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Tinjauan Literatur: KORIOKARSINOMA GESTASIONAL: ETIOPATOGENESIS, MANIFESTASI KLINIS RADIOLOGIS, SERTA TEMUAN MAKROSKOPIK DAN MIKROSKOPIK Rahmadiani, Nayla; Retnani, Diah Prabawati; Fadli, Muhammad Luqman
Majalah Kesehatan Vol. 11 No. 3 (2024): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2024.011.03.8

Abstract

Koriokarsinoma gestasional merupakan tumor ganas yang berasal dari komponen sinsitiotrofoblas, trofoblas intermediate, dan sitotrofoblas, yang kejadiannya terkait dengan kehamilan. Koriokarsinoma merupakan jenis neoplasma trofoblastik gestasional tersering, dengan insiden yang tinggi di negara-negara Asia Tenggara. Entitas ini penting untuk didiagnosis dan diterapi dengan tepat, karena ditemukan adanya metastasis pada lebih dari 50% kasus yang tidak tertangani. Pada kajian literatur ini, akan dibahas mengenai aspek diagnosis patologis menurut literatur-literatur terbaru. Secara klinis, gejala dan tanda yang dapat ditemukan antara lain perdarahan pervaginam dengan cairan tampak berwarna kecoklatan bercampur darah, serta kadar hCG serum dan urin yang sangat tinggi. Kriteria diagnosis patologisnya menurut WHO yakni adanya pola bifasik khas, dengan sitotrofoblas villous mononuklear dan trofoblas intermediate yang dikelilingi oleh sinsitiotrofoblas berinti banyak yang ganas. Imunohistokimia dapat membantu pada kasus di mana pola klasik tidak terlalu nampak, dan pemeriksaan genotip dapat dilakukan bila tersedia.
PROFIL KLINIKOPATOLOGI KARSINOMA SEL BASAL DI RSUD DR. SAIFUL ANWAR MALANG TAHUN 2016-2021 Retnani, Diah Prabawati; Anugrah Putri, Deka Miftalia; Putri, Berlian Anggraeni
Majalah Kesehatan Vol. 11 No. 3 (2024): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2024.011.03.4

Abstract

Karsinoma sel basal (KSB) merupakan karsinoma keratinosit dengan insiden tertinggi, terutama pada populasi kulit putih. Insiden karsinoma jenis ini meningkat setiap tahun. Penelitian epidemiologi tentang profil klinikopatologi kasus KSB di RSUD dr. Saiful Anwar Malang belum pernah dilakukan. Tujuan penelitian ini adalah untuk mengetahui profil klinikopatologi kasus KSB di RSUD dr. Saiful Anwar Malang periode tahun 2016 sampai dengan tahun 2021. Penelitian ini merupakan penelitian deskriptif untuk mengetahui jumlah kasus KSB di RSUD dr. Saiful Anwar selama tahun 2016 sampai dengan tahun 2021. Data diperoleh dari rekam medis biopsi spesimen dari Instalasi Patologi Anatomi RSUD dr. Saiful Anwar Malang. Data biopsi spesimen tersebut meliputi jenis kelamin, usia, lokasi, dan tipe histopatologi serta tingkat rekurensi yang dibagi menjadi rendah dan tinggi. Terdapat 66 kasus biopsi kulit yang terdiri dari 35 laki-laki dan 31 perempuan. Rentang usia yang memiliki kejadian KSB tertinggi adalah antara usia 61-70 tahun. Area predileksi kanker yang paling banyak adalah hidung. Tipe histopatologi terbanyak yang ditemukan pada kelompok dengan angka rekurensi rendah adalah tipe nodular, dan pada kelompok dengan angka rekurensi tinggi adalah tipe basosquamous.
Prototipe Lung Tumor e-mannequin untuk Pelatihan Keterampilan Fine Needle Aspiration Biopsy Retnani, Diah Prabawati; Anita, Kenty Wantri; Sulistyarini, Dwi Hadi; Barasabha, Thareq; Nurasih, Amelinda Natania; Putra Yudha, Muhammad Agung; Diputra, Ariyanta Dafa; Christiawan Purba, Andreas Putra
Medika Teknika : Jurnal Teknik Elektromedik Indonesia Vol. 5 No. 2 (2024): April
Publisher : Universitas Muhammadiyah Yogyakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mt.v5i2.21582

Abstract

Kanker paru merupakan penyebab kematian nomer 2 setelah kanker payudara dengan insiden 11,4% dari penyakit keganasan. Pengambilan spesimen untuk menegakkan diagnosis kanker paru oleh dokter spesialis Patologi Anatomik dapat dilakukan melalui prosedur Fine Needle Aspiration Biopsy (FNAB) menggunakan jarum halus melalui tuntunan imaging dari USG atau CT scan. Berbasis integrasi teknologi 3D Printer dengan manekin berbasis elektronik peneliti melakukan penelitian eksperimental dengan tujuan membuat e-mannequin yang  dilengkapi dengan tumor  paru untuk pelatihan keterampilan prosedur FNAB oleh  mahasiswa Pendidikan Dokter Spesialis Patologi Anatomik sebelum melakukan tindakan pada pasien. Pembuatan e-mannequin menggunakan bahan filamen,  tumor berbahan Thermoplastic Polyurethane (TPU) diletakkan pada  lokasi paru kiri dan kanan dengan konsistensi kenyal yang dapat dimasukkan jarum halus dan dipasang  sensor lampu sebagai validator ketepatan tindakan FNAB pada tumor paru.
Mohs Micrographic Surgery for Morpheaform Type Basal Cell Carcinoma: A Case Report Larasaty, Nanda Shaskia; Widiatmoko, Arif; Retnani, Diah Prabawati
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.03.9

Abstract

Morpheaform basal cell carcinoma (BCC) is an infiltrative and destructive type of BCC with a high recurrence, necessitating effective and minimally invasive management. Mohs Micrographic Surgery (MMS) is a treatment option for BCC with high conservation results of the entire tumor wall with minimal removal of surrounding healthy tissue, and the lowest recurrence rate compared to other treatment options.  In this study, we report a 48-year-old woman with dark spots on the left cheek area that had enlarged over the past year. Dermatological examinations showed hyperpigmentation patches with indistinct borders, irregular edges, and telangiectasis. Fine Needle Aspiration Biopsy (FNAB) confirmed BCC, and the patient underwent Mohs Micrographic Surgery (MMS) for tumor removal. The post-procedural follow-up showed a good outcome.
Beyond Co-Expression: Unraveling the Complex Relationship Between PD-L1 and Tumor-Infiltrating Lymphocytes in Basal Cell Carcinoma Subtypes Fitria Mayasari; Kenty Wantri Anita; Diah Prabawati Retnani; Rachmad Sarwo Bekti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (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.v9i8.1354

Abstract

Background: Basal cell carcinoma (BCC) is the most prevalent non-melanoma skin cancer, characterized by high recurrence rates. Immunotherapy, particularly targeting the Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1) axis, offers a promising therapeutic avenue. The interplay between PD-L1 expression on tumor and immune cells and the nature of Tumor-Infiltrating Lymphocytes (TILs) is crucial for immune response, yet their relationship in BCC, especially across diverse histological subtypes, remains incompletely understood. This study aimed to investigate the correlation between PD-L1 expression and TILs density in various BCC subtypes, seeking to elucidate the complexities of their interaction within the tumor microenvironment. Methods: This analytical observational study utilized a cross-sectional design, analyzing 20 archived paraffin-embedded BCC tissue samples from Dr. Saiful Anwar Regional General Hospital Malang. PD-L1 expression was assessed by immunohistochemistry using the 22c3 clone and evaluated via the Combined Positive Score (CPS). TILs were semi-quantitatively assessed as percentage infiltration and categorized into low, moderate, and high grades. Histological subtypes of BCC were documented. Spearman correlation was used to analyze the relationship between PD-L1 expression and TILs. Results: Of the 20 BCC cases, 55% exhibited PD-L1 positivity (CPS ≥ 1). TILs infiltration was predominantly moderate (70%), with 25% high and 5% low. The cohort included nodular (40%), infiltrating (35%), and basosquamous (25%) as the main subtypes, with specific variants also analyzed. Basosquamous BCC consistently showed positive PD-L1 expression (100% of its cases positive), while nodular and infiltrating subtypes displayed varied PD-L1 expression. TILs distribution also varied across subtypes, with nodular BCC exhibiting the full range from low to high TILs. Overall, no significant correlation was observed between PD-L1 expression and TILs density (Spearman's r = -0.077, p = 0.747). Conclusion: This study confirms PD-L1 expression and TILs presence in BCC but reveals no direct linear correlation between them across the cohort, even when considering broad subtypes. Basosquamous BCC consistently expressed PD-L1. The lack of overall correlation suggests a complex, potentially subtype-specific interplay within the BCC tumor microenvironment, warranting further investigation into functional TILs subsets and other immune modulators.
Beyond Tumor Grade: Investigating the Heterogeneity of PD-L1 Expression in Soft Tissue Sarcomas and the Need for Subtype-Specific Analysis Hamka Muhammad Nasir Laitupa; Eviana Norahmawati; RA Rose Khasana Dewi; Rachmad Sarwo Bekti; Diah Prabawati Retnani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (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.v9i8.1350

Abstract

Background: Soft tissue sarcomas (STS) represent a diverse group of malignant mesenchymal neoplasms with considerable histological variety and differing degrees of malignancy. Programmed Death-Ligand 1 (PD-L1) expression is a crucial immunotherapy target in various cancers, but its role and expression patterns in STS, particularly within the Indonesian population, remain inadequately defined. This study aimed to investigate the differences in PD-L1 expression between low-grade and high-grade STS and to determine the correlation between PD-L1 expression and histological grading in an Indonesian cohort. Methods: This analytical observational study utilized a cross-sectional design, incorporating 29 archival paraffin-embedded tissue blocks from STS patients diagnosed at Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia. PD-L1 expression was assessed immunohistochemically using the monoclonal antibody clone 22c3, and scoring was performed using the Combined Positive Score (CPS). Statistical analyses, including the Mann-Whitney U test and Spearman correlation, were employed to evaluate differences and correlations. Results: The majority of STS cases (89.7%) exhibited negative PD-L1 expression. The mean PD-L1 CPS was 0.1429 in low-grade STS and 0.233 in high-grade STS. No statistically significant difference in PD-L1 expression was observed between the low-grade and high-grade groups (p=0.620). Furthermore, Spearman correlation analysis revealed no significant association between PD-L1 expression (numeric CPS and categorical positivity) and histological grade (r=0.094, p=0.629 for CPS; r=0.102, p=0.600 for interpretation). Conclusion: This study found no significant difference in PD-L1 expression between low-grade and high-grade soft tissue sarcomas, nor a significant correlation with histological grade in the investigated Indonesian patient cohort. These findings suggest that PD-L1 expression, when assessed independently, may not be a reliable prognostic biomarker based solely on tumor grading in STS. Further research with larger sample sizes, encompassing diverse histological subtypes and incorporating additional immune biomarkers, is warranted.
Laporan Kasus: PENDEKATAN DIAGNOSIS DAN TATA LAKSANA LIVEDOID VASCULOPATHY Tazakka, Achmad Aidil; Brahmanti, Herwinda; Ekasari, Dhany Prafita; Retnani, Diah Prabawati
Majalah Kesehatan Vol. 12 No. 3 (2025): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2025.012.03.9

Abstract

Livedoid vasculopathy (LV) adalah penyakit trombo oklusif yang melibatkan pembuluh darah superfisial dan mid-dermis. Insidens LV sangat jarang dengan prevalensi 1/100.000 penduduk/tahun. Patogenesis LV berhubungan dengan oklusi dari mikrosirkulasi kapiler kutaneus yang menyebabkan trombosis, infark dan iskemia. Laporan kasus ini bertujuan untuk memaparkan pendekatan diagnosis dan tata laksana LV berdasarkan temuan klinis yang khas. Perempuan berusia 34 tahun mengeluhkan muncul bercak merah disertai nyeri pada kedua kaki sejak 3 minggu. Bercak berubah menjadi bintil berisi air dan menjadi luka. Luka menutup dengan meninggalkan bekas luka berwarna putih. Pemeriksaan dermatologis pada regio pedis dekstra dan sinistra didapatkan patch eritematosa, vesikel, ulkus, dan atrophie blanche. Pemeriksaan darah didapatkan trombositosis, PT, APTT, dan D-dimer normal, ANA test dan anti-dsDNA negatif. USG Doppler tidak terdapat insufisiensi pembuluh darah. Pemeriksaan histopatologi didapatkan gambaran dilatasi pembuluh darah dengan lumen berisi trombus disertai ekstravasasi eritrosit, infiltrat sel radang limfosit, histiosit di sekitar pembuluh darah. Pasien diberikan asam asetilsalisilat dengan dosis 4 x 80 mg dan metilprednisolon dosis rendah untuk menekan peradangan dalam waktu singkat. Didapatkan perbaikan gejala dan klinis setelah pemberian terapi dalam empat minggu. Penegakkan diagnosis pada kasus ini didasari dengan adanya atrophie blanche yang merupakan karakteristik LV disertai dengan pemeriksaan laboratorium dan histopatologi yang menunjang. Diagnosis banding lain seperti gangguan koagulasi, penyakit autoimun, dan gangguan pembuluh darah telah disingkirkan. Diagnosis dan tata laksana LV perlu ditegakkan dengan cepat dan tepat sehingga dapat meningkatkan kualitas hidup dan mencegah komplikasi.
Profil Klinikopatologi Meningioma di Instalasi Patologi Anatomi RSUD Dr. Saiful Anwar Malang Periode Tahun 2016-2020 Putri, Anggie Sasmita Kharisma; Retnani, Diah Prabawati; Dewi, Rose Khasana; Angelina, Aina; Diah Prabawati
Jurnal Klinik dan Riset Kesehatan Vol 2 No 3 (2023): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.02.3.3

Abstract

Background. The most common intracranial neoplasms worldwide is meningioma. It has been classified into three grades by World Health Organization (WHO) in which each grade has several histological variants. The prognosis of meningioma is affected by many factors including histopathological type of tumor, age, and gender. Objective. The aim of this study is to determine the frequency of meningioma based on histopathological type, age, and gender from 2016 to 2020 in Saiful Anwar General Hospital Malang. Methods. This study was a quantitative descriptive study and data was collected from medical records from 2016 to 2020 in Department of Anatomic Pathology, Medical Faculty, Brawijaya University, Saiful Anwar General Hospital Malang. Histopathological type of meningioma, age, and gender were acquired. Results and Discussion. From 2016 to 2020, there were 96 eligible cases of meningioma. Ratio of men to women was 1:12.7. Meningioma was most commonly found in age group 41­50 years old (43.75%). The most common histopathological type of meningioma was meningotheliomatous meningioma (37.5%). The average of meningioma cases was 19 per year. In this study, there was an increase in incidence rate of meningioma in 2017, and decreased in 2020. It may happen because The government has a better referral system to provide health care, thus meningioma can be detected earlier. Conclusion. Frequency of meningioma is higher in women than men, and increases with age until 50 years, which then decreases. Meningotheliomatous meningioma is the most common histopathological type in this study.
The Role of Surgical Resection as A Salvage Therapy and Immunohistochemical Stain to Confirm Mediastinal Yolk Sac Tumor Eka Agustina, Dwi Rosa; Pratiwi, Suryanti Dwi; Retnani, Diah Prabawati; Isharanto, Artono; Erawati, Rachma Dini
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (800.64 KB) | DOI: 10.21776/ub.mrj.2020.002.01.3

Abstract

Background: Mediastinal germ cell tumors are uncommon, representing less than 1% of all malignancies. They mostly occur in young men after puberty and have a poor prognosis with over all long term survival rate 42%. Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an anterior mediastinum tumor and VCSS The CT scan of the chest showed an anterosuperior mediastinal mass which compress the superior vena cava. The result from transthoracic FNAB with USG guidance showed an extragonadal germ cell tumor which resemble an Embryonal Carcinoma from mediastinum. The AFP serum level was elevated. Patient underwent a radiotherapy and a surgical debulking. The biopsy showed an Endodermal Sinus Tumor (Yolk Sac). Immunohistochemical stain for cytokeratin was positive in the tumor cells while stain for CD30 was negative. These were confirming the diagnosis of primary mediastinal yolk sac tumor. Patient received a combination chemotherapy for a total 6 cycles.Conclusion: Some procedures like biopsy, tumor marker, immunohistochemical stain, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining chemotherapy with surgical therapy or radiotherapy could increase the survival outcome of patients.
The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female Patient hardiyanto, frenky; Pratiwi, Suryanti Dwi; Erawati, Dini Rachma; Isharanto, Artono; Retnani, Diah Prabawati; Pudjo, Herwindo
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1427.792 KB) | DOI: 10.21776/ub.mrj.2020.002.02.5

Abstract

Title: The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing  Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female PatientAuthor: Frenky Hardiyanto, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Suryanti Dwi Pratiwi, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Diah Prabawati R, MD, Patology Anatomy Specialist, Herwindo P, MD, Internal Medicine Specialist.Introduction:. A woman with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x-rays and ct thorax revealed a mass in mediastinum.Case Description: Patient is a 24 years old female with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x rays and CT thorax revealed a mass in mediastinum. Open biopsy on right neck mass and transthoracic FNAB resulting of chronic inflammation, so the patient was diagnosed with glandular tuberculosis and Mediastinal Tumor. Patient was getting worse after one month consuming OAT. Patient was consulted to Cardiovascular and thorax Surgery Department. Patient was performed thoracotomy and debulking. Anatomical pathology was examined from debulking mass, the result of immunohistochemistry was found nodular mediastinal gray zone lymphoma.Discussion: this case it is very difficult to enforce the diagnosis. Patients have done neck FNAB, transthoracic FNAB, open biopsy right neck mass and FOB have not been able to establish diagnosis. Until finally done thoracotomy and debulking in this patient, from immunohistochemistry results obtained nodular sclerosis Hodgkin lymphoma. Collaboration from pulmonologist, radiologist, cardiovascular and thorax surgeon, and patology anatomy specialist  is needed to confirm the diagnosis in these patients.Keywords: mediastinal tumor, mediastinal gray zone lymphoma
Co-Authors Aina Angelina Amelinda Natania Nurasih Andrea Aprilia Andreas Putra Christiawan Purba Andri Andri Anggie Sasmita Kharisma Putri Anggun Putri Yuniaswan Anugrah Putri, Deka Miftalia Arief Andy Soebroto Arif Widiatmoko Ariyanta Dafa Diputra Barasabha, Thareq Berlian Anggraeni Putri Boco Pranowo, Tri Pradesa Christiawan Purba, Andreas Putra Dani, Adinda Amalia Dewi, Rose Khasana Diah Prabawati Dini Rachma Erawati Diputra, Ariyanta Dafa Djajalaksana, Susanthy Djanggan Sargowo Dwi Hadi Sulistyarini Dwi Intan Yuniasih Dwi Jayasa, Pande Made DYAH FAUZIAH, DYAH Eka Agustina, Dwi Rosa Ekasari, Dhany Prafita Ervina, Rita Eviana Norahmawati Eviana Norahmawati Fadli, Muhammad Luqman Fitria Mayasari Hamka Muhammad Nasir Laitupa Hanggara, Dian Sukma Hardika, Arif Satria hardiyanto, frenky Harun Al Rasyid Harun Al Rasyid Harun Al Rasyid Hendy Setyo Yudhanto Herman Saputra hermanto, djoko heri Herwinda Brahmanti Hery Susilo Hidayat Sujuti Holipah Holipah Ihda Dian Kusuma Ihda Dian Kusuma Indrastuti Normahayu, Indrastuti Isharanto, Artono Karyono Mintaroem Kenty Wantri Anita Kenty Wantri Anita, Kenty Wantri Larasaty, Nanda Shaskia Lilasari, Sekar Puspita Lita Setyowatie Lita setyowatie Lita Setyowatie Lita Setyowatie, Lita Lucky Pratama Muhammad Agung Putra Yudha Nurasih, Amelinda Natania Okta, Shinta Pande Made Dwi Jayasa Parsama Putra, Ngakan Putu Pinahayu, Griesinta Trianty Andria Prasetya, Fahmi Adhi Pratiwi, Suryanti Dwi Prawitasari, Suci Pudjo, Herwindo Putra Pandu Adikara Putra Yudha, Muhammad Agung Putri Rachma Safitri Putri, Anggie Sasmita Kharisma Putri, Berlian Anggraeni RA Rose Khasana Dewi Rachmad Sarwo Bekti Rahmadiani, Nayla Rahmawati, Yustian Devika Rumahorbo, Cicilia Angelica Safitri, Putri Rachma Setiyaningsih, Fera Yuli Shinta Oktya Wardhani, Shinta Oktya Sugiatno, Belladikna Brillianty Susilo, Hery Tazakka, Achmad Aidil Thareq Barasabha Widiatmoko, Arif Widiatmoko, Arif Yosephine, Septina Yudanto, Hendy Setyo Yudhanto, Hendy Setyo Yulian, Inneke Yuniaswan, Anggun Putri Yustian Devika Rahmawati