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Kata kunci: chromogranin, karsinoma sel skuamosa tidak berkeratin, NSE, pola pertumbuhan neuroendokrin, synaptophysin Veenda Herlyna Pertiwi; Bethy Suryawati Hernowo; Birgitta M Dewayani
Majalah Patologi Indonesia Vol 28 No 1 (2019): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Latar belakangKarsinoma sel skuamosa serviks adalah suatu keganasan epitelial serviks yang terdiri dari sel-sel tumor berdiferensiasiskuamous dengan derajat yang berbeda. Menurut data rekam medis di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung,insidensi karsinoma serviks menempati posisi pertama dengan jumlah kasus sebanyak 2.180 dalam rentang waktu Januari2010 sampai Maret 2016. Meskipun terdapat kemajuan terapi untuk karsinoma sel skuamosa yang tidak berkeratin tetapi masihditemukan kasus-kasus yang mengalami rekurensi cukup tinggi. Hal tersebut diduga disebabkan oleh adanya kesalahan dalammenentukan jenis histopatologi. Karsinoma sel skuamosa tidak berkeratin dengan pola pertumbuhan tumor neuroendokrinseperti trabekular, padat dan nested sering sulit dibedakan dengan tumor neuroendokrin di serviks uteri. Penelitian ini bertujuanuntuk mengetahui proporsi imunoekspresi chromogranin, neuron specific enolase (NSE), synaptophysin dan Ki-67, padakarsinoma sel skuamosa yang tidak berkeratin dengan pola pertumbuhan tumor neuroendokrin di serviks uteri, untukmendeteksi tumor neuroendokrin yang sebenarnya (true neuroendocrine tumor).MetodePenelitian ini menggunakan metoda deskriptif kategorik. Sampel yang digunakan adalah karsinoma sel skuamosa yang tidakberkeratin di serviks uteri sejak 1 Agustus 2014-31 Desember 2015 di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung.Dilakukan evaluasi ulang dan dipilih karsinoma sel skuamosa tidak berkeratin dengan pola tumor neuroendokrin sepertitrabekula, padat dan nested sehingga didapatkan sampel sebanyak 27 pasien dilakukan pewarnaan imunohistokimiachromogranin, NSE, synaptophysin dan Ki-67.HasilTerdapat 27 kasus karsinoma sel skuamosa yang tidak berkeratin di serviks uteri dengan pola pertumbuhan tumorneuroendokrin didapatkan proporsi yang menunjukkan imunoekspresi positif chromogranin, NSE dan synaptophysin sebesar10 (37%). Hal ini menunjukkan bahwa sampel merupakan tumor neuroendokrin dengan derajat tinggi (Ki-67>20%).KesimpulanImunoekspresi chromogranin, NSE dan synaptophysin sebesar 37% adalah tumor neuroendokrin derajat tinggi (Ki-67 >20%)pada karsinoma sel skuamosa tidak berkeratin dengan pola tumor neuroendokrin.
Hubungan antara Imunoekspresi Bcl-2 dan Caspase-3 dengan Respon Kemoterapi CHOP pada Limfoma Malignum Non-Hodgkin Tipe Sel B CD20 Positif Roro Wahyudianingsih; Bethy S Hernowo; Abdul H Hassan; Birgitta M Dewayani
Majalah Patologi Indonesia Vol 22 No 2 (2013): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

ABSTRAK Latar belakang Limfoma malignum merupakan suatu keganasan dari sel-sel jaringan limfoid. Limfoma non-Hodgkin (LNH) tipe sel B mencakup 90% dari seluruh limfoma di seluruh dunia, dengan angka kejadian mencapai 4% kasus baru per tahun. Regimen kemoterapi CHOP (Cyclophospamide, Hydroxydaunorubicin, Oncovin, Prednison) merupakan standar terapi penderita LNH, dengan angka respon komplit hanya sebesar 40% sampai 50%. Pada sekitar 30% kasus LNH tidak berespon dengan kemoterapi CHOP dan terjadi progresi penyakit bahkan sampai terjadi kematian. Respon kemoterapi yang efektif ditandai dengan peningkatan jumlah sel yang mengalami apoptosis. Protein bcl-2 berfungsi sebagai anti-apoptosis, sedangkan caspase-3 berperan sebagai eksekutor caspase (pro-apoptosis). Penelitian ini bermaksud menilai hubungan antara imunoekspresi bcl-2 dan imunoekspresi caspase-3 dengan respon kemoterapi CHOP. Metode Penelitian ini dilakukan secara retrospektif dengan desain analitik potong lintang terhadap 63 kasus LNH tipe sel B CD20 positif yang memenuhi kriteria penelitian, dari Januari 2009-Juni 2011 di Departemen Patologi Anatomik RSHS, Bandung. Kemudian dilakukan pulasan imunohistokima bcl-2 dan caspase-3, dan dihubungkan dengan respon kemoterapi dari data rekam medis. Hasil penelitian dianalisis statistik dengan uji Chi-square. Hasil Hasil penelitian ini adalah terdapat hubungan yang bermakna antara imunoekspresi bcl-2 yang lemah dengan baiknya respon kemoterapi CHOP (p=0,012), antara imunoekspresi caspase-3 yang kuat dengan baiknya respon kemoterapi CHOP (p=0,033), dan terdapat hubungan antara gabungan imunoekspresi bcl-2 yang lemah dan caspase-3 yang kuat dengan baiknya respon kemoterapi CHOP (p=0,009). Kesimpulan Ekspresi bcl-2 lemah dan imunoekspresi caspase-3 kuat menunjukkan respon kemoterapi CHOP yang lebih baik pada penderita LNH tipe sel B CD20 positif. Kata kunci : apoptosis, bcl-2, caspase-3, CD20, kemoterapi CHOP, LNH tipe sel B ABSTRACT Background Malignant lymphoma is malignancy originates from lymphoid tissue. B-cell type non-Hodgkin lymphoma (NHL) accounts for 90% from all lymphoma in the world. The incidence of B-cell type NHL approximately 4% of new cases every year. The chemotherapeutic agents CHOP (Cyclophospamide, Hydroxydaunorubicin, Oncovin, Prednison) is the standard treatment for NHL patient, with only 40%-50% complete response. In approximately 30% cases of NHL showed non-response with standard chemotherapy and underwent progressive disease until death. The effective chemotherapy response was shown by increasing number of cells that undergo apoptosis. Bcl-2 is a protein functions as anti-apoptotis, on the other hand caspase-3 has a role as excecutor caspase (pro-apoptotic). The aim of this study was to assess the association between bcl-2 and caspase-3 immunoexpression with CHOP chemotherapy response. Methods This is a retrospective study in 63 cases of B-cell type NHL which met the research criterias, using cross-sectional analytic design, at the Departement of Anatomical Pathology, Dr. Hasan Sadikin General Hospital in Bandung from January 2009 to June 2011. Immunohistochemistry for bcl-2 and caspase-3 were done, and then the clinical chemotherapy response were collected from the medical records. The result was analyzed using Chi-square. Results This study shows significant association between weak bcl-2 immunoexpression with good CHOP chemotherapy response (p=0.012), significant association between strong caspase-3 immunoexpression with good CHOP chemotherapy response (p=0.033), and significant association between combination of weak bcl-2 and strong caspase-3 immunoexpression with good CHOP chemotherapy response (p=0.009). Conclusion The weak bcl-2 immunoexpression and strong caspase-3 immunoexpression show good chemotherapy response in B-cell type LNH. Key words : apoptosis, bcl-2, B-cell type NHL, caspase-3, CD20, CHOP chemotherapy,
Histopathological and Clinical Features of Phyllodes Tumor in Hasan Sadikin during Period of 2012 - 2016 Natasha A Harsas; Birgitta M Dewayani; Raden Yohana
Journal of Medicine and Health Vol. 2 No. 2 (2018)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (397.273 KB) | DOI: 10.28932/jmh.v2i2.1016

Abstract

Phyllodes tumor is a breast fibroepithelial lesion that rarely occurred. This type of tumor has tendency to recurre and metastasize. This study aimed to determine the features of phyllodes tumor in Hasan Sadikin General Hospital in period of 2012 to 2016, histopathologically and clinically. Descriptive study with cross sectional design was conducted in Department of Pathological Anatomy, Hasan Sadikin General Hospital, Bandung, from September 2016 to May 2017. Using total sampling, the secondary data are taken from medical records with the diagnosis of phyllodes tumor. From 88 samples taken, the mean age of the tumor occurrence is 45,56 years old and the mean size of tumor diameter is 10,98 cm. Tumor with benign type has the highest prevalence, with 54 cases reported. Mastectomy is the most common procedure performed on this tumor. There are 7 recurred patients and 1 patient with metastasis. As conclusions, phyllodes tumor is a rare tumor. In Hasan Sadikin general hospital, it mostly occurs in women aged 45 years old in the benign type. Mastectomy is often performed as a choice of surgical treatment.
Risk Factors of Laryngeal Carcinoma in Otorhinolaryngology-Head and Neck Division of Dr. Hasan Sadikin Hospital Bandung Sarah A Putri; Yussy A Dewi; Birgitta M Dewayani
Journal of Medicine and Health Vol. 2 No. 2 (2018)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (358.698 KB) | DOI: 10.28932/jmh.v2i2.1007

Abstract

Laryngeal carcinoma is a squamous cell malignancy of larynx epithelial with the Indonesian incidence of 2.0 per 100,000 men and 0.2 per 100,000 women. The risk factors of laryngeal carcinoma include age, sex, family history, smoking habit, alcohol drink, and gastroesophangeal reflux disease (GERD)/ laryngopharyngeal reflux (LPR). This study aimed to know some risk factors for laryngeal carcinoma mentioned in Dr. Hasan Sadikin Hospital, Bandung. Hospital-based unmatched case control study was selected as the methods, involving 80 patients in Oncology Clinic of Otorhinolaryngology-Head and Neck Surgery Department, Dr. Hasan Sadikin General Hospital. The medical records of the carcinoma larynx patients was taken as a study instrument. The results were age percentage of 50-79 years old in the case group is 82.5% therefore, it increase the risk of having laryngeal carcinoma by 7.29 times. Male respondents dominate in the case group (90%) with OR =6.00. Respondents with GERD in the case group is 45%, increasing the risk 15.54 times and these results was significant (p<0.005). Other analyzed variables, such as family history, smoking history, and alcohol consumption is not significant statistically (p>0.005). This study shows the results of age, sex, and GERD/LPR are corresponding with the results with previous studies. Otherwise, the results of smoking, alcohol, and family history are not. Therefore, old age, male sex, and GERD increase the risk of having laryngeal carcinoma.
Pemeriksaan Real Time-Polymerase Chain Reaction (RT-PCR) pada Granuloma Well Organized dan Poorly Organized Limfadenitis Tuberkulosis Dianti Lestari; Birgitta M Dewayani; Abdul Hadi Hassan; Bethy S Hernowo
Majalah Patologi Indonesia Vol 23 No 2 (2014): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Introduction Tuberculous lymphadenitis (TBL) was the most common form of extrapulmonary tuberculosis. The diagnose of TBL was based on the tubercle formation that consist of granuloma and caseous necrosis. There were 2 type of granuloma, well organized (WOG) and poorly organized granuloma (POG). Well organized granuloma were characterized by varying amount of eosinophilic necrosis surrounded by granuloma composed of mature epithelioid macrophages, mainly Langhans type giant cells and a mantle of lymphocytes and fibrous tissues. Poorly organized granuloma were characterized by central area of sparse coarse necrosis with nuclear debris and often polymorphonuclear granulocytes, the granuloma had an ill-defined mantle with mixed cells composed of macrophages, lymphocytes and plasma cells, only few giant cells were seen and there was little or no fibrosis. Inflamatory granuloma also can be found in non TBL, especially POG. The purpose of this study was to find out the etiology of WOG and POG based on the RT-PCR result. Methods This study used 30 formalin-fixed paraffin-embedded tissue blocks from patients who were histopathologically diagnosed as TBL with hematoxillin eosin (HE) staining, consist of 15 samples WOG and 15 samples POG. This study performed RT-PCR to all cases in order to find out the etiology of GWO and GPO and to know if there will be any differences in RT-PCR result between WOG and POG. Results Of the 15 WOG cases, 10 (67%) cases were RT-PCR positive and 5 (33%) cases were RT-PCR negative, whereas 15 cases POG consist of 8 (53%) cases were RT-PCR positive and 7 (47%) cases were RT-PCR negative. Both of cases WOG and POG was analyzed, according to the statistical analysis had found that there were no differences RT-PCR result between WOG and POG significantly (p>0.05). Conclusion There were no differences in RT-PCR result between histopathologic feature of WOG and POG. Key words : Poorly organized granuloma, RT-PCR, tuberculosis lymphadenitis, well organized granuloma.
Analisis Gambaran Histopatologi Gastritis Kronik dengan dan Tanpa Bakteri Helicobacter pylori Menurut Sistem Sydney Deassy Ariefiany; Abdul Hadi Hassan; Birgitta M Dewayani; Anglita Yantisetiasti
Majalah Patologi Indonesia Vol 23 No 2 (2014): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Background Histopathology definition of chronic gastritis is a chronic inflammation of the gastric mucosa that can cause glandular atrophy and intestinal metaplasia of the gastric mucosal epithelium. Chronic gastritis can be caused by many factors. The most common etiology chronic gastritis by the bacterium Helicobacter pylori (Hp). The incidence chronic gastritis causes of Hp is more common in developing country than developed country. Histopathological picture on chronic gastritis causes of Hp similar with chronic gastritis non-Hp. The aims of this study to determine the difference of histopathological picture between chronic gastritis with Hp and chronic gastritis without Hp bacteria in the Hospital Dr Hasan Sadikin Bandung. Methods The sample used in this study were 30 cases of chronic gastritis with Helicobacter pylori (Hp) and 30 cases of chronic gastritis non-Hp bacteria from the Pathology Department of the hospital Dr. Hasan Sadikin Bandung. The research start from May 1st until November 30th 2012. All sample cases histopathology is seen the image of the Sydney sistem classification, after that are staining with immunohistochemical with antibody monoclonal Hp was performed to confirm the presence of the Hp. Results Immunohistochemical staining result obtained from 42 cases of the bacteria Hp positive and 18 negative cases the bacteria Hp. Chronic inflammation in chronic gastritis with Hp with chronic gastritis without Hp bacteria are in category 3 (limfosit cell more than 20/10HPF) as much as 88,1% and 88,9%. Conclusion Histopathological picture of chronic gastritis with Hp bacteria did not differ with chronic gastritis without Hp bacteria. Key words: Chronic gastritis, Helicobacter pylori, Sydney system.