Ening Krisnuhoni
Department Of Anatomic Pathology, Faculty Of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

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Diagnostic Findings of Sclerosing Mesenteritis and the Disease Correlations with Caecal Adenocarcinoma Rabbinu Rangga Pribadi; Murdani Abdullah; Rizka Puteri Iskandar; Velma Herwanto; Okto Dewantoro; I Wayan Murna Yonathan; Arman Adel Abdullah; Ening Krisnuhoni; Diah Rini Handjari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, AUGUST 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1245.218 KB) | DOI: 10.24871/1822017122-125

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Sclerosing mesenteritis (SM) is a rare disease with non-specific clinical manifestations and should be supported by radiological examination and confirmed by histopathological evaluation. Its relationship with cancer especially caecal adenocarcinoma is still unclear. This case report describes a young man who was diagnosed as having SM and poorly-differentiated caecal adenocarcinoma.
Correlation between Carcinoma Percentage (CP) and Lymphatic Microvessel Density (LMVD) Based on D2-30/Podoplanin as Metastatic Prognostic Factor to Lymph Nodes in not Otherwise Specified (NOS) Colorectal Adenocarcinoma Elisabeth Indria Sari; Ening Krisnuhoni; Puspita Eka Wuyung
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 1 (2017): VOLUME 18, NUMBER 1, April 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2429.936 KB) | DOI: 10.24871/18120172-8

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Background: In colorectal carcinoma (CRC), myofibroblast are the main component cells in tumour stroma which have an important role in the metastases process. The precentage between carcinoma and desmoplastic stroma known as carcinoma percentage (CP), can be used as an independent predictor metastases. D2-40/Podoplanin (PDPN) known as a spesific marker for lymphatic endothelial cell (LEC), which used to assess lymphatic microvessel density (LMVD) and lymphatic vessel invasion (LVI). This study aims to determine correlation and association between CP, LMVD and LVI with the metastases process to lymph node (LN).Method: CP assessment conducted on 44 samples of adenocarcinoma not otherwise specified (NOS) colorectal were divided into 22 cases with CP-High and 22 cases with CP-Low and examination D2-40/Podoplanin to assess LMVD and LVI. The statistical test is performed to find the correlation between CP and LMVD, as well as the relationship between CP, LVI and metastasis KGB.Results: There were a strong correlation between CP and LMVD intratumoral and peritumoral area with the negative correlation. There were a significant association (p=0,00) between LMVD (intratumoral and peritumoral area) with the LVI. There was a significant association between LVI and lymph node metastases (p = 0,03). Intratumoral area showed significant association with lymph node metastases (p = 0,04), whereas peritumoral area showed no significant association (p = 0,17).Conclusion: CP examination in histopathology specimen can be used to predict high/low rate of tumour cells metastases to the lymph node, based on a strong correlation between CP and LMVD.
Enterochromaffin-like (ECL) cells Hyperplasia in Fundic Gland Polyp and Its Association with the Usage of Proton Pump Inhibitors Ening Krisnuhoni; Fili Sufangga; Diah Rini Handjari; Nur Rahadiani; Marini Stephanie
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3453.97 KB) | DOI: 10.24871/2232021188-195

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Clinical Manifestation and Diagnosis of Cryptosporidiosis in Adult Infected with HIV Nunung Ainur Rahmah; Ening Krisnuhoni; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 3, December 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/43200396-99

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Cryptosporidiosis is a rare infection caused by a coccidian parasite, Cryptosporidium, which could cause diarrhea in humans, especially those who are immunocompromised Cryptosporidiosis could cause self- limited diarrhea infection in immunocompetent hosts, but in immunocompromised hosts, especially those with AIDS, the diarrhea can be chronic and severe. To date, no known effective therapeutic agents have been identified. The following is one case report of cryptosporidiosis of a 27 year-old male admitted with chronic diarrhea since 2 months. Endoscopy of the ileum and colon showed hyperemia, erosion and edema, and biopsy was performed. Histopathological examination of ileum showed an atrophic villous and atypical degeneration. There was a number of circular cryptosporidium lining up along the surface of epithelium. There was inflammatory cell infiltration, consisting of lymphocytes, eosinophils and a few neutrophils in the lamina propria. Serological examination revealed an HIV-positive result. Keywords: Cryptosporidiosis, HIV, diarrhea
A 17-Years Old Man of Colitis Tuberculosis with Fistula Perianal Paulus Kusnanto; Marcellus Simadibrata; Ari Fahrial Syam; Achmad Fauzi; Murdani Abdullah; Dadang Makmun; Chudahman Manan; Daldiyono Daldiyono; Abdul Aziz Rani; Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/932008103-106

Abstract

Tuberculosis (TB) remains to be one of the most common problems in developing countries such as Indonesia. It can involve many organs including gastrointestinal tracts. Colonic tuberculosis is an ancient disease and has long been recognized. However, it is sometimes difficult to make early diagnosis due to its nonspecific signs and symptoms. Perianal granulomas or perianal fistula presents some degree of diagnostic difficulty. A spectrum of diseases can produce granulomas in perianal region and perineum. Most are infectious or inflammatory diseases. Standard histological diagnosis often less significant to clarify the etiology and treatment will vary from one to another disease entity. In this report, we present a case 17-years old man with colitis TB and fistula perianal, in which the initial diagnostic workup suggested Crohn’s disease. Mantoux test, Acid Fast Bacilli test on fecal examination and polymerase chain reaction analysis revealed negative result. The chest X-ray was normal; while the fistulography X-ray: revealed 2 orifices in rectosigmoid area. The colonoscopy revealed mucosa edema with ulceration in rectosigmoid and pedincular polyp in the caecum. Initial colonoscopy diagnosis was Crohn’s disease with differential diagnosis colitis ulcerative, colitis TB, colitis infection. results of direct or post homogenizes examination (Ziel–Nielsen staining) revealed that no acid-fast bacilli was found. Multiple biopsies were done, which indicated  mucosa edema with ulceration in rectosigmoid area, pedincular polyp in the caecum, and surrounded by fistula perianal; while histopathological examination showed inflammatory-caseating-epithelioid-granulomas and giant cells (Langhans datia cell) caused by tuberculosis. It highlights the need for awareness of intestinal TB along with the differential diagnosis of chronic intestinal disease. Standard regimen of antituberculosis treatment was given and the patient showed good clinical response. Keywords: Crohn’s disease, caseating epithelioid granuloma, giant cell, colitis TB, perianal fistula
Cytokeratin 7 and Cytokeratin 19 Expressions in Oval Cells and Mature Cholangiocytes as Diagnostic and Prognostic Factors of Cholestasis Dyonesia Ary Harjanti; Ening Krisnuhoni; Santoso Cornain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/121201128-33

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Background: The activity of liver progenitor cells as bipotent liver stem cells, such as the oval cells, has been observed. The presence of oval cells and mature cholangiocytes forming hepatobiliary ductules may be applied to distinguish extrahepatic and intrahepatic cholestasis of the infants. Method: This cross sectional study was performed on 40 paraffin-embedded sections consisting of 2 groups of 20 cases with extrahepatic and intrahepatic cholestasis of the infants from histophatological examination in Cipto Mangunkusumo hospital Jakarta between January 2000 and September 2011. The liver fibrosis grading was reevaluated by hematoxylin and eosin and also trichrome staining. The specimens were tested by immunohistochemical staining for cytokeratin (CK) 7 and CK 19 expressions in oval cells and mature cholangiocytes. The correlation between CK7/CK19 expressions in oval cells and liver fibrosis were analyzed by Spearman’s correlation test. Results: Expressions of CK7 and CK 19 on oval cells and mature cholangiocytes performed in hepatobiliary ductules, were significantly higher in extrahepatic than intrahepatic cholestasis with p 0.05. CK7 and CK19 expressions in oval cells showed strong correlation with the degree of liver fibrosis with r = 0.793; p 0.05 for CK 7 and r = 0.827; p 0.05 for CK 19. Conclusion: Expressions of CK7 and CK19, in oval cells and mature cholangiocytes, were higher at extrahepatic than intrahepatic cholestasis. Expressions of CK7 and CK19 in oval cells were directly proportional to the degree of liver fibrosis in cholestasis of the infants.   Keywords: cholestasis, oval cell, cholangiocytes, fibrosis, CK7, CK19
Clinicomorphological Profile of Gastric Polyps in Anatomical Pathology Department, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital (CMH): A Retrospective Study in Correlation of Long-Term Use of Proton-Pump Inhibitors Fili Sufangga; Nur Rahadiani; Ening Krisnuhoni; Diah Rini Handjari; Marini Stephanie
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 1 (2019): VOLUME 20, NUMBER 1, April 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (297.335 KB) | DOI: 10.24871/201201911-16

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Background: Gastric polyps are mucosal elevation into the lumen, found incidentally during endoscopic examination and generally brings no specific symptoms. Long-term use of proton-pump inhibitors (PPIs) is related to the development of the fundic gland polyp (FGP). This retrospective study was conducted to determine the distribution of gastric polyps in CiptoMangunkusumo Hospital along with histomorphological features and their relation with long-term PPI use.Method: This retrospective review is a descriptive analytic study. Gastric polyp cases were taken consecutively from the archive of the Anatomical Pathology Department, Faculty of Medicine Universitas Indonesia/CiptoMangunkusumo Hospital the period of 2016-2017. Clinical data obtained from patient’s medical records. Statistical analysis was carried out with the IBM ® SPSS version 23 program.Results: Among 83 cases of gastric polyps, there were 66 cases of FGP, 11 cases of inflammatory polyps, 5 cases of hyperplastic polyps, and 1 case of Peutz-Jegher polyp. Long term PPI was used in 40 cases and was related with parietal cell hyperplasia.Conclusion: FGP is the most common type of gastric polyp in the Department of Anatomical Pathology CMH. Long term PPI use was found in half of gastric polyps and was related to parietal cell hyperplasia morphology.
Colorectal Cancer Metastasis of and the Risk Factors Ahmad Soefyani; Abdul Aziz Rani; Marcellus Simadibrata; Murdani Abdullah; Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/11120107-10

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Background: Colorectal cancer (CRC) is the fourth most prevalent cancer in the world and is positioned the second most common cancer in the United States. Patients with CRC in Indonesia showed a greater proportion. In Jakarta, 47.85% of CRC cases occur under the age of 45 years. The purpose of this study is to determine metastasis and the factors that influence colorectal cancer patients. Method: This study was conducted retrospectively from January 2003-December 2007 in Cipto Mangunkusumo hospital. Patients are eligible if they underwent colonoscopy, tumor biopsy, anatomical pathology, abdominal CT scan, abdominal ultrasonography, and radiology procedures. Result: Of all 1,615 patients who underwent colonoscopy procedure, 377 patients were diagnosed with colorectal cancer. Subject that met the criteria consist of 86 patients, where 56 (65.1%) male. Most aged 51-60 years old (26.7%), mean age 47.90 ± 14.53 years old. The tumor is most commonly located in the rectum and sigmoid 40 (46.5%), in which 18 (45%) among them had metastasized. Compared with male patients, female patients experienced more metastases, but not statistically significant. Among the patients with metastasized CRC, 42.3% of them 40 years old, 37.2% patients 41-60 years old, and 29.4% patients 60 years old. Well-differentiated CRC produce larger number of metastatic cases than poorly-differentiated CRC. Poorly-differentiated CRC tend to produce adjacent metastasis, and also happened in relatively young age in compared with well-differentiated cancer. Conclusion: There was significant correlation between younger age group with a poor degree of histopathologic differentiation. Patients with CRC consist of more male patients than female ones. Factors sex, age group, histopathologic subtypes, and tumor location was not associated with metastasis. Keywords: colorectal cancer, metastasis, well-differentiated, poorly-differentiated
Chronic Diarrhea Due to Intestinal Amyloidosis Lydia D Simatupang; Kharia Utia; Ari Fahrial Syam; Marcellus Simadibrata; Arya Govinda; Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 3, December 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/63200591-94

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Amyloidosis is a rare disease, when diagnosed it’s incurable and mostly affect over 40 years old male. Diagnostic is confirmed if histopathologic stained positive with Congo red and evidence of monoclonal protein. Survivals for untreated patients are 13 months in primary amyloidosis but if secondary to other chronic disease and systemic, survival could be 3-4 years. It can not be prevented but when affected, control of the underlying illness can prevent progression of amyloidosis. We report a rare case of a 67 year old male, who came with chronic diarrhea. The stool analysis, there were no negative gram microorganisme found, only food maldigestion and fungus infection. Stool analyze from parasitology department were found microspore, but the stool culture were sterile. The patient underwent colonoscopy which revealed hyperemis mucosa in rectum, sigmoid, descending transverse colon. From the biopsy was concluded intestinal amyloidosis. We treated the patient symptomatically and couldn’t find the underlying inflammatory disease which causes the problem. Keywords:  secondary  amyloidosis,  chronic  diarrhea, malabsorption,  colonoscopy,  protein electrophoresis
Correlation of Carcinoma Percentage (CP) in Colorectal Adenocarcinoma with Several Clinical Pathological Aspects in Anatomical Pathology Department Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital Jakarta in Year 2012-2013 Elisabeth Indria Sari; Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, AUGUST 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1120.983 KB) | DOI: 10.24871/182201786-93

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Background: Colorectal carcinoma is malignant tumour of the large intestinal epithelial, where more than 90% of colorectal carcinoma is adenocarcinoma. Desmoplastic stroma in primary tumour holds an important role in tumour development process. Mesker et al described carcinoma percentage (CP) evaluation in routine preparations with Haematoxylin-eosin (HE) staining as one of the prognostic factors.Method: This retrospective study was performed by collecting forms and slides of colorectal carcinoma resection cases from the archives of Anatomical Pathology Department FMUI-CMGNH in 2 years period (2012-2013). Collection of clinical data and re-evaluation of HE slides by 2 people which were the writer and supervisor were performed to determine CP value by observing the comparison between tumour percentage and desmoplastic stroma.Results: We included 92 cases of colorectal adenocarcinoma within those 2 years period (2012-2013). Comparison of total cases between male and female was 3:2, age 40 years old were the most commonly found; in regard to location in the colon, most were found in the left side compared to the right side of the colon with the ratio of 3:7. Tumour histological grading with good differentiation were the most commonly found and most pT value being found were pT3; most lymph node involvement was N1. The most CP value attained in every parameter was CP-Low.Conclusion: Carcinoma percentage (CP) which was divided as CP-High and CP-Low could be used as a prognostic factor. In this study, we found more cases of CP-Low compared to CP-High, either based on sex, age, location, degree of differentiation, pT value, or even lymph node involvement. CP-Low which showed worse prognosis could also be used as a marker of patients who were at higher risk of colorectal carcinoma.
Co-Authors Abdul Aziz Rani Abdul Aziz Rani Abdullah, Arman Adel ACHMAD FAUZI Achmad Fauzi Adang Bachtiar Agustina, Yohana Alfa Ahmad Aulia Jusuf Ahmad Soefyani Alan R. Tumbelaka Alif Gilang Perkasa Ari Fahrial Syam Arman Adel Abdullah Aru W. Sudoyo Ary H. Reksodiputro Arya Govinda Badriul Hegar Bethy Hernowo Chudahman Manan Chudahman Manan Chyntia Olivia Maurine Dadang Makmun Dadang Makmun Daldiyono Daldiyono Daldiyono Daldiyono Daldiyono Hardjodisastro Darmawan Kartono David Handojo Muljono Devy Serevina Dewantoro, Okto Dhuhani, Ika Diah Rini Handjari Diah Rini Handjari Diah Rini Handjari Diah Rini Handjari Diah Rini Handjari Dyonesia Ary Harjanti Eka Susanto Elisabeth Indria Sari Elisabeth Indria Sari Erni Erfan, Erni Esti DS Soetrisno Farida Briani Sobri Fili Sufangga Flora Dameria Handayani, Liza Handjari, Diah R. Hanifah Oswari Hutapea, Yuliance Nurhawati I Gusti Ayu Sri Mahendra Dewi I Made Gotra Iamaroon, Anak Ifransyah Fuadi Ifransyah Fuadi, Ifransyah Indriasti Indah Wardhany Irsan Hasan Irwina Eka Deraya Iskandar, Rizka Puteri Jelita Inayah Sari Juwita Cresti Rahmaania Kaka Renaldi Kharia Utia Kuntjoro Harimurti Kusmardi Kusmardi Kusmardi Kusmardi Kusmardi Suid Lia Mulyani Liem, Isabella Kurnia Liza Handayani Lugyanti Sukrisman Lydia D Simatupang Lydia Kencana Manatar, Amelia Fossetta Marcellus Simadibrata Marcellus Simadibrata Marini Stephanie Marini Stephanie Marini Stephanie Marini Stephanie Murdani Abdullah Murdani Abdullah Murdani Abdullah Nafrialdi Nafrialdi Nelly Tandiari Ni Putu Ekawati Nita Afriani Nunung Ainur Rahmah Nur Rahadiani Nur Rahadiani Nur Rahadiani Nur Rahadiani Nurdin, Wildawati Nurjati C Siregar Okto Dewantoro Paskarani, Putu Erika Patria Wardana Yuswar Paulus Kusnanto Permata Warastridewi, Arie Primariadewi Rustamadji Prisscila, Jessica Puspita Eka Wuyung Puspita Eka Wuyung Puspita Eka Wuyung Rabbinu Rangga Pribadi Rahadiani, Nur Rahmaania, Juwita Cresti Reni Oktavina Ria Kodariah Ria Kodariah Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rizka Puteri Iskandar Santoso Cornain Santoso Cornain Sari, Elisabeth Indria Saut Horas Hatoguan Nababan Seruni Tyas Khairunissa Sobri, Farida Briani Sonar Soni Panigoro Sufangga, Fili Tandiari, Nelly Velma Herwanto Velma Herwanto Vera Yuwono Welly Hartono Ruslim Wildawati Nurdin Wirasmi Marwoto Wirasmi Marwoto Wiwit Ade Fidiawati Yonathan, I Wayan Murna Yuniardini Septorini Wimardhani Yuswar, Patria Wardana Zakiyah Zakiyah