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All Journal Majalah Patologi Indonesia Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Indonesian Journal of Cancer Ebers Papyrus Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Agnes Stephanie Harahap
Departemen Patologi Anatomik, Fakultas Kedokteran, Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Hubungan Subtipe Imunofenotipik Berdasarkan Ekspresi CD56 dan CD16 dengan Ekspresi CD30 dan Ki-67 pada Limfoma Sel NK/T Ekstranodal Tipe Nasal Stephanie Maris; Kusmardi Kusmardi; Endang SR Hardjolukito; Maria Francisca Ham; Agnes Stephanie Harahap
Majalah Patologi Indonesia Vol 26 No 2 (2017): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Latar belakangLimfoma sel NK/T ekstranodal tipe nasal (NKTCL; extranodal NK/T-cell lymphoma, nasal type) dapat dikategorikan menjadi beberapa subtipe berdasarkan ekspresi CD56 dan CD16 sesuai dengan pola perkembangan fenotip sel natural killer (NK) normal. Ekspresi CD56 banyak ditemukan pada tahap diferensiasi sel NK yang lebih awal, sedangkan ekspresi CD16 terdapat pada sel NK dengan diferensiasi yang lebih mature. Selain fenotip normal, adanya infeksi virus Epstein-Barr (EBV) sebagai etiologi NKTCL berkaitan dengan fenotip teraktivasi yang ditandai dengan ekspresi CD30, kemudian mengaktifkan jalur sinyal nuclear factor kappa beta (Nf-KB) sehingga dapat menyebabkan pertumbuhan dan proliferasi sel tumor. Pada penelitian ini diteliti hubungan antara subtipe NKTCL berdasarkan ekspresi CD56 dan CD16 dengan ekspresi CD30 serta indeks proliferasi Ki-67.MetodaPenelitian ini menggunakan metoda potong lintang. Sampel terdiri atas 32 kasus NKTCL di Departemen Patologi Anatomik Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Cipto Mangunkusumo (FKUI/RSCM) periode Januari 2010 sampai April 2016. Dilakukan pulasan imunohistokimia CD16, CD30 dan Ki-67, sedangkan pewarnaan CD56 diambil dari arsip. Selanjutnya dihitung persentasis positivitas pada setiap pulasan tersebut.HasilPositivitas CD56 ditemukan pada semua kasus (100%). Positivitas CD16 sebanyak 16 (50%) kasus, positivitas CD30 sebanyak 17 (53,13%) kasus, dan indeks proliferasi Ki-67 tinggi sebanyak 16 (50%) kasus. Tidak terdapat perbedaan bermakna antara subtipe NKTCL (CD56+CD16- dan CD56+CD16+) dengan ekspresi CD30 (p=0,723). Tidak terdapat perbedaan bermakna antara subtipe NKTCL (CD56+CD16- dan CD56+CD16+) dengan indeks proliferasi Ki-67 (p=0,480). Tidak terdapat perbedaan bermakna antara ekspresi CD30 dengan indeks proliferasi Ki-67 (p=0,723).KesimpulanSubtipe imunofenotipik NKTCL (CD56+CD16- dan CD56+CD16+) tidak berhubungan dengan fenotip teraktivasi (CD30) maupun proliferasi (Ki-67).
Perbedaan Imunoekspresi Caspase-3 antara Diffuse Large B-Cell Lymphoma Subtipe Germinal Center B-Cell-Like dan Non-Germinal Center B-Cell-Like Rosita Alfi Syahrin; Maria Francisca Ham; Agnes Stephanie Harahap; Benyamin Makes; Endang SR Hardjolukito
Majalah Patologi Indonesia Vol 27 No 1 (2018): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Latar belakangTipe terbanyak dari limfoma non-Hodgkin (LNH) sel B adalah diffuse large B-cell lymphoma (DLBCL) yang merupakan entitas heterogen. Hans membagi DLBCL menjadi subtipe germinal center B-cell-like (GCB) dan non-germinal center B-cell-like (non-GCB) dengan tehnik pemeriksaan imunohistokimia menggunakan CD10, BCL6 dan MUM1. GCB mempunyai prognosis baik dan non-GCB berprognosis buruk. Caspase-3 adalah protein yang berperan utama dalam mekanisme apoptosis dan dapat mengalami mutasi somatik pada LNH. Tujuan penelitian ini untuk mengetahui perbedaan imunoekspresi Caspase-3 pada DLBCL subtipe GCB dan non-GCB yang mungkin berkaitan dengan perbedaan prognosis kedua subtipe tersebut.MetodePemeriksaaan imunoekspresi Caspase-3 pada kasus pasien DLBCL yang terdiri atas subtipe GCB dan non-GCB dilakukan dengan tehnik imunohistokimia. Subjek penelitian berasal dari blok parafin di Departemen Patologi Anatomik FKUI/RSCM dan enam rumah sakit lainnya di Jakarta. Metode penelitian observasional deskriptif analitik dengan pendekatan cross sectional. Prosedur pulasan imunohistokimia dengan cara Trekavidin biotin dan penilaian dilakukan oleh dua orang peneliti tanpa diketahui jenis subtipe GCB atau non-GCB.HasilDitemukan 41 kasus DLBCL yaitu 18 kasus subtipe GCB dan 23 kasus subtipe non-GCB. Subtipe GCB memberikan hasil positif dengan pulasan Caspase-3 berjumlah 13 kasus (72%) dan negatif berjumlah 5 kasus (28%). Hasil yang didapatkan dari subtipe non-GCB yaitu positif berjumlah 5 kasus (22%) dan negatif berjumlah 18 kasus (78%). Terdapat perbedaan bermakna imunoekspresi Caspase-3 antara DLBCL subtipe GCB dengan subtipe non-GCB (p=0,002). Imunoekspresi Caspase-3 menunjukkan positivitas yang lebih tinggi pada DLBCL subtipe GCB dibandingkan dengan subtipe non-GCB.KesimpulanPenelitian ini menunjukkan bahwa imunoekspresi Caspase-3 pada kedua subtipe DLBCL berbeda secara bermakna, di mana lebih tinggi pada subtipe GCB dibandingkan pada subtipe non-GCB. Hal ini mungkin dapat menjelaskan latar belakang perbedaan prognosis di antara kedua subtipe tersebut.
Laparoscopic Approach in Large Rare Adrenal Ganglioneuroma Kelvin Candiago; Egi Edward Manuputty; Syamsu Hudaya; Yulius Fajar Martanu; Budiawan Atmadja; Agnes Stephanie Harahap; Yosephine Gracia Susufi; Yustinus Hartanto; Ajeng Indah Pramesti
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.v16i3.889

Abstract

Introduction: Adrenal ganglioneuroma is an extremely rare and benign tumor comprising Schwann cells and ganglion cells. Adrenal ganglioneuroma is usually hormonally silent and tends to be discovered incidentally on imaging tests. Here, we present a case of a 39-year-old man with adrenal ganglioneuroma who underwent laparoscopic left adrenalectomy.Case Presentation: a 39-year-old man was admitted to our department with left flank pain after he recovered from Covid-19. He had no symptoms of nausea, vomiting, headache, diarrhea, palpitation, or chest distress, and there was no lack of appetite or weight loss. He denied any medical conditions, such as hyperaldosteronism, hypercortisolism, and hypertension. On further examination with contrast-enhanced CT identified a hypo-isodense mass in the left adrenal gland, measuring 4.8 x 4.4 x 5.0 cm, and spotty dense calcification in the middle of the mass. All functional laboratory evolution showed negative including urinalysis and serum electrolyte. Because the non-functioning suprarenal tumor was presumed to be benign, a laparoscopic approach was planned for definitive extirpation of the left adrenal gland. CT triple-phase whole abdomen was done before the procedure which showed contrast-enhanced identified an isodense mass with 43 HU in the left adrenal gland, measuring 4.8 x 4.4 x 5.0 cm with absolute washout of 49.3% and relative washout of 30.7%. Laparoscopic left adrenalectomy was performed. The patient underwent successful laparoscopic extirpation of the left adrenal gland. The postoperative pathology revealed a 7.0 x 6.0 x 3.0 cm encapsulated tumor with a firm texture. Microscopically, the tumor showed a mixture of mature ganglion cells and fascicles of Schwann cells. Adrenocortical cells were found near the capsule.Conclusions: Even though there have been some guidelines for the diagnosis of Adrenal ganglioneuroma, pre-operative misdiagnoses are still frequent. We recommend that complete operative resection should be considered once malignancy cannot be excluded by pre-operative evaluation. Laparoscopic adrenalectomy is a reasonable option at least for tumors < or = 4.5 cm. Adrenal ganglioneuroma can be successfully excised laparoscopically with an appropriate and experienced surgeon.
Hubungan Kepadatan Limfosit Intratumoral dan Tipe Histopatologik Karsinoma Tiroid di Departemen Patologi Anatomik FKUI/RSCM Fanny Kamarudy Lay; Agnes Stephanie Harahap; Maria Francisca Ham
Majalah Patologi Indonesia Vol. 32 No. 2 (2023): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i2.618

Abstract

Background The presence of tumor-infiltrating lymphocytes (TILs) has been widely explored as one of the factors that can affect the success of immunotherapy in various cancers. This study aims to investigate the TILs in various types of thyroid carcinoma (TC) and its association with the aggressive histopathological type compared to the less aggressive histopathological type of TC. Methods The population covered by this retrospective study was TCs diagnosed at the Department of Anatomic Pathology, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo National Central General Hospital, period 2015-2019. The research sample was divided into group of TCs with aggressive histopathological type and less aggressive histopathological type with a total of 25 samples for each group. TILs was calculated in 10 high power fields (HPF) with 400 kali magnification. The analyses were conducted using Mann-Whitney and Kruskal Wallis test. Results TILs count was found with a median value of 43 (3-660) in the aggressive histopathological group and 36 (9-387) in the less aggressive histopathological group (p:0.96, CI:95%). The highest TILs was found in anaplastic thyroid carcinoma (ATC) and papillary thyroid carcinoma (PTC) with anaplastic components. TILs count was also found with a median value of 17.5 (3-75) in male and 48 (9-660) in female (p:0.02, CI:95%). Conclusion There was no significant association between TILs and histopathological types of TC (aggressive and less aggressive). However, there is a tendency for high TILs in ATC and PTC with anaplastic components. There is also a significant difference in TILs between male and female gender.
Hubungan Lama Pemberian Makanan Tambahan Dengan Peningkatan Berat Badan Bayi dan anak Balita Di Puskesmas Kelurahan Meruya Utara Kecamatan Kembangan Jakarta Barat 26 November -10 Desember 2008 Catherine Catherine; Agnes Stephanie; Glenn Glenn; Yossie Sagitta H
Ebers Papyrus Vol. 15 No. 2 (2009): EBERS PAPYRUS
Publisher : Medical Faculty Universitas Tarumanagara

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Selama bulan Januari-Desember 2007 di Puskesmas Kelurahan Meruya Utara tercatat sebanyak 19,8% bayi dan anak balita mengalami gizi buruk, dan 33% di antaranya tidak mengalami peningkatan berat badan walaupun telah diberikan pemberian makanan tam­ bahan (PMT). Pemberian makanan tambahan memiliki kendala, karena jumlah penderita gizi buruk melebihi PMT yang tersedia sehingga lama PMT menjadi tidak optimal. Pe­ nelitian ini dilakukan untuk mengetahui hubungan antara lama PMT dengan peningka­ tan berat badan bayi dan anak balita gizi buruk. Penelitian menggunakan desain analitik case control. Pengambilan sampel dilakukan dengan consecutive non random sampling terhadap 258 responden, dengan jumlah kasus dan kontrol sama yaitu 129 responden, selama 2 minggu. Data dikumpulkan melalui wawancara, melihat pencatatan dan pen­ gukuran langsung dengan alat ukur berupa kursioner untuk variabellama  PMT dan KMS sedangkan dacin serta uniscale untuk variabel berat badan. Daripenelitian didapatkan 118 orang (45,74 %) mendapatkan PMT:S1 bulan dan 140 orang (54,26%) mendapat PMT>1 bulan. Di antara 129 kasus yang tidak mengalami peningkatan berat badan, 62 responden (48,06%) mendapat PMT selama s1 bulan sedangkan di antara 129 kontrol yang men­ galami peningkatan berat badan, 56 orang (43,41%) mendapat PMT selama :S1 bulan. Walaupun pada penelitian ini ditemukan asosiasi lemah (OR=1,21) antara lama PMT dan peningkatan berat badan namun asosiasi tersebut tidak bermakna (0,30<p-va/ue<0,50) secara statistik. Asosiasi lebih kuat (OR=2,72) dan bermakna (p<0,01) ditemukan antara cara PMT dan peningkatan berat badan.
A Case Report of a Giant Pheochromocytoma Lubis, Dian Anindita; Harahap, Agnes Stephanie; Em Yunir
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 1 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (655.112 KB) | DOI: 10.32734/jetromi.v2i1.2037

Abstract

Pheochromocytoma is a rare catecholamine secreting tumor that are usually arise from adrenal medulla and produces signs and symptoms of excessive catecholamine secretion from tumor. A 32 years old female presented to the hospital, with dyspeptic symptoms. She had fluctuative hypertension, palpitation and sweating. Abdominal ultrasonography showed a right adrenal mass, and computed tomography of the adrenal glands confirmed a right adrenal mass. However, clinical biochemistry tests specific for pheochromocytoma was not performed. Laparoscopic right adrenalectomy was done and the adrenal tumor was excised. Histopathology and immunohistochemistry confirmed the diagnosis of adrenal pheochromocytoma; the tumor cells being positive for chromogranin, synaptophysin, S-100 protein, and inhibin. Following the surgery, the patient did well and showed full recovery at follow-up after 1 month.
Primary Adrenal Insufficiency due to Tuberculosis Infection Pitfalls in Diagnosis and Management Ira Laurentika; Em Yunir; Tri Juli Edi Tarigan; Agnes Stephanie; Robert Shinto; Taufik Agung
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 1 No. 1 (2024): InaJEMD Vol. 1, No. 1
Publisher : PP PERKENI

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Abstract

Primary adrenal insufficiency (PAI) is a chronic condition in which both adrenal glands are not able to produce steroid hormones. In this article we reported a-20-year-old male with history of soft tissue tumor in thoracalregion and general hyperpigmentation of skin and mucous. Laboratory findings showed hypocortisolism and adrenal computed tomography (CT) scan showed bilateral enlargement of adrenal with multiple necrotic nodular lesion and calcification, suggesting adrenal metastasis or tuberculosis infection. The interferon gamma release assay (IGRA) and histopathology review of the specimen from soft tissue tumor in thoracal region showed confirmed the diagnosis of adrenal tuberculosis. Antituberculosis drugs were started, and hydrocortisone dose were frequently adjusted. Five months after therapy the patient is clinically improved with a minimal dose of steroid.
Limfadenitis KronikGranulomatosa Profil Klinikopatologik Limfadenitis Kronik Granulomatosa Tuberkulosis dan non-Tuberkulosis di Departemen Patologi Anatomik FKUI-RSCM Periode Tahun 2018-2022 Nurlia Erdian, Defi; Harahap, Agnes Stephanie; Ham, Maria Francisca
Majalah Patologi Indonesia Vol. 34 No. 1 (2025): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v34i1.609

Abstract

Background Chronic granulomatous lymphadenitis (CGL) is an inflammatory condition associated with lymphoproliferative lesions, infections, and autoimmune diseases. One of the etiologies of CGL is Mycobacterium tuberculosis (MTB). According to WHO data in 2020, Indonesia still ranks third globally for TB cases. To ensure appropriate patients’ treatment, there is a need to accurately diagnose TB lymphadenitis through clinicopathological. Therefore, this research aimed to determine the clinicopathological features that differentiate TB lymphadenitis from other types. Method This research was a retrospective analytical review and data were collected from the Department of Anatomic Pathology archives, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital for 5 years, from 2018 to 2022. Clinical data were obtained from electronic medical records. The histopathological assessment involved evaluating the presence of polymorphonuclear cells (PMN), datia cells, and central necrosis in CGL. Result A total of 156 CGL cases were identified, with 63.8% of TB lymphadenitis patients being female and the highest age group was <45 years. No significant association was found between age, a history of autoimmune diseases, malignancy, and TB lymphadenitis. The most commonly involved lymph node location was in the colic area, with a proportion of 62.2%. There was a significant association between lymph node location and the occurrence of TB lymphadenitis (p<0.003). Other variables assessed included the presence of PNM cells (81.7%), datia cells (94%), and central necrosis (88.8%), with p-values <0.000 for each variable. The results showed a significant association between PMN cells, datia cells, and central necrosis with TB lymphadenitis. Conclusion The characteristics of the female gender, lymph node location, presence of PMN cells, central necrosis, and datia cells could be considered as features to assess for diagnosing CGL caused by MTB.
Co-Authors Ajeng Indah Pramesti Benyamin Makes Budiawan Atmadja Catherine Catherine Egi Edward Manuputty Em Yunir, Em Endang SR Hardjolukito Fanny Kamarudy Lay Glenn Glenn Ham, Maria Francisca Ira Laurentika Kelvin Candiago Kusmardi Kusmardi Lubis, Dian Anindita Nurlia Erdian, Defi Robert Shinto Rosita Alfi Syahrin Salinah Stephanie Maris Susan Rahayu Syamsu Hudaya Taufik Agung Tri Juli Edi Tarigan Yosephine Gracia Susufi Yossie Sagitta H Yulius Fajar Martanu Yustinus Hartanto