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Eddy H. Tambajong
Fakultas Kedokteran Universitas Sam Ratulangi Manado

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DEDIFFERENTIATED LIPOSARCOMA PAYUDARA (LAPORAN KASUS) Lintong, Poppy M.; Tambajong, Eddy H.
Jurnal Biomedik : JBM Vol 3, No 3 (2011): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.3.3.2011.877

Abstract

Abstrak: Liposarkoma primer pada payudara termasuk salah satu tumor payudara yang sa-ngat jarang, insidennya kurang dari 1% dari semua tumor ganas payudara. Umumnya liposarkoma pada payudara jarang atau tidak menyebar ke kelenjar getah bening aksila. Gambaran histologik liposarkoma pada payudara sama dengan liposarkoma di ekstrimitas atau tubuh. Suatu liposarkoma yang sejati pada payudara ditegakkan bilamana gambaran cystosarcoma phyllodes tidak ditemukan dalam potongan-potongan  jaringan tumor. Satu kasus dilaporkan pada seorang wanita usia 49 tahun dengan tumor payudara besar. Gambaran Dedifferentiated Liposarcoma secara makroskopik menunjukkan massa multinoduler besar, warnanya bervariasi dari kuning, kuning kecoklatan bercampur coklat keabu-abuan. Mikroskopik terdiri dari 2 komponen yaitu lipogenik, menunjukkan gambaran  liposarkoma diferensiasi baik; dan nonlipogenik (dedifferentiated). Daerah dedifferentiated menunjukkan gambaran fibrosarkoma, malignant fibrous histiocytoma, dan liposarkoma miksoid. Daerah yang menyerupai malignant fibrous histiocytoma menunjukkan gambaran sitologik pleo-morfisme, arsitektur storiform, dan sel-sel datia. Fokus-fokus  liposarkoma miksoid telah dibuat pulasan dengan Alcian blue hasilnya positip. Kata kunci: dedifferentiated liposarcoma,  payudara.     Abstract: Primary liposarcoma of the breast belongs to very rarely found breast tumors, hav-ing an incidence of less than 1% of all malignant breast tumors. In general, this liposarcoma rarely or does not spread to axillar lymph nodes. Histopathologically, liposarcoma of the breast is similar to liposarcoma in extremities and other parts of the body. A true liposarcoma of the breast is diagnosed if there is no cystosarcoma phyllodes in the tumor tissues. We re-ported a 49-year-old female with a huge breast tumor (21x18x15cm), associated  with four lymph nodes in the ipsilateral axilla.  Histopathological examination of the tumor tissues showed a dedifferentiated liposarcoma, and of the four lymph nodes, as well as reactive hyperplasia with no metastase. Macroscopically, this dedifferentiated liposarcoma, appeared as large multinodular masses ranging in color from yellow to yellow-tan admixed with firm tan-gray areas. Microscopically, it consisted of two components: lipogenic, a well differen-tiated liposarcoma; and nonlipogenic, dedifferentiated one. These dedifferentiated areas showed a fibrosarcoma, malignant fibrous histiocytoma, and mixoid liposarcoma. Areas of malignant fibrous histiocytoma looked  cytologic pleomorphisme, storiform architecture, and multinucleate cells. Foci of mixoid liposarcoma were stained with Alcian blue, and showed positive results. Key words: dedifferentiated liposarcoma, breast.
PANKREAS EKTOPIK DI SUBMUKOSA ILEUM PADA PENDERITA ADENOKARSINOMA KOLON Lintong, Poppy M.; Tambajong, Eddy H.
JURNAL BIOMEDIK : JBM Vol 3, No 2 (2011): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.3.2.2011.869

Abstract

Abstract: Ectopic pancreatic tissue is a rarely found congenital anomaly. In routine autopsies, it has been found at about 2%. In this case, ectopic pancreatic tissues are found in the stomach, duodenum, jejunum, appendix, Meckel diverticulum, and more rarely in the ileum. Ectopic pancreas is mostly asymptomatic and occasionally found without any pre-operative suspicion. Microscopically, this ectopic tissue mostly consists of acini and gland ducts; albeit Langerhans islets were found in 1/3 of the cases. We reported a 57-year-old male, with a pain in the abdomen and an intestinal obstruction due to a sigmoid tumor. In laparatomy, there was a tumor mass in the sigmoid colon and a nodule (diameter 1.5 cm) in the submucosal layer of the ileum. In the histopathological examination, we identified that these ileum nodal tissues contained acini and pancreatic gland ducts, and the tumor mass of the sigmoid colon showed a papillary adenocarcinoma. At first, this submucosal nodule was diagnosed as a carcinoid tumor, but based on the immunohistochemical examination at the Diagnostic Centre of the Pathology Department, University of Indonesia, the nodule tissue, stained with chromogranin, showed a negative result. It means that the diagnosis of a carcinoid tumor was eliminated. Key words: exocrine glands, pancreatic gland ducts, submucosal layer of ileum.   Abstrak: Jaringan pankreas ektopik merupakan kelainan kongenital dan jarang ditemukan. Insidennya sekitar 2 % dari pemeriksaan otopsi rutin. Tempat tersering ditemukan pankreas ektopik  yaitu pada  lambung, duodenum, jejunum, apendiks, divertikulum Meckel, dan lebih jarang pada ileum. Pankreas ektopik sering asimtomatik, kadang ditemukan dan tanpa kecurigaan pada saat preoperatif. Gambaran mikroskopik jaringan pankreas ektopik umumnya terdiri dari asinus dan duktus kelenjar, sedangkan pulau-pulau Langerhans hanya ditemukan pada 1/3 kasus. Kami melaporkan kasus seorang laki-laki berusia 57 tahun dengan gejala nyeri perut dan obstruksi usus yang disebabkan tumor kolon sigmoid. Pada saat laparatomi, selain massa tumor pada kolon sigmoid juga ditemukan nodul berdiameter 1,5 cm pada submukosa ileum. Pada pemeriksaan histopatologi,   jaringan dari nodul submukosa ileum menunjukkan asinus-asinus dan duktus duktus kelenjar pankreas di antara stroma submukosa ileum, sedangkan massa tumor pada kolon sigmoid menunjukkan  adenokarsinoma papiler. Pada awalnya nodul submukosa pada ileum dibuat diagnosis sebagai carcinoid tumor, namun berdasarkan  pemeriksaan imunohistokimia  di Sentra Diagnostik Departement Patologi Anatomik FK UI yang memberi hasil pulasan kromogranin negatif, maka diagnosis carcinoid tumor telah disingkirkan. Kata kunci: kelenjar eksokrin, duktus kelenjar pankreas, lapisan submukosa ileum.