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All Journal Majalah Patologi Indonesia Malang Respiratory Journal
Hendy Setyo Yudhanto
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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Ekspresi Bcl-2 pada Karsinoma Urotelial Kandung Kemih dan Hubungannya dengan Berbagai Faktor Prognosis Hendy Setyo Yudhanto; Budiana Tanurahardja; Puspita Eka Wuyung
Majalah Patologi Indonesia Vol 28 No 3 (2019): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (511.187 KB)

Abstract

ABSTRAKLatar belakangKarsinoma urotelial kandung kemih merupakan kasus terbanyak di organ kandung kemih mencapai 90% kasus.Stadium dibedakan menjadi 2 kelompok yaitu non invasif jika belum menembus lapisan muskularis dan invasifjika sudah menembus lapisan muskularis. Kesintasan 5 tahun tergantung dari derajat keganasan dan stadium.Derajat keganasan rendah dan belum invasi muskuler dapat mencapai 90%, tetapi angka rekurensi berkisar40-60%. Derajat keganasan tinggi dan sudah invasi hanya berkisar 10-17%. Mitosis dan invasi limfovaskulerberhubungan dengan angka rekurensi tinggi. Namun masih terdapat kontroversial terhadap ekspresi Bcl-2 padakarsinoma urotelial kandung kemih. Penelitian ini bertujuan untuk menilai perbedaan ekspresi Bcl-2 dengan 4faktor yang berhubungan dengan prognosis yaitu derajat keganasan, stadium, mitosis, dan invasi limfovaskuler.MetodeDilakukan penelitian deskriptif analitik secara potong lintang pada karsinoma urotelial kandung kemih tahun2010-2014 di Departemen Patologi Anatomik FKUI/RSCM. Didapatkan 21 kasus derajat keganasan rendah dan21 kasus derajat keganasan tinggi. Dilakukan pulasan Bcl-2 pada seluruh kasus dan dihitung persentasenyadan dilakukan skoring 0-3.HasilUsia terbanyak pada dekade 5 sebanyak 27 kasus. Didapatkan 4 kasus ditemukan invasi limfovaskuler.Penelitian ini mendapatkanhubungan antara mitosis dengan derajat keganasan (p:0,00) dengan koefisienkorelasi 0,512 Penelitian ini mendapatkan hampir seluruh kasus mengekspresikan Bcl-2 (39 dari 42 kasus), 1kasus tidak mengekspresikan dan 2 kasus mengekpresikan sedikit. Tidak didapatkan perbedaan antaraekspresi Bcl-2 dengan derajat keganasan (p:0,232), stadium (p:0,455), mitosis (p:0,835), dan invasilimfovaskuler (p:0,087).
Primary Pulmonary Leiomyosarcoma : an Extremely Rare, Difficult-to-Manage Case of Lung Cancer Adlan Pratama Binharyanto Binharyanto; Ngakan Putu Parsama Putra; Ungky Agus Setyawan; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 5 No. 2 (2023): September Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.02.05

Abstract

Background: Primary Pulmonary Leiomyosarcoma (PPL) known as <0.5% of total lung cancer. Histopathological examinations are the pillars of PPL diagnosis as clinical manifestations and radiological features are usually not specific. Treatments of PPL include surgical resection, radiotherapy, and chemotherapy. Case Illustration: A 51-year-old male, smoker, with a productive cough for 2 weeks, accompanied by chest pain, weight loss, and loss of appetite. Imaging studies showed a solid mass in the right lung, which was confirmed through bronchoscopy, cytology, histology, and immunohistochemistry evaluations. Bronchoscopy showed an intraluminal mass in the right main bronchus suggesting malignancy. Immunohistochemistry of Desmin and Smooth Muscle Actin, which were positive, confirmed the diagnosis of PPL of the right lung stage T4N1M1a IVA. Discussion: Surgical resection is the gold standard treatment for PPL whose clinical conditions and tumor spread still allowed for safe operation. Surgical resection did not undergo because already in stage IVA. Radiotherapy and chemotherapy can be added for patients who are unable to have surgery. There are no guidelines regarding chemotherapeutic regimens that are recommended for PPL. Cisplatin/carboplatin and etoposide are two chemotherapeutic agents that are commonly used in other variants of lung cancer. Cisplatin is successful in 5-23% of patients and etoposide is successful in 8%. Doxorubicin and ifosfamide are usually used for soft tissue sarcoma too. After administration of 4 cycles of carboplatin/etoposide, a chest CT scan with contrast recist shows the progression of PPL. Conclusion: Carboplatin and etoposide have been long used as therapy for lung cancer. Currently, available literature shows that their effectiveness in PPL is still considered low. Nevertheless, more studies are needed to further explore the possibilities of using carboplatin and etoposide in PPL patients. Keywords: chemotherapy, lung cancer, primary pulmonary leiomyosarcoma
Co-Authors Adlan Pratama Binharyanto Binharyanto Budiana Tanurahardja Dini Rachma Erawati Ngakan Putu Parsama Putra Puspita Eka Wuyung Setyawan, Ungky Agus