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All Journal Jurnal Kedokteran Brawijaya CRJIM (Clinical and Research Journal in Internal Medicine)
Shinta Oktya Wardhani, Shinta Oktya
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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A 44 Year Old Man with Chronic Myeloid Leukemia and Mass at Right Lower Leg Islamiah, Ahadini; Wardhani, Shinta Oktya
Jurnal Kedokteran Brawijaya Vol 29, No. 4 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.04.17

Abstract

Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of primitive hematopoetic stem cells that is characterized by overproduction of myeloid series cells, splenomegaly, and leukocytosis. We reported a case of 44 years old male with CML who complained about swelling right leg and pain for 3 month. It had been diagnosed as CML for 3 years, and he took hydroxyurea but stopped for a year due to economic problem. The results of clinical examination, laboratory, biopsy, and radiology showed a result matched to CML with soft tissue mass. The results of Fine Needle Aspiration Biopsy (FNAB) of fragmented histiocytes leg mass, multinucleated giant cells, and atypical nucleated with a possibility of fibroma with atypical nucleated cells. Magnetic resonance imaging (MRI) showed multilocular lobulated soft tissue mass from the popliteal region to the cruris dextra, cyst mass high protein dd/solid tumor with vascular encasement and lesions in bone marrow replacement, and fluid collection on bursa parapatella. The patient was treated with hydroxyurea and showed clinical improvement and decreased mass size in the legs.
Nasopharyngeal Non Hodgkin Lymphoma Wardhani, Shinta Oktya; Kartikasari, Nanik Triana
Jurnal Kedokteran Brawijaya Vol 29, No. 3 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.03.15

Abstract

Non Hodgkin lymphomas (NHL) are tumors originating from lymphoid tissue, mainly from lymph nodes. These tumors may result from chromosomal translocation, infections, environmental factors, immunodeficiency states, and chronic inflammation. In general, the incidence of NHL is slightly higher in men than in women. The incidence of NHL nasopharynx is rare. A high degree of suspicion is required to avoid unnecessary radiologic and surgical procedures since NHL can be mistakenly diagnosed as carcinoma. We reported a 16 year old male patient with gradual epistaxis, hearing impairment, decreased body weight, and multiple nodules in right forehead, right axilla, right colli posterior, and left waist. The patient also suffered from inferior paraplegic extremities. The Head CT scan result showed carcinoma nasopharynx. After biopsy of nodules was done, it revealed differential diagnoses such as blastoma, Non Hodgkin lymphoma, and small cell carcinoma. Immunohistochemistry result showed Leucocyte Common Antigen (LCA) positive, and MRI thorax showed suspect of schwannoma. Based on the data, chemotherapy with regiment CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin/vincristine, and prednisone) was given. The prognosis of NHL Nasopharynx was better than nasopharyngeal squamous cell carcinoma. The prognostic of NHL depends on the age, performance status, staging, extranodal involvement, serum Lactate Dehydrogenase (LDH) and response of therapy. The prognosis in our patient was poor.Keywords: Mass, Non Hodgkin Lymphoma, nasopharyngeal carcinoma, prognostic
Perempuan 17 tahun dan Laki-laki 15 tahun dengan Interdigitating Dendritic Cell Sarcoma (IDCS) Saraswati, Diyah; Wardhani, Shinta Oktya
Jurnal Kedokteran Brawijaya Vol 29, No. 4 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.04.18

Abstract

Neoplasma yang berasal dari sel dendritik dan histiosit merupakan keganasan yang jarang terjadi, <1% dari semua neoplasma. Interdigitating dendritic cell sarcoma (IDCS) merupakan keganasan yang jarang terjadi yang berasal dari antigen-presenting cells sistem imun.  Keganasan ini seringkali melibatkan limfonodi, dan meskipun jarang dapat terjadi ekstranodal. Telah dilaporkan dua kasus dengan IDCS pada tulang. Kasus pertama, wanita 17 tahun dengan fraktur tulang paha kanan. Pemeriksaan radiologis menunjukkan fraktur 1/3 proksimal diafise dan lesi litik yang dicurigai fraktur patologis. Kasus kedua, laki-laki 15 tahun dengan massa pada region temporoparietal kanan. Pemeriksaan radiologis menunjukkan proses dengan lesi osteolitik pada calvaria yang dicurigai proses metastase. Analisa imunohistokimia pada kedua kasus tersebut menunjukkan antibodi anti S100 yang positif dan antibodi CD1a yang negatif. Pasien pertama telah mendapat kemoterapi dengan regimen CHOP (Siklofosfamid-Doksorubisin-Vinkristin-Prednison) sebanyak 6 siklus dan mengalami perbaikan secara klinis sedangkan kasus kedua kami kehilangan kontak. 
Effect of Chemotherapy and Hormonal Therapy on Bone Mineral Density in Patients with Breast Cancer in Saiful Anwar Hospital Malang Nurshanty, Ade; Wardhani, Shinta Oktya; Suryana, Bagus Putu Putra
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.4

Abstract

Osteoporosis is an important health problem, and the number of patients who suffered from it is increasing. Breast cancer is a condition that has a  high risk of osteoporosis. Cancer induced bone disease results from the primary disease, metastatic process, or from therapies against the prime condition, causing bone fragility. Therefore, there are still different opinions regarding the therapeutic effect of breast cancer on bone mineral density. Aim: to determine the effect of chemotherapy and hormonal therapy on bone mineral density in patients with breast cancer in Saiful Anwar Hospital Malang. Method: this is a case-control study conducted in 30 patients with breast cancer who had undergone chemotherapy and hormonal therapy are compared to 30 patients without breast cancer as controls.  Bone Mineral Density (BMD) was measured by DEXA. Result: there are 53% of breast carcinoma patients having osteopenia and 13% having osteoporosis, with one patient has osteoporosis located in the femoral neck and three patients in lumbar (L1-L4). We obtain a significant T-score (p=0.02) in the great trochanter. Odds Ratio (OR) 0.233 with p = 0.008 showed a protective effect of chemotherapy and hormonal therapy for breast cancer to the bone density. Conclusion: the incidence of osteoporosis in the study was 13%, with the most location in the lumbar spine. Chemotherapy and hormonal therapy had a protective effect on BMD in patients with breast cancer in Saiful Anwar Hospital Malang.
Co-Authors Herman Bagus Trianto, Herman Bagus Islamiah, Ahadini Kartikasari, Nanik Triana Muhammad Anshory, Muhammad Nurshanty, Ade Saraswati, Diyah Suryana, Bagus Putu Putra