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LIMFOMA MALIGNA PADA MATA YANG DIRAWAT DI RUMAH SAKIT Dr. M. DJAMIL PADANG TAHUN 2003-2010 Linda Wira Putri; Ardizal Rahman
Majalah Kedokteran Andalas Vol 35, No 1 (2011): Published in April 2011
Publisher : Faculty of Medicine, Universitas Andalas

AbstrakMelaporkan kasus Limpoma pada Mata yang dirawat di RS. Dr. M. Djamil Padang.Studi retrospektif dari 17 rekam medik yang didiagnosa sebagai limfoma pada mata di Bagian Mata RSUP dr. M. Djamil antara 2003 – 2010.Terdapat 17 kasus limfoma pada mata di RSUP Dr. M. Djamil antara 2003 – 2010. Pasien laki-laki sebanyak 15 orang dan pasien perempuan 2 orang, dengan usia antara 4 bulan – 71 tahun. Keluhan utama paling sering (82,35%) adalah proptosis pada mata. Semua pasien diperiksa dengan CT scan dan pemeriksaan histopatologis. Tipe limfositik yang paling banyak ditemukan secara histopatologis (64,70%). Semua pasien dianjurkan untuk kemoterapi, tetapi hanya 10 pasien yang menjalani kemoterapi.Proptosis pada mata merupakan tanda yang paling sering dari limfoma maligna pada pasien yang berobat di RSUP Dr. M. Djamil. Tipe limfositik adalah tipe yang paling sering. Tidak semua pasien menjalani kemoterapi karena adanya masalah ekonomi.Kata kunci: Limfoma maligna, limfoma pada mata, proptosisAbstractReporting cases of hospitalized ocular lymphoma at Dr. M. Djamil Hospital from 2003 – 2010.Retrospective study of the medical records of 17 Ocular Lympomas diagnosed patients at the Ophthalmology Department of Dr. M. Djamil Hospital, between 2003 – 2010.There were 17 cases of Ocular Lymphoma at Dr. M. Djamil Hospital between 2003 – 2010. They are 15 male and 2 female patients, in range of age between 4 months to 71 years old. Most of them (82.35%) have chief complaint proptosed of the eye since months to years. All patients were examined using CT imaging and histopatologically. Lymphosityc type was the most type of hystopathological characterictic (64.70%) All patient were suggested to chemotherapy, but only 10 patients received chemotherapy.LAPORAN KASUS51Proptosed of the eye was the most commont sign of malignant lymphoma patient visited at Dr. M. Djamil Hospital. Lymphosityc type was the most common type. Not all patients could receive chemotherapy for they have economic problems.Key word : Malignant lymphoma,ocular lymphoma, proptosis

DILEMA DALAM MANAJEMEN RETINOBLASTOMA Ardizal Rahman
Majalah Kedokteran Andalas Vol 37, No 2 (2014): Published in September 2014
Publisher : Faculty of Medicine, Universitas Andalas

Abstrak:Retinoblastoma merupakan keganasan intraokular tersering pada anak-anak. Deteksi dini memegang peranan penting dalam manajemen retinoblastoma karena sangat mempengaruhi prognosa. Namun, hal ini sulit dilakukan di negara berkembang dengan tingkat sosioekonomi penduduk yang rendah. Penelitian ini bertujuan untuk menggambarkan profil retinoblastoma di RS Dr. M. Djamil Padang tahun 2003-2012, dan menunjukkan hubungan antara faktor sosioekonomi dengan manajemen retinoblastoma. Data diperoleh dari rekam medis pasien. Terdapat 99 pasien retinoblastoma dalam periode tersebut, 56 orang (56,56%) laki-laki dan 43 orang (43,44%) perempuan.Rentang umur terbanyak yaitu 3-4 tahun (40,40%). Retinoblastoma unilateral terdapat pada 76 pasien (76,76 %). Protusio merupakan keluhan tersering sebanyak 65,66% (65 orang). Kombinasi eksenterasi dan kemoterapi merupakan tindakan yang umum dilakukan (32,32%). Alasan terbanyak datang terlambat untuk berobat disebabkan oleh karena tidak punya biaya (42,42%) dan tidak mengerti mengenai bahaya penyakitnya (35,35%). Kedua faktor tersebut menjadi dilemma, oleh karena di satu sisi kita berusaha mendeteksi dini penyakit retinoblastoma ini, sementara dari segi finansial dan faktor sosioekonomi keluarga penderita tidak mendukung.Abstract:Retinoblastoma is the most common intraocular malignancy in children. Early detection plays an important role in management of retinoblastoma because it significantly affects the prognosis. Unfortunately, early detection is difficult in developing country due tolow socioeconomic level. This study aims to describe the profile of retinoblastoma in Dr. M. Djamil Hospital Padang from 2003 to2012, and to show the relationship between socioeconomic factors and management of retinoblastoma. Data was obtained from patients’ medical records.There were 99 retinoblastoma patients in this period, 56 (56.56%) male and 43 (43.44%) female. The majority of patients aged 3-4 years (40.40%). Unilateral retinoblastoma presented in 76 patients (76.76%). Protusio is the most common ocular presentation(65.66 %). Combination of exenteration and chemotherapy was the most commonmanagement (32.32%). The most common reason causing delay to seek treatment wasfinancial problems (42.42%) followed by lack of informationabout the complication of disease (35.35%). These two factors were dilemma,because on one hand we were trying to find cases earlier, but patients’ financial and socioeconomic factors were not supporting.

DIAGNOSIS DAN PENATALAKSANAAru LIMFOMA ORtsITA Ardizal Rahman
Majalah Kedokteran Andalas Vol 37 (2014): Supplement 2 | Published in December 2014
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (7450.651 KB)

Limfoma orbita merujuk pada limfoma yang terjadi di konjungtiva, kelenjar lakrimal, palpebradan otot-otot ekstraokular. Limfoma primer non-Hodgkin (NHL) dari orbita dapat ditemukanpada hanya 1o/o dari semua limforna non-Hodgkin. Anaiisis mutasi somatik pada regiovariabel (V) dari immunoglobulin (ig) dan segmen gen rantai berat (H) telah menunjukkanperan dari stimulasi antigen kronik pada patogenesis limfoma /nucosa-associated lymphoidflssue (MALT). Patogen mikroba seperti Helicobacter pylaridan Chlamydia pneumonia dapaimendasari proses inflamasi dan pada akhirnya memicu akuisisi MALT juga memainkanperan penting dalam tranformasi maligna dan ekspansi klonal lanjutan limfoma. Penentuanstadium kanker sangat penting karena akan menentukan terapi apa yang akan diberikan dankemungkinan remisi dan prognosisnya. Berdasarkan sistem stadium Ann-Arbor, limfoma yangterbatas di orbita disebut sebagai stadium l, keterlibatan struktur sekitar (sinus paranasal,tonsil, dan hidung) menjadikannya stadium ll. Stadium lll adalah penyakit nodal abdominaldibawah diafragma dan stadium lV merujuk pada keterlibatan yang tersebar dari satu ataulebih lokasi ekstranodal (hepar, sum-sum tulang atau sistem saraf pusat). Mayoritas pasiendatang dengan keluhan massa konjungtiva berwarna pink (91%), diikuti hiperemis konjungtiva(32%), propiosis (27%), massa palpebra atau orbita (19"fi, penurunan visus dan ptosis (6%),dan diplopia(2%). Bilateralitas terjadi pada 10% hingga 15% kasus dimana 80 % terjadisecarasimultan sedangkan 20% merupakan kondisi yang berurutan. Penilaian lanjut untuk stagingyang akurat dan perencanaan terapitermasuk anamnesis yang lengkap dan pemeriksaan fisik,pemeriksaan laboratorium rutin, elektroforesis protein sei-um, LDH serum, Fr-mikroglobulin,rontgen thoraks, CT scan thoraks, abdornen, dan pelvis, dan biopsisum-sum tulang. Diagnosapositif harus berdasarkan pada perneriksaan histologik dari sampeltumor yang memadai yangdiperoleh dengan biopsiorbita. Beberapa kriteria mayor harus dipertimbangkan pada penilaianawal penyakit untuk menentukan ierapi optimal secara jelas, yaitu : (1) subtipe histopatolcgiklimfoma, menurut klasifikasiWHO; (2) perluasan penyakit, clidalam dan di luar regio periokuiar;(3) faktor prognostik yang berhubungan dengan penyakit dan pasien; dan (4) dampak limfomaorbita pada mata dan fungsi visual. Berbagai modalitas terapi konvensiona! dapat diterapkanuntuk iimfoma orbita, termasuk agen tunggal atau kombinasi regimen kemoterapi, radioterapi,dan antibodi anti-CD20 monoklonal atau imunoterapi interferon.

PERBANDINGAN RETINAL GANGLION CELL THICKNESS DAN PERIMETRI PASIEN DIABETES MELITUS TIPE 2 sherly muchlis muchlis; Ardizal Rahman; Weni Helvinda
HUMAN CARE JOURNAL Vol 5, No 3 (2020): Human Care Journal
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i3.788

Diabetic retinopathy (RD) is a microvascular complication that often occurs in diabetes mellitus (DM). Retinal ganglion cells (RGC) are reduced in the early stages of DM, even before microvascular abnormalities are seen on the retina. Methods: Sample of 35 eyes of non RD RD type 2 patients and 35 mild non proliferative diabetic retinopathy (NPDR) eyes After examination of ophthalmological status, perimetry and optical coherence tomography (OCT) were examined. Results: The mean MD on non-RD type 2 DM -2.74 ± 3.5 mild NPDR -5.61 ± 4.5 with p value 0.414. The average non-RD type 2 PSD DM was -3.35 ± 3.3, mild NPDR was 4.16 ± 1.4 with a p value of 0.206. The mean RGC thickness of patients with non-RD type 2 DM was 83.8 ± 7.4 µm, mild NPDR 82.7 ± 8.1 μm. There was a decrease in the value of RGC thickness, MD and PSD in patients with type 2 DM, but it was not statistically significant . Conclusion: No significant difference was found in RGC thickness in DM patients between non-RD and mild NPDR. No significant difference was found between MD and PSD in DM patients between non-RD and mild NPDR. No significant relationship was found between RGC thickness and perimetry in DM patients between non-RD and mild NPDR.

PERBANDINGAN TEKANAN INTRAOKULAR LATIHAN BENCHPRESS DAN BICEPS MASS ROUTINE POLA PROGRESSIVE OVERLOAD Dian Eka Saputra; Ardizal Rahman; Andrini Ariesti
HUMAN CARE JOURNAL Vol 5, No 2 (2020): Human Care Journal Special Edition
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i2.787

Weight training as an isometric exercise can increase intraocular pressure (IOP) during exercise. Several mechanism theories are proposed in analyzing IOP elevation in weight training. Increased intra-abdominal pressure increases intracranial pressure thereby increasing IOP. Another theory is the Valsalva maneuver which results in an increase in intrathoracic venous pressure that is transmitted to the veins leading to the ocular so that IOP increases. IOP elevations over a period of time are at risk of causing glaucoma and blindness.Method: This study’s sample consisted of 62 students who were given biceps mass routine and benchpress training with 5 sets of progressive overload patterns. IOP values were measured before training, between sets and 30 minutes after rest using a non-contact tonometry.Result: There was a statistically significant correlation between the increase in IOP values between before exercise with the fifth set in the right eye lying position exercise (10.323mmHg) and the left eye (11.419mmHg) to the increase in the IOP value before exercise with the fifth set in the sitting position of the right eye ( 6,581mmHg) and left eye (7,435mmHg).Conclusion: IOP values increase during weight training at both positions of the progressive overload pattern. The greater the training load the greater the IOP value. The lying down position gives the effect of increasing the greater IOP value.

The Molecular and Epidemiological Atlas of Primary Orbital Lymphoma: A Global Meta-Analysis of 3,832 Cases and Pathophysiological Correlates Silvia Roza; Ardizal Rahman; Mardijas Efendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1425

Background: Primary orbital lymphoma is the most common orbital malignancy in adults, yet its global distribution and the prevalence of its histopathological subtypes remain poorly defined by large-scale evidence. This study provides a comprehensive quantitative synthesis of the global landscape of orbital lymphoma to inform diagnostic frameworks and guide future research. Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published between January 2015 and December 2023. We searched PubMed, Scopus, Web of Science, and Embase for observational studies reporting histopathological data on orbital lymphoma. Two independent reviewers performed study selection, data extraction, and quality appraisal using the Joanna Briggs Institute (JBI) checklist. Pooled prevalence for each lymphoma subtype was calculated using a random-effects model. Heterogeneity was explored via subgroup analyses and meta-regression, and the robustness of findings was confirmed with a sensitivity analysis. Results: Fifteen studies comprising 3,832 patients met the inclusion criteria. Extranodal marginal zone lymphoma (EMZL) was the most prevalent subtype globally, with a pooled prevalence of 57.1% (95% CI: 51.5-62.7%). This was followed by diffuse large B-cell lymphoma (DLBCL) at 16.5% (95% CI: 13.1-20.0%), follicular lymphoma (FL) at 10.2% (95% CI: 8.0-12.4%), mantle cell lymphoma (MCL) at 5.1% (95% CI: 3.6-6.6%), and small lymphocytic lymphoma (SLL) at 3.4% (95% CI: 2.2-4.5%). Subgroup analysis revealed a significantly higher prevalence of EMZL in Asia (61.3%) compared to Europe (54.2%) and North America (55.8%) (p=0.04), while FL was more common in North American (14.1%) and European (12.8%) cohorts versus Asian cohorts (4.5%) (p<0.01). Sensitivity analysis confirmed the stability of these estimates. Conclusion: This meta-analysis establishes EMZL as the predominant histopathological subtype of orbital lymphoma worldwide, while highlighting profound geographical disparities in the distribution of EMZL and FL. These findings provide a robust global benchmark critical for clinical practice and underscore the influence of distinct geographical, genetic, and microenvironmental factors in orbital lymphomagenesis.

Malignant Transformation of Primary Acquired Melanosis into Conjunctival Melanoma in an Adolescent Male: A Clinico-Pathological Case Report and Management Review Fitrah; Ardizal Rahman; Mardijas Efendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1426

Background: Conjunctival malignant melanoma (CMM) is a rare but potentially lethal ocular surface malignancy, especially uncommon in adolescents. It often arises from a precursor lesion known as primary acquired melanosis (PAM) with atypia. We present a case of CMM developing from long-standing PAM in an 18-year-old male, highlighting the diagnostic and therapeutic challenges in this unusual demographic. Case presentation: An 18-year-old male presented with a pigmented conjunctival lesion in his right eye, which had been present for over a decade but had recently shown progressive enlargement and darkening. Slit-lamp biomicroscopy revealed a 5x2 mm, variegated, hyperpigmented lesion on the bulbar conjunctiva with a prominent feeding vessel. The patient underwent an excisional biopsy using a "no-touch" technique with 4 mm margins and adjunctive double freeze-thaw cryotherapy. Histopathological analysis confirmed an invasive malignant melanoma, Breslow thickness of 1.8 mm, arising from PAM with severe atypia. Surgical margins were clear of the tumor. Conclusion: This case underscores that malignant transformation of conjunctival melanocytic lesions can occur even in young patients. The presence of a changing pigmented lesion, regardless of patient age, necessitates a high index of suspicion and a low threshold for excisional biopsy. Meticulous surgical technique combined with adjuvant therapy and vigilant long-term surveillance is paramount for optimizing patient outcomes.

A Masquerading Giant: Unprecedented Sebaceous Gland Carcinoma with Massive Orbito-facial Invasion and the Diagnostic and Therapeutic Challenges of an Extreme Presentation Rizki Dwayana Putra; Mardijas Efendi; Ardizal Rahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1434

Background: Sebaceous gland carcinoma (SGC) is a rare, aggressive adnexal malignancy of the eyelid, notorious for masquerading as benign inflammatory conditions. Presentations involving massive, destructive orbito-facial invasion are exceptionally rare and pose profound diagnostic and therapeutic challenges, often reflecting a confluence of biological aggression and systemic delays in care. Case presentation: A 68-year-old male presented with a one-year history of a progressively enlarging mass on his left upper eyelid, which had evolved into a giant, 15 x 15 x 7 cm fungating tumor, causing complete destruction of the orbital contents and extensive invasion into adjacent facial structures. An initial incisional biopsy was paradoxically interpreted as benign sebaceous hyperplasia. Due to the stark clinico-pathological discordance, a repeat, deeper biopsy was performed. The subsequent histopathological examination revealed a high-grade carcinoma, and the diagnosis was definitively confirmed by a panel of immunohistochemical stains, including strong positivity for Epithelial Membrane Antigen (EMA) and Cytokeratin 7 (CK7). The disease was staged as T4dN1M0 and deemed unresectable. Conclusion: This case documents a catastrophic outcome of SGC, resulting from a combination of delayed patient presentation and initial diagnostic error. It highlights that giant SGC, while rare, must be considered in the differential of destructive facial tumors and underscores that immunohistochemistry is mandatory for resolving clinico-pathological paradoxes in ocular adnexal pathology. This case serves as a call to action for improved public health awareness and enhanced diagnostic acumen to prevent such devastatingly advanced presentations.

A Diagnostic Rarity: Apocrine Hidrocystoma Presenting as a Medial Canthal Mass in Adolescence Atika Syafendra; Mardijas Efendi; Ardizal Rahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1438

Background: Apocrine hidrocystomas are benign adnexal tumors of the glands of Moll, typically diagnosed in adults. Their presentation in adolescence is an exceptional clinical finding that challenges standard diagnostic paradigms for periocular masses in this age group, necessitating a broad and meticulous differential diagnosis. Case presentation: A 15-year-old female presented with a two-month history of a stable, asymptomatic, 7×5×1 mm cystic mass at the inferomedial canthus of the left eye. The patient's primary concern was cosmetic. A comprehensive ophthalmologic examination was unremarkable. Orbital computed tomography confirmed a simple, preseptal subcutaneous cyst. A complete excisional biopsy was performed, and histopathological analysis revealed a unilocular cyst lined by a double layer of epithelium with inner columnar cells demonstrating pathognomonic decapitation secretion, confirming an apocrine hidrocystoma. Conclusion: This case highlights the necessity of including apocrine hidrocystoma in the differential diagnosis of periocular masses in adolescents. The primary lesson is that a patient's age should broaden, not narrow, the diagnostic possibilities. Definitive diagnosis relies on histopathology, not demographic probability, and complete surgical excision remains the gold standard for both diagnosis and curative therapy, yielding an excellent prognosis.

Clinicopathological Spectrum and Management of Lacrimal Gland Tumors: A Five-Year Retrospective Analysis from an Indonesian Tertiary Center Agustin Virajati Negoro; Mardijas Efendi; Ardizal Rahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1456

Background: Lacrimal gland tumors are a rare and heterogeneous group of neoplasms, representing a significant diagnostic and therapeutic challenge. Regional data, particularly from Southeast Asia, is sparse. This study aims to define the clinicopathological spectrum, radiological features, and management strategies for lacrimal gland tumors at a major tertiary referral center in Indonesia. Methods: A retrospective, cross-sectional analysis was conducted on all patients with histopathologically confirmed lacrimal gland tumors treated between January 2019 and June 2024. Data extracted from medical records included demographics, detailed clinical presentations (visual acuity, proptosis, pain scores), radiological findings from computed tomography (CT) and magnetic resonance imaging (MRI), definitive histopathological diagnoses with immunohistochemical profiles, and treatment modalities with short-term outcomes. Descriptive statistics and comparative analyses were performed. Results: A total of 35 patients (19 male, 16 female; mean age 48.2 ± 16.5 years) were included. Non-epithelial lesions (88.6%) were more common than epithelial tumors (11.4%). The most prevalent diagnosis was idiopathic orbital inflammation (IOI) (n=12, 34.3%), followed by lymphoproliferative disorders (n=11, 31.4%). Adenoid cystic carcinoma (ACC) was the most frequent malignant epithelial tumor (n=3, 8.6%). Superior eyelid edema was the hallmark of non-epithelial lesions (83.9%), whereas proptosis (mean 6.2mm) and severe pain (mean VAS 7.3/10) were characteristic of ACC. Radiological findings were highly correlative, with IOI showing diffuse gland enhancement and ACC demonstrating bone erosion and perineural invasion. Management was tailored to histology, with corticosteroids for IOI, radiotherapy for lymphomas, and radical surgery for ACC. Conclusion: In this Indonesian cohort, lacrimal gland tumors are predominantly non-epithelial, with inflammatory and lymphoproliferative conditions being most common. A high index of suspicion for malignancy, particularly ACC, is warranted in patients presenting with pain and proptosis. Integrating clinical, radiological, and pathological data is paramount for accurate diagnosis and effective management.

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