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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 Binharyanto, Adlan Pratama 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
Gene Muatatuion Changes in Adenocarcinoma Lung Cancer Patient With Left Pyopneumothorax Nurandhini, Marsha; Suryanti Dwi Pratiwi; Yani Jane R. Sugiri; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 7 No. 1 (2025): March 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.01.06

Abstract

Introduction: Adenocarcinoma is the most common subtype of lung cancer, around 40% of lung cancer cases worldwide. It’s specific to epidermal growth factor receptor (EGFR) mutation. Lung cancer can be risk factor and increases the mortality rate of pyopneumothorax (12.8% higher in cancer patients). Case Illustration: A 69 year old woman, non smoker, who is diagnosed with lung adenocarcinoma (Exon 18 and 21 mutation) in May 2021 and came to emergency room with complaints of worsening shortness of breath. Cloudy-yellow pleural fluid was drained during thoracocentesis procedure. Imaging study using thorax CT scan showed a left lung mass obliterating bronchial segments 1/2, 3 and left hydropneumothorax. The patient was later diagnosed with pyopneumothorax and thorax drain procedure was performed. Antibiotic therapy was based on culture result. Through a following ctDNA (circulating tumor DNA) test, the mutations change to Exons 19 and 20 T790M. Discussion: Pyopneumothorax in this patient can occur due to disorder in the integrity of the host defense mechanisms, which then develops infection in the pleural cavity. The T790M mutation is found in 50-60% cases that are resistant to tyrosin kinase inhibitors (TKI). Third-generation TKI is main option for this condition, however, platinum-based chemotherapy can be considered, as in the case above, where third-generation chemotherapy cannot be given due to limitation of insurance coverage. Conclusion: Lung cancer can be associated with occurance of pyopneumothorax. Genetic mutation changes can occur due to resistance mechanisms. Giving platinum-based chemotherapy can be considered in such cases. Keywords: lung adenocarcinoma, genetic mutation, pyopneumothorax
Co-Authors Binharyanto, Adlan Pratama Binharyanto Budiana Tanurahardja Dini Rachma Erawati Ngakan Putu Parsama Putra Nurandhini, Marsha Puspita Eka Wuyung Setyawan, Ungky Agus Suryanti Dwi Pratiwi Yani Jane R. Sugiri