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Peritoneal (Paraovarian) Malignant Mesothelioma Erna Kristiani; Stephanie Marisca
Medicinus Vol 6, No 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1149

Peritoneal Malignant Mesothelioma (PMM) is uncommon disease, but increasing in frequency nowadays. This highly aggressive malignancy occurs most commonly in older men and has a strong association with asbestos exposure. It manifests most often as diffuse sheet-like or nodular thickening of the peritoneal surfaces, but it may occasionally be a localized mass. The very large variations of its clinical features and its histological appearance mimicking adenocarcinoma make this tumor is difficult to diagnose.We report a case of PMM that previously diagnose as adenocarcinoma of the ovary. A 29 year-old female came to gynecology clinic with para-ovarian mass. She had no history of asbestos exposure. The mass was oval 9x6x6 cm in size, whitish and firm. Microscopic features showed papillary dense structure with desmoplastic stroma, covered by a layer of cuboidal to columnar cells. The cells with mild pleomorphism and hyperchromatic nuclei, mitotic figures were minimal. The immunohistochemistry tests revealed positive for D2-40, Calretinin, CK8 and CK 18, weakly positive for Inhibin and EMA, and negative for CEA and AFP. Patient had been received chemotherapy, there were no metastasis.

Karakteristik Histopatologik dan Imunofenotipik Kanker Payudara di Rumah Sakit Cipto Mangunkusumo Jakarta, Indonesia Primariadewi Rustamadji; Stephanie Marisca
Medicinus Vol 6, No 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1147

Introduction: Breast cancer can be classified into luminal A, luminal B, Her2+, dan basal-like molecular subtype according to genetic profile and immunophenotype. The aim of this study is to assess histopathologic and immunophenotype characteristics of breast cancer in Cipto Mangunkusumo Hospital Jakarta, Indonesia.Material and methods: This study is a cross-sectional retrospective study. The sample was 2632 breast cancer case in Department of Anatomical Pathology Cipto Mangunkusumo Hospital from the year 2011 until 2015. ER, PR, Her2, Top2 α, and Ki67 immunohistochemical stain was then grouped into luminal A (ER+/PR+/Her2-/Ki67<20%) subtype, luminal B (ER+/PR+/Her2-/Ki67≥20%) subtype, Her2+ (ER-/PR-/Her2+) subtype, and basal-like (ER-/PR-/Her2-) subtype. Kendall’s Tau analysis was done to assess association between sample characteristics and molecular subtype, association between top2α positive and molecular subtype.Result: The most prevalent to the less prevalent breast cancer molecular subtype was luminal B (43,9%), Her2+ (14,6%), luminal A (14,0%), and basal-like (11,3%). There was a significant association between the tumor stage and breast cancer subtype (p=0,0001). There is also a significant association between Top2α expression and molecular subtype (p=0,0001).Conclusion: The most prevalent breast cancer molecular subtype was luminal B. There was an association between breast cancer molecular subtype and a higher degree and Top2α expression.

Ez Prep Concentrate (Ez Prep) Sebagai Alternatif Reagen Deparafinasi Pada Pewarnaan Hematoksilin Eosin Apriani; Andrianus; Stephanie Marisca; Patricia Diana
G-Tech: Jurnal Teknologi Terapan Vol 7 No 1 (2023): G-Tech, Vol. 7 No. 1 Januari 2023
Publisher : Universitas Islam Raden Rahmat, Malang

Xylol is a deparaffinizing agent that is commonly used in each deparaffinization step in tissue histology staining. However, due to its high toxicity and high price, efforts have been made to find alternatives that are safer and cheaper. Ez Prep concentrate is one of the most commonly used deparaffinizing agents in Ventana Medical Systems, Inc (Ventana) devices. This product is designed for use as a BenchMark Series automated slide stainer. Besides being cheaper than xylol, its toxicity is also low. It is necessary to prove the effectiveness of the EZ Prep concentrate reagent so that it can be used as an alternative to xylol. This research is experimental in nature and will be carried out from September to November 2022 at the Siloam Hospital Lippo Village Anatomical Pathology Laboratory. The sample used is myoma and breast tissue. The results showed that all samples deparfined with EZ prep concentrate gave good quality microscopic results (score 3). Thus, EZ Prep concentrate can be considered as a substitute for xylol

Relationship Between Clinical Factors of Lymphoma DLBCL GCB and Non-GCB Subtype with Ki-67 Proliferation Index in Siloam Karawaci Hospital 2014 - 2018 Kristiani, Erna; Marisca, Stephanie; Qurro, Tri Ulfatul; Kweeswara, Natasya; Chandra, Amos Immanuel
Medicinus Vol 12, No 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7365

Background: Non-Hodgkin large cell B-lymphoma (DLBCL: Diffuse Large B-cell Lymphoma) were classified into two subtypes of Germinal Center B-Cell Like (GCB) and non-Germinal Center B-Cell Like (non-GCB), which GCB has a better prognosis. The Ki-67 antigen is one of the most reliable markers of cell proliferation. This research aims to establish the relationship between proliferation index Ki-67 with DLBCL subtypes and to evaluate the utility of Ki-67 proliferative index as a predictive marker for predicting stages of lymphoma.Methods: We obtained 60 cases of patient samples DLBCL in Siloam Hospital Lippo Karawaci in 2014-2018. Clinical and pathological data were obtained from medical records. Chi-square methods were used to analyze data.Result: There were more ≤60 years compared to >60 years. In this study, there were more male patients than female patients. lymphoma provided in extranodal were higher than lymphoma in nodal form.Conclusions: There is a relationship between Ki-67 proliferation index with lymphoma GCB and non-GCB subtypes and stage of lymphoma, which can be used as a predictive factor in predicting the stage of lymphoma.

Intracranial Solitary Fibrous Tumor in a 25-Year-Old Woman Prasetyo, Patricia Diana; Marisca, Stephanie; Wahjoepramono, Eka J.
Medicinus Vol 13, No 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8890

Introduction: Intracranial solitary fibrous tumors (ISFTs) are extremely rare spindle cell tumors originating from dendritic mesenchymal cells expressing CD34 antigens that are usually benign, although malignant transformation had been reported. The knowledge of natural course and prognostic factors of ISFTs is still limited and the tumor is easily misdiagnosed.Case Presentation: An intra-cranial extra-axial tumor tissue resection from a 25-year-old woman was evaluated in the Surgical Pathology Laboratory. Histologic findings (cellular spindle cell tumor with ‘patternless’ pattern, staghorn blood vessels and <5 mitoses per 10 hpf) and immunophenotype (positive for CD34, weakly and focally positive for STAT6) suggested a diagnosis of intracranial solitary fibrous tumor WHO Grade II.Discussion: ISFTs have very low incidence in the CNS and are difficult to distinguish radiologically from meningiomas, thus post operative pathological examination and immunohistochemistry markers evaluations are the mainstay for diagnosis. ISFT is associated with NAB2-STAT6 gene fusion and may exhibits a wide spectrum of histological features. STAT6 immunohistochemistry is considered as one of the most sensitive diagnostic methods, while the evaluation of CD34 expression can be used as alternative diagnostic method despite having lower sensitivity.

Intracranial Solitary Fibrous Tumor in a 25-Year-Old Woman Prasetyo, Patricia Diana; Marisca, Stephanie; Wahjoepramono, Eka J.
Medicinus Vol. 13 No. 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8890

Introduction: Intracranial solitary fibrous tumors (ISFTs) are extremely rare spindle cell tumors originating from dendritic mesenchymal cells expressing CD34 antigens that are usually benign, although malignant transformation had been reported. The knowledge of natural course and prognostic factors of ISFTs is still limited and the tumor is easily misdiagnosed.Case Presentation: An intra-cranial extra-axial tumor tissue resection from a 25-year-old woman was evaluated in the Surgical Pathology Laboratory. Histologic findings (cellular spindle cell tumor with ”˜patternless’ pattern, staghorn blood vessels and <5 mitoses per 10 hpf) and immunophenotype (positive for CD34, weakly and focally positive for STAT6) suggested a diagnosis of intracranial solitary fibrous tumor WHO Grade II.Discussion: ISFTs have very low incidence in the CNS and are difficult to distinguish radiologically from meningiomas, thus post operative pathological examination and immunohistochemistry markers evaluations are the mainstay for diagnosis. ISFT is associated with NAB2-STAT6 gene fusion and may exhibits a wide spectrum of histological features. STAT6 immunohistochemistry is considered as one of the most sensitive diagnostic methods, while the evaluation of CD34 expression can be used as alternative diagnostic method despite having lower sensitivity.

The Profile of P63 Expression and Epstein-Barr-Encoded RNA (EBER) Distribution in Primary Central Nervous System Lymphoma: A Retrospective Bi-Center Study Kristiani, Erna; Marisca, Stephanie; Suharyani, Sally; Dermawan, Kevin; Widodo, Stephanie T.; Ham, Maria F.; Harahap, Agnes S.; Susanto, Eka; Tjahjadi, Hartono; July, Julius
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9545

Background : Primary central nervous system lymphoma (PCNSL) is a type of lymphoma occurring around 0.5 – 1.2% of all intracranial neoplasms. However, recent epidemiological research shows a threefold increase in the number of cases. The Epstein-Barr virus (EBV) and PCNSL are both associated with the condition of immunosuppression or immunodeficiency, which often found to have a significant relationship with each other. Moreover, the TP63 mutation is associated with a poor prognosis. Methods : This is a descriptive study to assess the expression of TP63 and EBER on PCNSL, and present the characteristics of the disease. The study was conducted on 25 cases from two health centers with the most cases of brain tumors in Indonesia, Siloam Hospital Lippo Village and Cipto Mangunkusumo Hospital (CMH) from 2014 to 2018, the P63 expression and EBER-1 examinations were done by 4 pathologists. A total of 25 patients, 13 (52%) patients were male, ranging from age 30 – 79, with average 57,6 years old, located mostly in the frontal lobe in 8 patients (30.9%). Result : From the research results obtained positive P63 results in 20 cases (80%), while the EBER test was negative for all 25 patients. Further analysis with software SPSS 25 proving that P63 expression is not associated with germinal center B-cell type (GCB) or non-GCB type (p-value 0,87). Neither, P63 have any association with Ki67 with p-value of 1.00. Conclusions : This study concludes that there is a possibility that PCNSL cases in Indonesia are not associated with Epstein-Barr virus infection, but most of the cases will have a poor prognosis as indicated by P63 expression.

Karakteristik Histopatologik dan Imunofenotipik Kanker Payudara di Rumah Sakit Cipto Mangunkusumo Jakarta, Indonesia Rustamadji, Primariadewi; Marisca, Stephanie
Medicinus Vol. 6 No. 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1147

Introduction: Breast cancer can be classified into luminal A, luminal B, Her2+, dan basal-like molecular subtype according to genetic profile and immunophenotype. The aim of this study is to assess histopathologic and immunophenotype characteristics of breast cancer in Cipto Mangunkusumo Hospital Jakarta, Indonesia.Material and methods: This study is a cross-sectional retrospective study. The sample was 2632 breast cancer case in Department of Anatomical Pathology Cipto Mangunkusumo Hospital from the year 2011 until 2015. ER, PR, Her2, Top2 Î±, and Ki67 immunohistochemical stain was then grouped into luminal A (ER+/PR+/Her2-/Ki67<20%) subtype, luminal B (ER+/PR+/Her2-/Ki67‰¥20%) subtype, Her2+ (ER-/PR-/Her2+) subtype, and basal-like (ER-/PR-/Her2-) subtype. Kendall’s Tau analysis was done to assess association between sample characteristics and molecular subtype, association between top2Î± positive and molecular subtype.Result: The most prevalent to the less prevalent breast cancer molecular subtype was luminal B (43,9%), Her2+ (14,6%), luminal A (14,0%), and basal-like (11,3%). There was a significant association between the tumor stage and breast cancer subtype (p=0,0001). There is also a significant association between Top2Î± expression and molecular subtype (p=0,0001).Conclusion: The most prevalent breast cancer molecular subtype was luminal B. There was an association between breast cancer molecular subtype and a higher degree and Top2Î± expression.

Peritoneal (Paraovarian) Malignant Mesothelioma Kristiani, Erna; Marisca, Stephanie
Medicinus Vol. 6 No. 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1149

Peritoneal Malignant Mesothelioma (PMM) is uncommon disease, but increasing in frequency nowadays. This highly aggressive malignancy occurs most commonly in older men and has a strong association with asbestos exposure. It manifests most often as diffuse sheet-like or nodular thickening of the peritoneal surfaces, but it may occasionally be a localized mass. The very large variations of its clinical features and its histological appearance mimicking adenocarcinoma make this tumor is difficult to diagnose.We report a case of PMM that previously diagnose as adenocarcinoma of the ovary. A 29 year-old female came to gynecology clinic with para-ovarian mass. She had no history of asbestos exposure. The mass was oval 9x6x6 cm in size, whitish and firm. Microscopic features showed papillary dense structure with desmoplastic stroma, covered by a layer of cuboidal to columnar cells. The cells with mild pleomorphism and hyperchromatic nuclei, mitotic figures were minimal. The immunohistochemistry tests revealed positive for D2-40, Calretinin, CK8 and CK 18, weakly positive for Inhibin and EMA, and negative for CEA and AFP. Patient had been received chemotherapy, there were no metastasis.

Relationship Between Clinical Factors of Lymphoma DLBCL GCB and Non-GCB Subtype with Ki-67 Proliferation Index in Siloam Karawaci Hospital 2014 - 2018 Kristiani, Erna; Marisca, Stephanie; Qurro, Tri Ulfatul; Kweeswara, Natasya; Chandra, Amos Immanuel
Medicinus Vol. 12 No. 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7365

Background: Non-Hodgkin large cell B-lymphoma (DLBCL: Diffuse Large B-cell Lymphoma) were classified into two subtypes of Germinal Center B-Cell Like (GCB) and non-Germinal Center B-Cell Like (non-GCB), which GCB has a better prognosis. The Ki-67 antigen is one of the most reliable markers of cell proliferation. This research aims to establish the relationship between proliferation index Ki-67 with DLBCL subtypes and to evaluate the utility of Ki-67 proliferative index as a predictive marker for predicting stages of lymphoma.Methods: We obtained 60 cases of patient samples DLBCL in Siloam Hospital Lippo Karawaci in 2014-2018. Clinical and pathological data were obtained from medical records. Chi-square methods were used to analyze data.Result: There were more ‰¤60 years compared to >60 years. In this study, there were more male patients than female patients. lymphoma provided in extranodal were higher than lymphoma in nodal form.Conclusions: There is a relationship between Ki-67 proliferation index with lymphoma GCB and non-GCB subtypes and stage of lymphoma, which can be used as a predictive factor in predicting the stage of lymphoma.

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