Diah Rini Handjari
Department of Anatomical Pathology, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia

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Ekspresi HER-2 pada Adenokarsinoma Gaster dan Hubungannya dengan Tipe Histopatologik dan Derajat Diferensiasi Diah Setiawati; Diah Rini Handjari; Primariadewi Rustamadji
Majalah Patologi Indonesia Vol 23 No 1 (2014): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Background Gastric carcinoma is the most common malignant tumor in upper gastrointestinal. According to epidemiologic data, gastric adenocarcinoma intestinal type and diffuse type showed different carcinogenesis. Recently, targeting therapy for adenocarcinoma has established. The aim of the study to know the relationship between HER-2 expression and histopathologic type according to Lauren’s classification and grading of gastric adenocarcinoma. Methods This study has done in Department of Anatomical Pathology Faculty of Medicine University of Indonesia/Cipto Mangunkusumo National Hospital, Jakarta. HER-2 expression is analyzed to see the relationship with histopathologic type and differentiation of gastric adenocarcinoma. The specimens were from resection and biopsy (2007-2011). Histopathologic type evaluated with Hematoxylin Meyer’s staining. HER-2 expression evaluated with immunostaining with HER-2 antibody. Results We found 55 cases from 2007 until 2011 (76.4% men and 23.6% women). The mean age is 50.55 years (the range of age 29-73 years). HER-2 expression 3+,2+ and 1+ are 14.5%, 34.5%, and 25.5% sampling. 25% sample did not show HER-2 expression. We found overexpression HER-2 (3+) in 8 cases (14.5%) of adenocarcinoma gastric intestinal type. Conclusion There is a significant relation between HER-2 expression with histopathologic type (p=0.021). There is no significant relation between HER-2 with grading (p=0.253). Key words: grading, gastric adenocarcinoma, HER-2.
Perbandingan antara Klasifikasi Jepang dan Sistem TNM dalam Menentukan Stadium Keganasan Sigmoid dan Rektum di RSCM-RSF (Laporan Pendahuluan) Yusak Kristianto; Agi satria Putranto; Rofi Y Saunar; diah Rini Handjari; Grace Wangge
Majalah Patologi Indonesia Vol 27 No 2 (2018): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Latar belakangMetastasis kelejar getah bening (KGB) pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan. Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar. Klasifikasi Jepang (KJ) menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB (parakolika/pararektal, intermediate, dan pangkal arteri mesenterika) tanpa melihat jumlah KGB nya.MetodeStudi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September-Oktober 2015. Dilakukan penilaian histopatologi terhadap spesimen tumor, aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB. Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian.HasilDidapatkan ≥12 KGB dari semua sampel. Menurut sistem TNM terdapat 7 pasien stadium II, 3 pasien stadium III-b dan 5 pasien stadium IIIc, sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II, 1 pasien stadium IIIa dan 7 pasien stadium III-b. Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46,67%. Penentuan stadium III-a (KJ) dan stadium IIIa-b (TNM) dengan kecocokan sebesar 6,7% . Kecocokan sebesar 13,3% dalam menentukan stadium III-b (KJ) dan stadium III-c (TNM). Analisis kesesuaian terhadap kedua sistem klasifikasi, didapatkan nilai Kappa sebesar 49,3% (kategori sedang) dengan P value: 0,04.KesimpulanPada studi pendahuluan ini didapatkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang. Klasifikasi Jepang dapat dijadikan salah satu pertimbangan. Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian.
Hubungan antara Profil Histomorfologik dengan Gambaran Endoskopi Esofagitis Refluks pada Dewasa Intan Nevita Oktamia Bernanthos; Diah Rini Handjari
Majalah Patologi Indonesia Vol 30 No 3 (2021): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (310.182 KB) | DOI: 10.55816/mpi.v30i3.482

Abstract

BackgroundEarly diagnosis of GERD is very important because chronic reflux esophagitis is a major risk factor for Barrett esophagus, which is aprecursor lesion for esophageal adenocarcinoma. The aim of this study is to determine the frequency, demographic characteristics,histomorphological profile based on Esohisto criteria and endoscopic features of reflux esophagitis in FKUI/RSCM in 2016-2018.MethodsA cross-sectional study was conducted in Anatomical Pathology Department, Cipto Mangunkusumo General Hospital from January2016 to December 2018. Assessment criteria include demographic characteristics, histomorphological profiles, and endoscopicfeatures. Histomorphological assessment of reflux esophagitis in this study used the Esohisto criteria, by assessing basal cellhyperplasia, elevated papillae, dilated intercellular spaces and intraepithelial eosinophils. Assessment of the lesion severity isclassified as normal mucosa, mild lesion and severe lesion.ResultsThere were 65 cases of reflux esophagitis in adults over a period of 3 years in the Department of Anatomical PathologyFKUI/RSCM. Reviewing demographic data in January 2016-December 2018. The assessment criteria included demographiccharacteristics, histomorphological profiles, and endoscopic features. Histomorphological assessment of reflux esophagitis in thisstudy used the Esohisto criteria, by assessing basal cell hyperplasia, elevated papillae, dilated intercellular spaces in 65 casesfound 33 cases (50.8%) in men and 32 cases (49.2%) in women, with an average sample age of 56 years. The location of the mostlesions was distal esophagus in 30 cases (46.2%). Clinical manifestations in 13 cases (20%) were esophagitis. The most commonclinical symptoms were dysphagia in 21 cases (32.3%). Most endoscopic features were laryngopharyngeal reflux in 12 cases(18.5%), followed by grade C esophagitis in 9 cases (13.8%). The lesion severity of reflux esophagitis lesions based on Esohistocriteria found 37 cases (56.9%) mild lesion followed by severe lesion as many as 28 cases (43.1%)ConclusionThe Esohisto criteria can be used to help diagnose the lesion severity of reflux esophagitis with endoscopic pictures
Perbedaan Profil Histomorfologik Jaringan Hati Resipien dan Donor Pascatransplantasi Hati Anak antara Kelompok Pasien Rejeksi dan Tidak Rejeksi di Departemen Patologi Anatomik FKUI/RSCM Periode 2010-2019 Alif Gilang Perkasa; Marini Stephanie; Nur Rahadiani; Diah Rini Handjari; Ening Krisnuhoni; Hanifah Oswari
Majalah Patologi Indonesia Vol 31 No 1 (2022): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (435.793 KB) | DOI: 10.55816/mpi.v31i1.487

Abstract

BackgroundLiver rejection is an immune system response of recipient in which attacking the antigen originating from a donor that can causedamage to the transplanted organ. Although the prevalence of liver rejection has decreased due to the use of immunosuppressivedrugs, it is estimated that 20-40% of recipients still experience rejection and are at risk of re-transplantation and even death. Thisstudy aims to investigating histomorphological characteristics that can play a role as risk factors for rejection by assessing thedifferences in histomorphological characteristics before transplantation between recipient groups with rejection and non-rejection inpediatric liver transplant recipients in the Department of Anatomical Pathology, Faculty of Medicine, University of Indonesia, Dr.Cipto Mangunkusumo (PA-FKUI/RSCM)MethodsThis study was an analytical study with a cross sectional design, using secondary data from the archives of the Department ofAnatomical Pathology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo 2010-2019. The clinical andhistopathologic data obtained were analyzed using comparative statistical tests.ResultsRejection were found in 25% of recipients. Rejection were more common in the group of recipients aged >1 (75%), male (58%),cirrhosis 4C (92%) and mild portal inflammation (56%). Rejection were more common in the group of donor with male (66%) andsteatosis ≤10% (92%). There were no significant differences in the histomorphological profiles of recipients and donors with orwithout rejection.ConclusionThe histomorphologic profiles of both recipients and donors were known to be descriptively associated with complications of posttransplant liver rejection. However, in terms of analysis, there was not any significant differences
Diagnostic Findings of Sclerosing Mesenteritis and the Disease Correlations with Caecal Adenocarcinoma Rabbinu Rangga Pribadi; Murdani Abdullah; Rizka Puteri Iskandar; Velma Herwanto; Okto Dewantoro; I Wayan Murna Yonathan; Arman Adel Abdullah; Ening Krisnuhoni; Diah Rini Handjari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, AUGUST 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1245.218 KB) | DOI: 10.24871/1822017122-125

Abstract

Sclerosing mesenteritis (SM) is a rare disease with non-specific clinical manifestations and should be supported by radiological examination and confirmed by histopathological evaluation. Its relationship with cancer especially caecal adenocarcinoma is still unclear. This case report describes a young man who was diagnosed as having SM and poorly-differentiated caecal adenocarcinoma.
Ileal Endometriosis Tjahjadi Robert Tedjasaputra; Marcellus Simadibrata; Diah Rini Handjari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/102200982-84

Abstract

Endometriosis at the ileum site is a rare case and among the difficult cases of endometriosis. Intestinal endometriosis may cause obstructing symptoms, which is difficult to be distinguished from malignant or inflammatory disease. We report a case of 33-year-old woman, who admitted to the hospital because of sub-ileus intestinal obstruction. She underwent one session laparoscopy and laparatomy operation. Her ileum showed obstruction because of stenosis and adhesion with an ovarian brown cyst. She experienced terminal ileal resection, ileocaecostomy anastomosis, followed by laparatomy ovarial cystectomy and appendectomy. Microscopic evaluation of the intestine revealed vascular congestion, lymph nodes inflammation, and typical endometrial glands in the muscle layer of ileum. There was no sign of malignancy. These findings led to the diagnosis of ileal endometriosis. The ovarian cyst was actually the endometrial cyst of the ovary.   Keywords: sub-ileus obstructive, ileal endometriosis, endometrial cyst
The Cyclooxygenase-2 and Nuclear Factor-kappa B Expressions in Colorectal Polyps Ahmar Abyadh; Diah Rini Handjari; Murdani Abdullah; Pamela Abineno Damaledo; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201055-60

Abstract

Background: Cyclooxygenase-2 (COX-2) is the rate-limiting enzyme in prostaglandin synthesis, while nuclear factor kappa B (NF-kB) is a family of transcription factors. Both play an important role in tumorigenesis. In the present study, we examined NF-kB and COX-2 expressions pattern, and their association in neoplastic and non-neoplastic colorectal polyps (CP). Method: Formalin-fixed and paraffin embedded tissue blocks from 77 patients with CP were immunostained with anti-NF-kB (p 65) and anti-COX-2. Expressions of NF-kB, and COX-2 were detected immunohistochemically. The relationship between these expressions and the two types of CP, and other clinicopathological findings were evaluated Results: The expressions of NF-kB and COX-2 in patients with neoplastic and non-neoplastic CP were high. The results of this study indicated that generally in CP, NF-kB was associated with COX-2 and the association was also seen in neoplastic and non-neoplastic polyps. There was no significant difference of NF-kB and COX-2 expressions in terms of patient’s age, sex, histologic type, and location of the CP. Neoplastic CPs were more common in the distal colon, female patients and older patients ( 60 years) compared with non-neoplastic CPs. Neoplastic CP were located more at the distal colon, more in female, and more in older ( 60 years) patients as compared with the non-neoplastic CP. Further studies are needed to elaborate the role of inflammation in sporadic colorectal carcinogenesis. Conclusion: The expressions of NF-kB and COX-2 in patients with CP were high, and strong correlated each other. There were no significant differences between expression of NF-kB and COX-2 in neoplastic and non-neoplastic polyps. Keywords: colorectal polyps (CP), NF- B, COX-2, inflammation
Hepatocellular Carcinoma in an Infant due to HBV Vertical Transmission Nunung Ainur Rahmah; Wirasmi Marwoto; Vera Yuwono; Ening Krisnuhoni; Diah Rini Handjari; Darmawan Kartono; David Handojo Muljono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/101200929-32

Abstract

Hepatocellular carcinoma (HCC) is one of the common tumors in the world. The incidence of HCC generally increases with age in all population but there is a tendency of decreasing incidence in the elderly and it is very rare in children. This is a case report of HCC in a 9-month-old boy, who was admitted to the hospital with palpable abdominal mass in the right upper quadrant. Imaging modality by ultrasonography could not adequately demonstrate definite findings demonstrating that the tumor was derived from liver, and the diagnosis was neuroblastoma. Intra-operatively, the tumor mass appeared to be derived from the surface of the posterior edge of the liver, so it was a pedunculated tumor. The histopathological examination revealed a pedunculatedhepatocellular carcinoma grade 3. The Victorian blue staining and immunohistochemical staining were done afterward, which showed HBsAg positive result as found in non-tumor lesion as well as inneoplastic lesion of liver tissue.Keywords: hepatocellular carcinoma, pedunculated HCC, infant HCC, occult hepatitis B virus infection
Alteration of Subcellular Beta Catenin Expression in Normal Mucosa Adenoma and Carcinoma in Relation to Colorectal Carcinogenesis Pamela Damaledo Abineno; Diah Rini Handjari; Budiningsih Siregar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201083-87

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Background: Adenomatous polyposis coli (APC) gene mutation was found in up to 80% of cases of sporadic colorectal cancers and adenomas. Loss of APC protein function has been known as one of the early process in colorectal carcinogenesis. This event leads to the accumulation of beta catenin in the cytoplasm and nucleus and subsequently activates target genes that regulate cell proliferation and apoptosis. The aim of this study was to investigate the alteration of subcellular beta catenin expression in the progression of colorectal cancer. Method: This cross-sectional study was conducted with 30 paraffin-embedded tissue sections each of normal colorectal mucosa, adenomas and carcinomas. Alteration of beta catenin expression in membranous, cytoplasmic, and nuclear compartments were evaluated by immunohistochemical staining. Results: Beta catenin immunoreactivity was detected in all cases, of which 87 (96.7%) cases showed membranous expression, 78 (86.7%) cases had cytoplasmic and 51 cases (56.7%) had nuclear expression. Such results were statistically significant (p 0.000). All normal colorectal epithelium showed membranous beta catenin expression with 18 (60.0%) cases showed cytoplasmic and no nuclear beta catenin expression was found. Strong cytoplasmic expression was found in 17 (56.7%) adenomas and 25 (83.3%) carcinomas; while strong nuclear expression was found in 12 (40.0%) adenomas and 17 (56.7%) carcinomas. There was no statistical significant association between beta catenin expression in the membranous, cytoplasmic and nuclear compartment with the degree of dysplasia or differentiation of tumor (p 0.05). Conclusion: Altered subcellular expression of beta catenin occurs as the oncogenic process develops from adenoma into carcinoma. Such finding reflects the importance of beta-catenin in colorectal carcinogenesis. Keywords: beta catenin, colorectal cancer, adenoma, colorectal cancer progression
Prevalence of Crohnƒs Disease in Endoscopic Unit Cipto Mangunkusumo Hospital Nata Pratama; Murdani Abdullah; Dolly Dolven Kansera; Jane Estherina; Rizki Yaruntradhani; Fransiska Hardi; Raden Nur Ista; Marcellus Simadibrata; Achmad Fauzi; Daldiyono Daldiyono; Abdul Aziz Rani; Diah Rini Handjari; Pamela Abineno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.343 KB) | DOI: 10.24871/122201185-88

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Background: The cumulative number of inflammatory bowel disease patients in Asia has raised three times since early 1990s, although Crohn’s disease is still less common than ulcerative colitis. The objective of this study was to provide clinical and demographic data of Crohn’s disease patients seen in Endoscopic Unit Cipto Mangunkusumo Hospital and compare the Results with other Asian countries. Method: This study was done retrospectively cross-sectional descriptive from medical records of all patients underwent colonoscopy at Endoscopic Unit, Cipto Mangunkusumo Hospital, and histological evaluation in the Department of Anatomical Pathology, Faculty of Medicine, University of Indonesia, between 2007 and 2008. Data was analyzed using SPSS version 17. Results: Of 921 patients who underwent colonoscopy, 19 (2.1%) patients were diagnosed with Crohn’s disease. There was no sex preponderance. The mean age was 47.7 years with a peak age at presentation between 51 and 60 years. The main clinical complaints were diarrhea (42.1%), lower gastrointestinal bleeding (36.8%), abdominal pain (10.5%) and upper gastrointestinal bleeding (5.3%). Colonoscopic findings were hyperemia in 94.7%, edema in 57.9%, erosions in 63.2%, ulcerations in 89.5%, pseudopolyp in 31.6%, fragile lesion in 10.5%, stenosis, fistulation, and cobblestone appearance in 5.3%. Involvement of isolated left colon was 26.3%; other manifestations were isolated right colon (10.5%), pancolitis (57.9%), ileitis (5.3%), ileocolitis (36.8%) and skip lesion (5.3%). Conclusion: The prevalence of Crohn’s disease in this study was similar to the findings in previous studies in Asian countries, with diarrhea as the main clinical complaint, and pancolitis as the dominant finding in colonoscopy examination. Keywords: Crohn’s disease, prevalence, clinical complaints, colonoscopy description