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RETRO-ORBITA EXTRAPLEURAL SOLITARY FIBROUS TUMOR Mahastuti, Ni Made; Saputra, Herman; Gotra, I Made
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Extrapleural solitary fibrous tumor (SFT) merupakan tumor jaringan mesenkimal tipe fibroblastikdengan gambaran haemangipericytoma-like branching vascular yang menonjol dan sangat jarangdijumpai. Penderita perempuan usia 38 tahun mengeluh mata kanan menonjol sejak 2 tahun yanglalu. Klinis ditemukan massa menonjol di belakang mata kanan. Pada pencitraan CT scan tampakmassa solid heterogen di cavum orbita kanan, tidak menginfiltrasi bulbus okuli. Makroskopis, massasolid berbatas tegas di regio retro orbita, berukuran 6,5 x 6,5 x 6 cm. Mikroskopis, tumor berbatastegas, sebagian besar tampak hiperselular mengandung proliferasi sel spindel neoplastik diselingidengan haemangipericytoma-like branching vascular yang menonjol. Mitosis sulit ditemukan. Pulasanimunohistokimia CD34 positif kuat dan Ki67 kurang dari 5%. Pasien didiagnosis retro-orbitaextrapleural SFT berdasarkan temuan klinis, radiologis, makroskopis, mikroskopis yang khas sertapemeriksaan imunohistokimia. [MEDICINA 2015;46:195-200].Extrapleural solitary fibrous tumor (SFT) is an ubiquitous mesenchymal tumour of fibroblastic type,which shows a prominent haemangipericytoma-like branching vascular. A 38 years old woman camewith protruding right eye since 2 years ago. Clinical examination found a protruding mass in the rightretro orbita. Computed tomography scan demonstrated heterogen solid mass in right cavum orbitawithout infiltration into bulbus oculi. Macroscopically, the tumour appeared as well circumscribedsolid mass 6,5 x 6,5 x 6cm. Microscopic examination showed well circumscribed tumour, hypercellular,consist of neoplastic spindle cell proliferation intermingled with prominent haemangiopericytomalikebranching vascular pattern . Mitoses are rarely found. CD34 stained strongly positive with lowexpressionof Ki67 (< 5%). The diagnosis was made based on the clinical data, radiologic, histopathologicfindings,and also immunohistochemistry staining. [MEDICINA2015;46:195-200].

Perbedaan Ekspresi Cox-2 pada Beberapa Parameter Kliniko-patologi Adenokarsinoma Kolorektal . I Made Gotra, Moestikaningsih
Majalah Patologi Indonesia Vol 21 No 2 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Cox-2 dapat diekspresikan pada berbagai kanker pada manusia termasuk kanker kolorektal. Cox-2 dapat berperan dalam terjadinya dan progresivitas kanker kolorektal, sehingga ekpresi Cox-2 akan berkaitan dengan derajat diferensiasi, kedalaman infiltrasi dan stadium Dukes adenokarsinoma kolorektal. Tujuan penelitian ini adalah untuk mengetahui persentase ekspresi Cox-2 pada adenokarsinoma kolorektal dan hubungannya dengan beberapa parameter klinikopatologi seperti derajat diferensiasi, kedalaman infiltrasi dan stadium Dukes, sehingga dapat dipakai untuk penanganan klinis. Metode Penelitan ini dilakukan secara potong lintang, dengan sampel adenokarsinoma kolorektal yang telah dilakukan pemeriksaan histopatologi di Laboratorium Patologi Anatomi Rumah Sakit Sanglah Denpasar sejak 1 Januari 2008-31 Maret 2011.Sediaan Hemaktosilin-Eosin kemudian dievaluasi parameter kilnikopatologinya dan blok parafinnya dipotong untuk pulasan Cox-2. Penilaian skor imunohistokimia dihitung secara semikuantitatif, tanpa mengetahui data parameter klinikopatologi pasien. Karakteristik sampel dianalisis secara deskriptif, sedangkan perbedaan ekspresi Cox-2 pada berbagai parameter klimikopatologi dianalisis dengan uji X2 dengan tingkat kemaknaan a < 0,05. Hasil dan kesimpulan Didapatkan sebanyak 64 sampel, 10 sampel dari bahan biopsi dan 54 sampel dari bahan operasi yang dapat dianalisa. Rata-rata umur penderita 52,3 tahun (rentang umur 20-80 tahun). Dari 64 sampel didapatkan 71,9% (46/ 64) kasus menunjukkan ekspresi Cox-2 positif. Tidak ada perbedaan bermakna ekspresi Cox-2 dengan derajat diferensiasi( p= 0.114).Demikian pula dengan kedalaman infiltrasi tumor (p= 0,128), dan dengan stadium Dukes( p= 0,053). Kata kunci: Adenokarsinoma kolorektal, ekspresi Cox-2, derajat diferensiasi, kedalaman infiltrasi, stadium Dukes. ABSTRACT Background Expression of cyclooxygenase-2 (Cox-2) could be demonstrated in various human cancers including colorectal cancer. The overexpression of Cox-2 may involve in the growth and progression of colorectal cancer, and hence influence the degree of, depth of infiltration and Dukes stadium. The aims of this study are to know the percentage of Cox-2 expression in adenocarcinoma colorectal aa well as in various clinicopathology parameters i.e degree of differentiation, depth of infiltration and Dukes stadium, so it can be applied in clinical management. Method This research is a cross-sectional study with colorectal adenocarcinoma samples from January 1-March 31, 2011. The clinicopathological parameters were evaluated and. Immunohistochemisty scores of Cox-2 staining were counted semiquantitatively, blindelly clinicopathological. Sample characteristics were analyzed descriptively, while the difference of Cox-2 overexpression in various clinicopathological parameters were analyzed by X2 test with significance value Î± < 0.05. Result and conclusion 64 samples (10 from biopsy and 54 from operation) that can be analyzed. The average of age was 52.3 years (range 28-80 years). 71.9% (46/64) cases showed Cox-2 overexpression. There were no significance differencys of Cox-2 expression in various degree (p = 0.114), and also in depth of infiltration (p= 0.128), as well as in Dukes stadium (p= 0.053) Key words: Adenocarcinoma colorectal, Cox-2 expression, differentiation degree, depth of infiltration, Dukes stadium.

KARAKTERISTIK PASIEN DENGAN GAMBARAN HISTOPATOLOGI APENDISITIS DI RSUP SANGLAH DENPASAR TAHUN 2015 - 2017 Cathleya Fransisca; I Made Gotra; Ni Made Mahastuti
E-Jurnal Medika Udayana Vol 8 No 7 (2019): Vol 8 No 7 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Apendisitis merupakan suatu keadaan darurat yang paling umum terjadi di bagian bedah abdomen dansebanyak 621.435 kasus apendisitis terjadi di Indonesia. Pemeriksaan histopatologi merupakan metodediagnosis yang banyak digunakan untuk mendiagnosis apendisitis. Tujuan penelitian ini adalah untukmengetahui data karakteristik pasien dengan gambaran histopatologi apendisitis di RSUP SanglahDenpasar Tahun 2015 – 2017.Penelitian ini merupakan penelitian deskriptif dengan rancangan penelitiancross sectional. Teknik pengambilan sampel berupa total sampling dimana data penelitian berasal daribuku registrasi hasil pemeriksaan histopatologi di Laboratorium Patologi Anatomi RSUP SanglahDenpasar tahun 2015 – 2017 sebanyak 723 sample yang telah memenuhi kriteria inklusi dan tidak adakriteria eksklusi. Didapatkan bahwa pasien yang melakukan pemeriksaan histopatologi di RSUP SanglahDenpasar terbanyak terjadi pada kelompok dengan diagnosis histopatologi apendisitis phlegmontosasebanyak 250 orang (34,6%), pada kelompok usia remaja akhir dengan rentang usia 41-50 tahun sebanyak212 orang (29,3%), dengan jenis kelamin laki-laki sebanyak 398 orang (54,9%), dan sebagian besardengan keluhan nyeri perut kanan bawah sebanyak 628 orang (86,9%). Kata Kunci: Apendisitis, pemeriksaan histopatologi, usia, jenis kelamin, gejala klinis, RSUP SanglahDenpasar

AKURASI SITOLOGI IMPRIN PADA TUMOR TULANG DI RSUP SANGLAH DENPASAR I Putu Gede Putra Darmawan; I Wayan Juli Sumadi; I Made Gotra; Ni Made Mahastuti
E-Jurnal Medika Udayana Vol 8 No 12 (2019): Vol 8 No 12 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Tumor tulang termasuk tumor dengan insiden yang relatif jarang namun memiliki angka mortalitas yang tinggi. Diagnosis tumor tulang umumnya menggunakan pemeriksaan histopatologi rutin namun memerlukan proses yang lama. Pemeriksaan sitologi imprin merupakan salah satu metode pemeriksaan yang cepat dan murah. Sitologi imprin telah dibuktikan memiliki akurasi yang tinggi dalam mendiagnosis berbagai jenis tumor. Penelitian ini bertujuan untuk mengetahui akurasi pemeriksaan sitologi imprin pada kasus tumor tulang. Jenis penelitian merupakan uji diagnostik untuk menganalisis tingkat akurasi pemeriksan sitologi imprin pada kasus tumor tulang, yang dilakukan core biopsy dan dari pemeriksaan potong beku di RSUP Sanglah Denpasar selama periode Januari 2013 hingga Agustus 2018. Menggunakan metode consecutive sampling dengan melakukan pencatatan nomor data sekuder yang berisi hasil diagnosis sitologi imprin dan histopatologi tumor tulang. Pada penelitian ini didapatkan 23 kasus tumor tulang yang memenuhi kriteria, yang terdiri dari 11 sampel frozen section dan 12 sampel core biopsy. Pemeriksaan sitologi imprint tersebut memiliki akurasi sebesar 91,3%, dengan sensitivitas 93,3%, spesifisitas 87,5%, nilai prediktif positif 93,3%, nilai prediktif negatif 87,5%, likehood ratio positif 7,4 dan likehood ratio negatif 0,07. Sehingga pemeriksaan sitologi imprin dari spesimen core biopsy dan pemeriksaan potong beku pada kasus tumor tulang dengan menggunakan pemeriksaan histopatologi rutin sebagai baku emas di RSUP Sanglah Denpasar memiliki akurasi yang tinggi. Kata Kunci : Akurasi, Sitologi Imprin, Tumor Tulang, RSUP Sanglah

Spinal Schwannoma as Pregnancy Related Spinal Tumor Kadek Dede Frisky Wiyanjana; Kevin Kristian Putra; Sri Maliawan; I Made Gotra
Neurologico Spinale Medico Chirurgico Vol 2 No 3 (2019)
Publisher : Indoscholar

Spinal schwannoma is the most common benign spinal tumors that originated from peripheral nerve sheath tumors. Male and females are equally affected. Due to hormonal imbalance during pregnancy, it might affect the release of the tumor-growth factor. The symptoms usually start with pain and sensory loss at the spinal cord level. We report a case of thoracolumbar schwannoma with a history of chronic low back pain since post-pregnancy. A Thirty-Seven years old female, suffered chronic low back pain for 3 years since she had a pregnancy. In the last 4 months, she suffered paresis and tingling sensation on the right foot. MRI shown intradural mass at Th 12 – L2. Biopsy, tumor resection, and laminectomy were performed to do the histopathology analysis, resect, and stabilization. Histopathology examination revealed Schwannoma types. The patient was discharged three days after complete tumor resection and stabilization, with an improvement of neurological function. Spinal Schwannoma can occur as a Pregnancy-related spinal tumor (PRST), it can be diagnosed during pregnancy or within a year after delivery. The incidence is rare, therefore proper workup and early examination are needed and followed by careful and considerate treatment.

Prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital Michelle Anne Anthonysamy; Luh Putu lin Indrayani Maker; I Made Gotra; Herman Saputra
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Colorectal carcinoma (CRC) is a disease in which epithelial cells in the colon or rectum become abnormal and divide without control, forming a mass called a tumor. Colorectal carcinoma is the fourth most frequent cancer in men after prostate and lung or bronchus cancers whereas in women is the third most frequent cancer after breast and lung or bronchus cancers. Colorectal cancer is a leading cause of cancer death worldwide, accounting for 693,900 deaths in 2012 and is the fourth most frequent cancer in men whereas in women is the third most frequent cancer. In Indonesia amount of rectal cancer were 1407 (5.67%) and 990 cases (3.99%) of colon cancer. Specifically in Denpasar, there are a total of 75 cases (7.11%) of rectal cancer and 38 cases (3.60%) of colon cancer in the year.Aim: This study aims to know the prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital in Denpasar from January 2014 to January 2016.Method: This study used descriptive retrospective research based on the secondary data from patients medical record which was taken at Sanglah General Hospital from January 2014 to January 2016. Population and sample amounted to 275 patients.Results: This study shows that the highest prevalence of colorectal carcinoma was in a group of age <50 years old with 86 samples (31.3%) and in a male with 163 samples (59.3%). Adenocarcinoma has the highest prevalence of colorectal carcinoma with 270 samples (98.2%). The rectum was the most frequent tumor location with 170 samples (61.8%). In adenocarcinoma, the age group with the highest prevalence of CRC was <50 years with 85 samples (30.9%). The highest prevalence of CRC based on anatomical location and age group was <50 years in the rectum with 57 samples (20.7%).Conclusion: Most of the CRC was found in age group < 50 years, men had a higher risk to get colorectal carcinoma, adenocarcinoma is the most common microscopic type, and rectum was the most common site of colorectal carcinoma.

Characteristic of thyroid carcinoma based on age, sex and histology type at Sanglah General Hospital, Bali, Indonesia, 2016 Kishan Arrumugam; Ni Putu Ekawati; I Made Gotra
Intisari Sains Medis Vol. 9 No. 3 (2018): (Available online: 1 December 2018)
Publisher : DiscoverSys Inc.

Background: Thyroid cancer is one of the most common malignancies in the endocrine system whereas the annual mortality rate is increasing each year in Indonesia. This study aims to determine characteristic of thyroid carcinoma based on age, sex, and histology type at Sanglah General Hospital, Bali, Indonesia, 2016.Methods: A cross-sectional study was carried out among 84 patients with thyroid carcinoma at Sanglah General Hospital during January-December 2016. Data were analyzed using secondary data from medical record based on age, sex, and histology type by SPSS ver. 16.Results: The highest prevalence of thyroid carcinoma based on age was found in the 50-54 years group (17.86%). Females were predominant that attributed to 73.8% compared with males (26.2%). In addition, papillary thyroid carcinoma has the highest prevalence in both sexes that is 75% among other types.Conclusion: A 50-54 years-age group, females, and papillary thyroid carcinoma types were predominant at Sanglah General Hospital in 2016.

Hubungan antara ekspresi Vascular Endothelial Growth Factor (VEGF) dengan karakteristik klinikopatologi osteosarkoma di RSUP Sanglah Denpasar, Bali Johanes Prasetyo Harjanto; I Wayan Juli Sumadi; I Made Gotra; Ni Putu Ekawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Osteosarcoma is the most common malignant primary bone tumor. Although osteosarcoma cases are relatively rare compare to carcinoma, the mortality rate is quite high. Osteosarcoma prognosis can be seen from conventional pathology and biological markers, such as Vascular Endothelial Growth Factor (VEGF). In various studies, the presence of VEGF expression has been associated with the worsening prognosis of osteosarcoma. This study aims to determine the relationship between VEGF expression and osteosarcoma's clinicopathological characteristics at Sanglah General Hospital, Denpasar, 2015-2019.Method: This research is a cross-sectional analytic study. The sampling technique used all affordable populations that were included in the inclusion criteria, with a total sample of 30 samples. The research data used secondary data obtained from the archive of histopathological examination reports at the Anatomical Pathology Laboratory at Sanglah General Hospital and paraffin blocks from all available samples for immunohistochemical examination. Data were analyzed using SPSS version 22 for Windows.Results: The clinicopathological characteristics of the osteosarcoma studied were age, tumor location, histological type, and grading. Patients with osteosarcoma in this study were predominantly found in the age group <20 years (66.67%), femur locations (60.00%), mixed type osteosarcoma (53.33%), and high grade (100.00%). A total of 26 samples (86.67%) had high VEGF expression and 4 samples had low VEGF expression (13.30%). There was no significant relationship between age (p=0.241), location of the tumor (p=0.739), and histological type (p=1.000) to the VEGF expression.Conclusion: The relation between each osteosarcoma clinicopathological characteristic associated with VEGF expression showed insignificant results in age, location, and histological type. Further research is needed with a more significant number of samples to get better results. Latar Belakang: Osteosarkoma adalah tumor tulang primer ganas yang paling umum. Meskipun kasus osteosarkoma relatif jarang dibandingkan dengan karsinoma, angka kematiannya cukup tinggi. Prognosis osteosarkoma dapat dilihat dari patologi konvensional dan penanda biologis, salah satunya adalah Vascular Endothelial Growth Factor (VEGF). Dalam berbagai penelitian, kehadiran ekspresi VEGF telah dikaitkan dengan prognosis yang memburuk dari osteosarcoma. Penelitian ini bertujuan untuk mengetahui hubungan ekspresi VEGF dengan karakteristik klinikopatologi osteosarkoma di RSUP Sanglah Denpasar tahun 2015-2019.Metode: Penelitian ini merupakan penelitian analitik potong lintang. Teknik pengambilan sampel menggunakan semua populasi terjangkau yang termasuk dalam kriteria inklusi, dengan jumlah sampel sebanyak 30 sampel. Data penelitian menggunakan data sekunder yang diperoleh dari arsip laporan pemeriksaan histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah dan blok parafin dari semua sampel yang tersedia untuk pemeriksaan imunohistokimia. Data dianalisis dengan SPSS versi 22 untuk Windows.Hasil: Karakteristik klinikopatologi dari osteosarkoma yang diteliti adalah usia, lokasi tumor, tipe histologis, dan grading. Penderita osteosarkoma pada penelitian ini paling banyak ditemukan pada kelompok usia <20 tahun (66,67%), lokasi femur (60%), tipe campuran osteosarkoma (53,33%) dan High-Grade (100.00%). Sebanyak 26 sampel (86,67%) memiliki ekspresi VEGF tinggi dan 4 sampel memiliki ekspresi VEGF rendah (13,30%). Tidak terdapat hubungan yang bermakna antara usia (p=0,241), lokasi (p=0,739), dan tipe histologis (p=1,000).Kesimpulan: Hubungan antara masing-masing karakteristik klinikopatologi osteosarkoma yang terkait dengan ekspresi VEGF menunjukkan hasil yang tidak bermakna pada usia, lokasi, dan tipe histologis. Diperlukan penelitian lebih lanjut dengan jumlah sampel yang lebih banyak untuk mendapatkan hasil yang lebih baik.

HUBUNGAN ANTARA EKSPRESI EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) DENGAN P-STAGE PADA ADENOKARSINOMA KOLOREKTAL TIPE TIDAK SPESIFIK DI RSUP SANGLAH DENPASAR Diahningrum, Sylvi; Sri Mahendra Dewi, I Gusti Ayu; Sriwidyani, Ni Putu; Gotra, I Made; Winarti, Ni Wayan; Muliarta, I Made
E-Jurnal Medika Udayana Vol 11 No 7 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i7.P05

ABSTRAKEGFR memegang peranan penting dalam progresifitas dari KKR. P-Stage merupakan faktor prognosis independen pada KKR. Tujuan penelitian ini adalah untuk membuktikan adanya hubungan ekspresi EGFR dengan P-Stage pada karsinoma kolorektal tipe tidak spesifik di RSUP Sanglah Denpasar. Penelitian ini merupakan cross-sectional study, observasional analitik potong lintang. Sampel adalah penderita adenokarsinoma kolorektal tipe tidak spesifik yang telah dilakukan operasi dan pemeriksaan histopatologi di Laboratorium Patologi Anatomik RSUP Sanglah, Denpasar yang memenuhi kriteria inklusi dan eksklusi yang ditetapkan peneliti dengan besar sampel 46 pasien. P-Stage adalah sistem pengelompokan pasien yang dibuat berdasarkan penggabungan nilai dari 3 faktor prognosis yaitu umur pasien, derajat diferensiasi dan ukuran tumor, dikelompokkan menjadi P0 dan P1. Hasil penelitian dianalisis dengan analisis Chi square menganalisis hubungan antara ekspresi EGFR dengan P-Stage pada adenokarsinoma kolorektal tipe tidak spesifik di RSUP Sanglah Denpasar. Analisis uji rasio risiko prevalensi untuk mengetahui rasio risiko prevalensi dari ekspresi EGFR dengan P-stage. Nilai kemaknaan ditetapkan pada p<0,05. Hasil penelitian menunjukkan rentang usia 81 tahun, median 61,5 tahun dan rerata usia 61,98±9,824 tahun, kasus terbanyak pT3 (80,4%), derajat diferensiasi sedang (71,7%), lokasi tumor di kiri (45,7%), laki-laki (67,4%), P0 (67,4%) dan ekspresi EGFR positif (69,6%). Dari analisis chi-square didapatkan hubungan yang signifikan secara statistik antara ekspresi EGFR dengan P-Stage (p= 0,036). Pada analisis estimasi risiko didapatkan adenokarsinoma kolorektal tipe tidak spesifik yang memiliki ekspresi EGFR positif memiliki risiko 10 kali lebih besar ditemukan dengan P-stage P1 dibandingkan dengan kasus ekspresi EGFR negatif (IK 95% 1,177-86,846).Kata kunci: Adenokarsinoma kolorektal, Ekspresi EGFR, P-Stage, Faktor Prognostik

Extragastrointestinal Stromal Tumor (EGIST) in 59 Years Old Male: A Rare Case Report Mahendra Dewi, I Gusti Ayu Sri; Ekawati, Ni Putu; Gotra, I Made; Krisnuhoni, Ening; Paskarani, Putu Erika; Hutapea, Yuliance Nurhawati
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1237

Introduction: GISTs usually occur in older adults with a median age of about 60–65 years. The incidence rate between men and women is equal (1:1). The most common location of GISTs is the stomach which accounts for 60%, followed by the jejunum and ileum around 30%, duodenum 5%, and colorectal 5% and a small percentage of cases occur in the esophagus, appendix, gallbladder, and extraintestinal areas such as the mesentery, omentum, and retroperitoneum. Case Presentation: A 59-year-old male, suffered from a lump under the umbilicus 3 months before admission to the hospital. The results of the ultrasound examination showed a mass in the superior area of the bladder, and the mass did not appear to infiltrate the intestines, bladder, umbilicus, and surrounding organs. The biopsy tissues showed spindles and round-to-oval morphology with eosinophilic cytoplasm. Mitoses 65/50 High Power Field In addition, immunohistochemistry examination showed positive stains in DOG 1, CD117, SMA, CD 34, and negative for S100.Conclusion: Extragastrointestinal stromal tumor is a rare tumor. Based on, clinical, imaging, histopathological, and immunohistochemical examination, this case was diagnosed as an extragastrointestinal stromal tumor, spindle cell type.

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