CASE REPORTPATIENT IDENTITYName : Mrs. RAge: 43 years old Sex : maleOccupation : UnemployeedDate of admission : April 29th 2014Registration : 652179ANAMNESISChief complain: Lump at the backSuffered since 7 month ago.Initially as big as a marble and gradually increase in size. The consistency of the lumb is solid and hard. Patient also complained of pain in his back since more than a year ago. Accompanied by sharp pain, not radiating, continuous, increase when the patient walk and relieved if the patient rest. History of prolonged cough (+), history of dyspneu (+), history of loose weight (+), history of high fever (-), history of sweat on night(+), history of trauma (-), history of TB treatment (-) , history of family with same disease (-), history of contact with patient with TB (+) Urination and defecation are normal.PHYSICAL EXAMINATIONa. General Statue: Poor nourished/ Conscious b. Vital SignBlood Pressure : 120 / 80 mmHg Heart Rate : 78 x/mnt Respiratory Rate : 20 x/mnt Temperature : 36,7 C LOCALIZED STATUS:Inspection : Skin colors same with vicinity, Deformity (+) , Swelling (-), Hematoma (-), Gibbus (+)Palpation : Tenderness (-), step off (-) LABORATORY RESULTLaboratoriumHasilWBC9.3. 103/UlHGB12.4 g/DlRBC4,77. 106/uLHCT32.6 %PLT324 103/uLGOT52 u/lGPT184 u/lUreum48 mg/dLCreatinine1,3 mg/dLLED69/101RADIOLOGY FINDINGSa. Thoracolumbal X-Ray b.