 522957 JS L 30 THY 3 (JINAK) FN (JINAK) FA (JINAK)

25 506839 SUN P 50 THY 5,KPT (GANAS) KPT (GANAS) KPT (GANAS)

26 524299 AR P 33 THY 2,CG (JINAK) CG (JINAK) KPT (GANAS)

27 525484 RAM P 46 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

28 515797 ALG L 65 THY 2,CG (JINAK) CG (JINAK) CG (JINAK)

29 522119 DUM P 56 THY 2, (JINAK) TIROIDITIS (JINAK) TIROIDITIS (JINAK)

Keterangan :

L : Laki-laki KPT : Karsinoma papiler tiroid

P : Perempuan KFT : Karsinoma folikular tiroid

Thy 1 : Bahan tidak cukup KAT : Karsinoma anaplastik tiroid

Thy 2 : Jinak (nodul goiter) FA : Adenoma folikular

Thy 3 : curiga suatu neoplasma (folikular) FN : Neoplasma folikular

Thy 4 : curiga keganasan CG : Colloid goiter

KUMPULAN GAMBAR MIKROSKOPIK SAMPEL

Karsinoma Papiler Tiroid

Karsinoma Folikular Tiroid

Adenoma Folikular

Sitologi, HE, 100x Sitologi, HE, 400x

Potong beku, HE, 40x Histopatologik, HE, 400x

Sitologi, MGG, 40x Potong beku, HE, 40x

Histopatologik, HE, 40x Histopatologik, HE, 200x

Colloid Goiter

Karsinoma Anaplastik Tiroid

Sitologi, MGG, 40x Sitologi, HE, 100x

Potong beku, HE, 40x Histopatologik, HE, 100x

Sitologi, MGG, 100x _{Sitologi, MGG, 100x}

Dalam dokumen Konfirmasi Diagnostik Sitologi Imprint, Potong Beku dan Histopatologi pada Lesi Tiroid di RSUP. Haji Adam Malik Medan tahun 2011-2012 (Halaman 78-91)