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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Nusantara Hasana Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research
Fitri Nur Handriyani
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Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Education Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing

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ATYPICAL MICROGLANDULAR ADENOSIS MIMICKING INVASIVE TUBULAR CARCINOMA, A RARE CHALLENGING DIAGNOSIS Hera Novianti; Fitri Nur Handriyani; Aswiyanti Asri; Yenita Yenita; Noza Hilbertina; Pamelia Mayorita; Yessy Setiawati; Zulda Musyarifah; Meta Zulyati Oktora; Maisyah Nelzima
Nusantara Hasana Journal Vol. 4 No. 7 (2024): Nusantara Hasana Journal, December 2024
Publisher : Yayasan Nusantara Hasana Berdikari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59003/nhj.v4i7.1297

Abstract

Background: Microglandular adenosis (MGA) is a rare breast lesion that poses diagnostic challenges due to its resemblance to invasive carcinoma, particularly invasive tubular carcinoma (ITC). Atypical MGA is of clinical concern because of its potential for malignant transformation. Accurate diagnosis relies on histopathological examination and immunohistochemical (IHC) analysis. Case Presentation: A 34-year-old woman presented with a painless lump in her left breast. Intraoperative frozen section analysis revealed small glandular structures with histological features mimicking ITC. Definitive diagnosis required further evaluation. Immunohistochemical analysis demonstrated S100 positivity, consistent with glandular differentiation, and negative p63 staining, indicating the absence of a myoepithelial layer. These findings, in the absence of definitive stromal invasion, supported a diagnosis of atypical MGA. Complete surgical excision was performed to ensure negative margins and exclude associated malignancy. Discussion: This case highlights the diagnostic complexity of atypical MGA, particularly in young patients. Frozen section analysis alone often fails to distinguish MGA from invasive carcinoma due to overlapping histological features. IHC markers, such as S100 and p63, are critical for differentiation. S100 positivity confirms glandular origin, while p63 negativity indicates the lack of a myoepithelial layer, distinguishing MGA from benign proliferative lesions. Accurate diagnosis is essential to avoid overtreatment, such as unnecessary chemotherapy or radical surgery, while ensuring appropriate management to mitigate malignant potential. Conclusion: This report underscores the importance of combining frozen section and IHC findings for rare breast lesions like atypical MGA. Increased awareness and careful evaluation are essential to achieve timely and precise diagnosis, enabling optimal surgical management and long-term outcomes.
Differential Roles of CD117 and Ki67 in Gastrointestinal Stromal Tumors: Diagnostic Utility Versus Prognostic Power Fitri Nur Handriyani; Noza Hilbertina; Henny Mulyani; Loli Devianti; Avit Suchitra; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1337

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the digestive tract, primarily driven by mutations in KIT or PDGFRA genes. CD117 (c-KIT) expression is a key diagnostic marker, while the Ki67 labeling index reflects cellular proliferation. Risk stratification, often using modified NIH criteria based on tumor size, mitotic rate, and location, guides prognosis and treatment. This study investigated the distinct roles of CD117 and Ki67 expression in relation to risk stratification in GIST patients. Methods: This cross-sectional analytical study examined 27 GIST cases diagnosed between January 2021 and December 2024 from three Indonesian hospitals. Formalin-fixed paraffin-embedded tissues were analyzed using immunohistochemistry for CD117 (clone YR145) and Ki67 (clone K2). CD117 positivity was defined as ≥5% tumor cell staining, and high Ki67 expression as >10% nuclear staining. Risk stratification utilized the modified NIH criteria. The Chi-square test assessed correlations (p<0.05 significance). Results: The cohort predominantly comprised patients >50 years (66.7%), males (59.3%), with gastric tumors (51.9%), large tumor size (>5cm in 96.3%), spindle cell morphology (77.8%), and high mitotic rates (74.1%). Most cases (85.2%) were classified as high-risk. CD117 was positive in 81.5% (22/27) of cases but showed no significant correlation with risk stratification (p=0.561). High Ki67 expression was found in 74.1% (20/27) of cases and demonstrated a significant positive correlation with high-risk stratification (p=0.002). The combination of CD117 and Ki67 status also showed a significant association with risk stratification (p=0.001). Conclusion: While CD117 expression remains a cornerstone for GIST diagnosis and targeted therapy selection, it did not correlate significantly with risk stratification in this cohort. Conversely, a high Ki67 labeling index was significantly associated with high-risk GIST, underscoring its potential as a valuable prognostic marker alongside established risk stratification parameters.
Differential Roles of CD117 and Ki67 in Gastrointestinal Stromal Tumors: Diagnostic Utility Versus Prognostic Power Fitri Nur Handriyani; Noza Hilbertina; Henny Mulyani; Loli Devianti; Avit Suchitra; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1337

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the digestive tract, primarily driven by mutations in KIT or PDGFRA genes. CD117 (c-KIT) expression is a key diagnostic marker, while the Ki67 labeling index reflects cellular proliferation. Risk stratification, often using modified NIH criteria based on tumor size, mitotic rate, and location, guides prognosis and treatment. This study investigated the distinct roles of CD117 and Ki67 expression in relation to risk stratification in GIST patients. Methods: This cross-sectional analytical study examined 27 GIST cases diagnosed between January 2021 and December 2024 from three Indonesian hospitals. Formalin-fixed paraffin-embedded tissues were analyzed using immunohistochemistry for CD117 (clone YR145) and Ki67 (clone K2). CD117 positivity was defined as ≥5% tumor cell staining, and high Ki67 expression as >10% nuclear staining. Risk stratification utilized the modified NIH criteria. The Chi-square test assessed correlations (p<0.05 significance). Results: The cohort predominantly comprised patients >50 years (66.7%), males (59.3%), with gastric tumors (51.9%), large tumor size (>5cm in 96.3%), spindle cell morphology (77.8%), and high mitotic rates (74.1%). Most cases (85.2%) were classified as high-risk. CD117 was positive in 81.5% (22/27) of cases but showed no significant correlation with risk stratification (p=0.561). High Ki67 expression was found in 74.1% (20/27) of cases and demonstrated a significant positive correlation with high-risk stratification (p=0.002). The combination of CD117 and Ki67 status also showed a significant association with risk stratification (p=0.001). Conclusion: While CD117 expression remains a cornerstone for GIST diagnosis and targeted therapy selection, it did not correlate significantly with risk stratification in this cohort. Conversely, a high Ki67 labeling index was significantly associated with high-risk GIST, underscoring its potential as a valuable prognostic marker alongside established risk stratification parameters.
Co-Authors Aswiyanti Asri Avit Suchitra Fachry Abda El Rahman Henny Mulyani Hera Novianti Husna Yetti Loli Devianti Maisyah Nelzima Meta Zulyati Oktora Noza Hilbertina Pamelia Mayorita Yenita Yenita Yessy Setiawati Zulda Musyarifah