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Putu Erika Paskarani
Anatomical Pathology Division, Faculty Of Medicine Udayana University - Udayana University Hospital, Denpasar
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

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Benign Inflammatory Lesion Mimicking Malignancy “Kimura’s Disease”: A Case Report Putu Erika Paskarani; Luh Ayu Widayanti; Anak Agung Ayu Ngurah Susraini; Herman Saputra; Ni Putu Sriwidyani
Indonesian Journal of Cancer Vol 14, No 4 (2020): December
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1083.031 KB) | DOI: 10.33371/ijoc.v14i4.762

Abstract

Introduction: Kimura’s disease (KD) in Indonesia is quite rare. It is a distinct benign reactive process; however, it is usually mimicking malignancy. It usually affects young adults with a peak incidence in three decades, and men are mostly affected compared to women with a 3:1 ratio. KD is a chronic inflammatory disorder characterized by lymphoid hyperplasia, eosinophilia, and associated with soft tissue swelling that usually arises in head and neck regions with regional lymphadenopathy.Case Presentation: Herein, we report a case in a 55-year-old man from East Indonesia who presented a huge lump on his left head and neck regions. The lump started about 8 years ago. Physical examination found a tumor mass of 20 x 10 cm with indistinct border and multiple lymphadenopathies left coli with the biggest size of 1.3 x 0.7 x 0.5 cm. Peripheral blood examination shows marked eosinophilia. Nasopharyngeal CT scan revealed soft tissue masses and multiple lymphadenopathies suspected of malignancy; however, thorax plain radiology did not show any sign of metastatic process. Histopathological examination shows reactive follicular proliferation, extensive eosinophilia, focal area Folliculolysis, and polykaryocytes of the WarthinFinkeldey type.Conclusion: Based on a complete history, laboratory findings, and histopathological examination, this case is concluded as Kimura’s disease. Although clinical findings and radiological examination suspected it as malignancy, those discrepancies were confirmed as a benign lesion by specific histopathological and laboratory findings. Commonly, most patients have a favorable prognosis and good response to therapy.
Histopathological Features of the Lung Parenchyma in a 64-Year-Old Male Patient with Post-COVID-19 Infection with Spontaneous Pneumothorax Dextra Due to AlveolarPleural Fistula (APF): A Case Report Putu Erika Paskarani; Ni Wayan Winarti; Santi Maya Lestari Siahaan; Made Dalika Nareswari
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.888

Abstract

Introduction: Histopathological features of the lung parenchyma due to the Alveolar-Pleural Fistula (APF) in a patient with post-COVID-19 infection have not been reported. APF usually occurs after a spontaneous pneumothorax. Spontaneous pneumothorax is an abnormal traumatic accumulation of air within the pleural space. It is classified as primary or secondary pneumothorax based on multiple risk factors.Case Presentation: A sixty-four-year-old patient was referred from one of the remote hospitals in the west of Bali due to spontaneous simple pneumothorax dextra. A week after being diagnosed with COVID-19 infection, the patient underwent a bullectomy procedure and was clinically diagnosed with recurrent spontaneous pneumothorax dextra due to APF. Then, the bullectomy specimen was sent to the anatomical pathology laboratory. Histopathology test revealed extensive areas of necrosis and fibrosis with scattered lymphocytes and emphysematous alveoli found in APF lesions. Conclusions: In conclusion, the evidence of extended fibrosis, which destroys the pulmonary parenchymal septum and dilated alveoli with diffuse fibrosis in the subpleural and intraparenchymal areas, may cause impairment of both perfusion and ventilation. Unfortunately, viral cytopathic like-changes related to COVID-19, such as multinucleated cells with large nuclei, amphophilic cytoplasm, and prominent nucleoli in alveolar spaces with intranuclear inclusions, were not found in this case. In this case, surgery is needed in case of fistula, either related or unrelated to infection of the pleural cavity indicating the patient’s functional recovery.
Metaplastic Breast Carcinoma (MBC), Primary Squamous Cell Carcinoma Subtype in A 49-Year-Old Woman: A Case Report Putu Erika Paskarani; Ni Gusti Ayu Agung Manik Yuniawaty Wetan; Ni Putu Sriwidyani; Sang Ayu Putu Yuliantini
Indonesian Journal of Cancer Vol 16, No 4 (2022): December
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i4.932

Abstract

Introduction: Metaplastic Breast Carcinoma (MBC) is quite a challenging case because metaplastic breast cancer is one of the rarest subtypes of invasive breast cancer. It is reported that MBC occurs only 0.2 to 1% throughout the world. The metaplastic changes can be squamous cells or other mesenchymal cell types. Clinically, MBC presents as a large palpable mass and may be associated with rapid growth. The size of MBC tends to be larger compared with other types of invasive breast cancer ranging from 1 to more than 10 cm. Although there are several main categories of MBC, some carcinoma can be difficult to classify due to their unusual histologic patterns. This case report study is to provide a clinicopathological overview and approach to MBC.Case Presentation: We reported a 49-year-old woman who suffered from a breast mass that rapidly grew for less than one year. The microscopic findings showed squamous cell carcinoma. While molecular studies revealed triple negative results for hormone receptors although Human Epidermal Growth Factor Receptor 2 (HER2) overexpression was unusual (< 5%). Then, we confirmed with chromogen in situ hybridization (CISH) and there was no gen amplification for HER2. Microscopically, we found ductal carcinoma in situ and this finding supported breast origin.Conclusions: Metaplastic carcinoma did not have any specific and distinctive signs clinically. Metaplastic carcinoma can be monophasic (with only a metaplastic component) or biphasic with two or more components. As treatment options, our patient received conventional chemotherapy. Metaplastic breast cancer is reported to have a lower response rate to conventional adjuvant chemotherapy and worse clinical outcome after chemotherapy than other forms of triple-negative breast cancer.
Incidental Findings of Duodenal-Type Follicular Lymphoma by Endoscopic Screening: A Case Report Herman Saputra; Ni Putu Sriwidyani; Putu Erika Paskarani; Silvia Khosasi
Indonesian Journal of Cancer Vol 17, No 2 (2023): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i2.965

Abstract

Introduction: Follicular Lymphoma (FL) is a B-cell neoplasm arising from the germinal center. Gastrointestinal FL is a rare case, accounting for less than 4% of all primary lymphoma of the gastrointestinal tract. Duodenal-type Follicular Lymphoma (DTFL) was included in an entity of primary intestinal FL. However, in the 2017 World Health Organization (WHO) Classification, this entity was included in a specific variant called DTFL. In this article, we report a case of DTFL in a 56-year-old man which was incidentally found during upper gastrointestinal endoscopy Case Presentation: : We report a case of incidentally found DTFL in a 56-year-old man during an endoscopy. The endoscopic finding showed a small, hypertrophic, or nodular lesion on part two duodenum. Microscopic evaluation of duodenal mucosa consists of proliferative atypical lymphoid cells arranged in follicular architecture. The lesion was confined to the lamina propria. The atypical lymphoid cells were dominated by monotonous centrocyte-like cells, small-sized, with scant cytoplasm, and cleaved nuclei. There were some scattered larger centroblast-like cells with multiple nucleoli. No mantle zone and tingible body macrophage were found. The immunohistochemical evaluation showed positivity for CD 20, CD 10, Bcl-6, and Bcl-2 in the follicular structure. CD 21 was dominantly stained at the periphery of the follicular structure, and Ki-67 was low. Conclusions: According to clinical data, endoscopic findings, and histopathological and immunohistochemical findings, the patient was diagnosed with DTFL. 
Co-Authors Anak Agung Ayu Ngurah Susraini Herman Saputra Herman Saputra Luh Ayu Widayanti Made Dalika Nareswari Ni Gusti Ayu Agung Manik Yuniawaty Wetan Ni Putu Sriwidyani Ni Putu Sriwidyani Ni Wayan Winarti Sang Ayu Putu Yuliantini Santi Maya Lestari Siahaan Silvia Khosasi