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Hubungan Ekspresi IGF-1R dan HER-2 Terhadap Jumlah Mitosis dan Derajat Histopatologik pada Karsinoma Payudara Invasif Tidak Spesifik Yessy Setiawati; Aswiyanti Asri; Rosfita Rasyid
Majalah Patologi Indonesia Vol 29 No 3 (2020): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

BackgroundThe IGF-1R signaling pathways have cross-talk with HER-2 signaling pathways and was thought to be one of the resistance mechanism intrastuzumab therapy. This research was proposed to analyze the correlation between IGF-1R and HER-2 expression with mitosis count andhistopathological grade in invasive breast carcinoma of no special type.MethodsThis research was a cross-sectional design. A total of fifty-five invasive breast carcinoma of no special type cases diagnosed in theAnatomical Pathology Centre Diagnostic of Medical Faculty of Andalas University in a period of 2014-2015 were collected and stainedimmunohistochemically with IGF-1R and HER-2 antibodies. IGF-1R and HER-2 expression were examined and their correlation with mitosiscount and histopathological grade were statistically analyzed with T-test, Oneway Anova and Chi-Square test.ResultsIGF-1R cytoplasm and membranous expression were found positive in 18.2% and 34.5% cases respectively, meanwhile, HER-2 expressionswere found positive in 23.6% cases of invasive breast carcinoma of no special type. There were significant correlations between IGF-1Rcytoplasm expression with mitosis count (p=0.049). There were no significant correlations between IGF-1R membranous expression withmitosis count (p=0.641) with histopathological grade (p=1.00). There were no significant correlations between HER-2 expression withmitosis count (p=0,495) and histopathological grade (p=1.000).ConclusionIGF-1R expressions have a significant correlation with mitosis count rather than HER-2 expressions. Inhibition it’s signaling pathways mayhave therapeutic value in breast carcinoma. Combination therapy of anti-HER-2 and anti-IGF-1R are expected to overcome resistance withtrastuzumab in HER-2 positive breast carcinoma

ATYPICAL MICROGLANDULAR ADENOSIS MIMICKING INVASIVE TUBULAR CARCINOMA, A RARE CHALLENGING DIAGNOSIS Hera Novianti; Fitri Nur Handriyani; Aswiyanti Asri; Yenita Yenita; Noza Hilbertina; Pamelia Mayorita; Yessy Setiawati; Zulda Musyarifah; Meta Zulyati Oktora; Maisyah Nelzima
Nusantara Hasana Journal Vol. 4 No. 7 (2024): Nusantara Hasana Journal, December 2024
Publisher : Yayasan Nusantara Hasana Berdikari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59003/nhj.v4i7.1297

Background: Microglandular adenosis (MGA) is a rare breast lesion that poses diagnostic challenges due to its resemblance to invasive carcinoma, particularly invasive tubular carcinoma (ITC). Atypical MGA is of clinical concern because of its potential for malignant transformation. Accurate diagnosis relies on histopathological examination and immunohistochemical (IHC) analysis. Case Presentation: A 34-year-old woman presented with a painless lump in her left breast. Intraoperative frozen section analysis revealed small glandular structures with histological features mimicking ITC. Definitive diagnosis required further evaluation. Immunohistochemical analysis demonstrated S100 positivity, consistent with glandular differentiation, and negative p63 staining, indicating the absence of a myoepithelial layer. These findings, in the absence of definitive stromal invasion, supported a diagnosis of atypical MGA. Complete surgical excision was performed to ensure negative margins and exclude associated malignancy. Discussion: This case highlights the diagnostic complexity of atypical MGA, particularly in young patients. Frozen section analysis alone often fails to distinguish MGA from invasive carcinoma due to overlapping histological features. IHC markers, such as S100 and p63, are critical for differentiation. S100 positivity confirms glandular origin, while p63 negativity indicates the lack of a myoepithelial layer, distinguishing MGA from benign proliferative lesions. Accurate diagnosis is essential to avoid overtreatment, such as unnecessary chemotherapy or radical surgery, while ensuring appropriate management to mitigate malignant potential. Conclusion: This report underscores the importance of combining frozen section and IHC findings for rare breast lesions like atypical MGA. Increased awareness and careful evaluation are essential to achieve timely and precise diagnosis, enabling optimal surgical management and long-term outcomes.

CASE REPORT MALIGNANT GLOMUS TUMOR: A RARE CASE Pamelia Mayorita; Mustika Sari; Zulda Musyarifah; Hera Novianti; Yessy Setiawati; Meta Zulyati Oktora
Nusantara Hasana Journal Vol. 4 No. 8 (2025): Nusantara Hasana Journal, January 2025
Publisher : Yayasan Nusantara Hasana Berdikari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59003/nhj.v4i8.1309

Background: Glomus tumor is a rare mesenchymal neoplasm that accounts for less than 2% of all soft tissue tumors and 1.5% of extremity neoplasms. Malignant glomus tumors are exceptionally rare, comprising only 1-2.9% of all glomus tumors, and are often associated with significant diagnostic and therapeutic challenges. Case Presentation: We report a case of a 62-year-old male presenting with a painful lump on his left thumb, progressively enlarging over six months. Clinical examination revealed a 3x2x1 cm subungual mass with positive cold sensitivity and pin love tests. The patient underwent amputation, and histopathological analysis showed a proliferation of round-to-oval and spindle cells with nuclear atypia, frequent mitotic figures (>5/50 HPF), and atypical mitoses, consistent with malignant glomus tumor grade 2. Surgical margins and bone were free of tumor infiltration. Conclusion: This case highlights the importance of clinical-pathological correlation in diagnosing malignant glomus tumors, which remain a diagnostic challenge due to their rarity. Complete surgical excision with negative margins remains the gold standard for treatment, ensuring favorable outcomes and minimizing recurrence risk.

Primary Malignant Peritoneal Mesothelioma Mimicking Ovarian Carcinoma: A Case Report Highlighting the Importance of Immunohistochemistry Rio Hendra; Tofrizal; Hera Novianti; Yessy Setiawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (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.v9i3.1212

Background: Primary malignant peritoneal mesothelioma (PMPM) is an uncommon and aggressive malignancy arising from the mesothelial lining of the peritoneal cavity. The diagnosis of PMPM is often challenging due to its rarity, nonspecific clinical presentation, and histologic similarities to other malignancies, particularly adenocarcinomas. Immunohistochemistry plays a crucial role in differentiating PMPM from metastatic adenocarcinoma, which is essential for accurate diagnosis, appropriate treatment, and prognostication. Case presentation: We present the case of a 43-year-old female who presented with abdominal distension, ascites, and weight loss, initially raising suspicion of ovarian carcinoma. However, histopathological examination of the omental tissue revealed a proliferation of epithelial cells with papillary and glandular-like growth patterns. Immunohistochemical staining demonstrated strong positivity for calretinin, a mesothelial marker, while staining for estrogen receptor (ER) and progesterone receptor (PR) was negative, effectively ruling out an ovarian or endometrial origin. The diagnosis of PMPM, epithelioid subtype, was confirmed. Conclusion: This case underscores the challenges in diagnosing PMPM and highlights the critical role of immunohistochemistry in differentiating it from metastatic adenocarcinoma. Accurate diagnosis is essential for determining appropriate management strategies and providing prognostic information.

Correlation between differentiation grade and lymphovascular invasion in colorectal adenocarcinoma Nana Liana; Loli Devianti; Yessy Setiawati; Sri Nani Jelmila; Ruhsyahadati
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 1 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i1.20536

Colorectal carcinoma is the third most common malignant tumor worldwide. It is a heterogeneous disease with diverse clinicopathological and prognostic characteristics. The TNM (tumor, node, metastasis) staging system is currently used as a prognostic predictor. However, its predictive value is limited, as approximately 30% of patients with lymph node-negative disease die due to metastasis progression. It is suspected that other prognostic factors other than TNM staging system, may play a significant role. Differentiation grade and lymphovascular invasion have been proposed as essential prognostic factors for lymph node-negative colorectal carcinoma. This study aimed to evaluate the correlation between differentiation grade and lymphovascular invasion in colorectal carcinoma. It was an observational study with a cross-sectional design. Samples were collected from 4 Anatomical Pathology laboratories in West Sumatera in 2018. A total of 97 paraffin blocks of colorectal adenocarcinoma met the inclusion criteria. Differentiation grade and lymphovascular invasion were evaluated according to the 2019 World Health Organization (WHO) classification. The correlation between differentiation grade and lymphovascular invasion was analyzed using Fisher's Exact test. A p value <0.05 considered statistically significant. The most prevalent age group for cases of colorectal adenocarcinoma was 51–60 yr (36.1%). Low-grade differentiation was the most common grade of differentiation (72.2%). Lymphovascular invasion in small vessels was commonly encountered (73.3%). High-grade differentiation adenocarcinomas had 100% lymphovascular invasion. A significant correlation between differentiation grade and lymphovascular invasion was observed (p = 0.031). This study confirms that lymphovascular invasion is a valuable predictor of colorectal carcinoma progressiveness.

Primary Malignant Peritoneal Mesothelioma Mimicking Ovarian Carcinoma: A Case Report Highlighting the Importance of Immunohistochemistry Rio Hendra; Tofrizal; Hera Novianti; Yessy Setiawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (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.v9i3.1212

Background: Primary malignant peritoneal mesothelioma (PMPM) is an uncommon and aggressive malignancy arising from the mesothelial lining of the peritoneal cavity. The diagnosis of PMPM is often challenging due to its rarity, nonspecific clinical presentation, and histologic similarities to other malignancies, particularly adenocarcinomas. Immunohistochemistry plays a crucial role in differentiating PMPM from metastatic adenocarcinoma, which is essential for accurate diagnosis, appropriate treatment, and prognostication. Case presentation: We present the case of a 43-year-old female who presented with abdominal distension, ascites, and weight loss, initially raising suspicion of ovarian carcinoma. However, histopathological examination of the omental tissue revealed a proliferation of epithelial cells with papillary and glandular-like growth patterns. Immunohistochemical staining demonstrated strong positivity for calretinin, a mesothelial marker, while staining for estrogen receptor (ER) and progesterone receptor (PR) was negative, effectively ruling out an ovarian or endometrial origin. The diagnosis of PMPM, epithelioid subtype, was confirmed. Conclusion: This case underscores the challenges in diagnosing PMPM and highlights the critical role of immunohistochemistry in differentiating it from metastatic adenocarcinoma. Accurate diagnosis is essential for determining appropriate management strategies and providing prognostic information.

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