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Majalah Patologi Indonesia
Published by Perhimpunan Ahli Patologi Indonesia
ISSN : 02157284     EISSN : 25279106     DOI : https://doi.org/10.55816/
Core Subject : Health,
Health Professions Public Health
Majalah Patologi Indonesia (MPI) digunakan sebagai wahana publikasi hasil penelitian, tinjauan pustaka, laporan kasus dan ulasan berbagai aspek di bidang patologi manusia. Tujuannya ialah menghadirkan forum bagi permakluman dan pemahaman aneka proses patologik serta evaluasi berbagai penerapan cara diagnostik sejalan dengan kemajuan perkembangan ilmu dan teknologi. Selain itu juga untuk merangsang publikasi barbagai informasi baru/mutakhir.
Arjuna Subject : Kedokteran - Patologi dan Kedokteran Kesehatan
Articles 384 Documents
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Correlation of Microvessel Density with Clinicothological Features of Hodgkin Lymphoma Bima Zulfikar, M.; Murti, Krisna; Andriyani Liberty, Iche; Dewi, Citra; Sari Puspita Rasyid, Riana
Majalah Patologi Indonesia Vol. 32 No. 1, Januari 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i1.564

Abstract

BackgroundAngiogenesis is the process of new blood vessel growth that has an important role in tumor development. Microvessel density (MVD) assessment is one of the methods to assess angiogenesis. A high MVD is associated with a poor prognosis in various types of cancer including Hodgkin lymphoma (HL). Although, HL incidence is lower in developing countries, the death rate is higher in these regions. Moreover, this type of lymphoma is higher among young and reproductive people. The aim of this study was to determine the association between microvessel density and HL clinicopathological characteristics.MethodsThis was an observational analytic study with a cross-sectional method, conducted at the Anatomical Pathology Department/Dr. Mohammad Hoesin Palembang. The samples were paraffin blocks diagnosed as HL for period 2016-2021 and had complete clinicopathological data according to the criteria of this study. The slides were immunostained with antibody anti-CD34. One microvessel was determined by observing the endothelial morphology and CD34 expression in endothelial cytoplasm and/or cell membrane, then was evaluated and calculated by Image J. Data was statistically analyzed by STATA version 15.ResultsMajority HLs in this study were discovered in the age group of <45 years (71.00%), male (61.30%), nodal location (80.60%) and lymphocyte rich classical HL (LRCHL) subtype (51.60%). Although there was no significant association between MVD and the clinicopathological characteristics of HL, high MVD tend to occur in the age <45 years, male, nodal location, and LRCHL subtype.ConclusionThere was no significant association between microvessel density and HL clinicopathological characteristics.
Klinikopatologik dan Profil Imunohistokimia Primary Mediastinal Large B-cell Lymphoma dan Limfoma Hodgkin Nodular Sclerosis di Regio Mediastinum Dameria, Flora; Francisca Ham, Maria; Stephanie Harahap, Agnes
Majalah Patologi Indonesia Vol. 32 No. 1, Januari 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i1.565

Abstract

Background Primary mediastinal large B-cell lymphoma (PMBCL) and Hodgkin nodular sclerosis (LHNS) lymphoma was the most common lymphomas involved the mediastinum. These two lymphomas had similar histopathological features. The purpose of this study was to analyzed clinical data, histopathological characteristics, and immunohistochemistry (IHC) profiles on PMBCL and LHNS. Methods This is a retrospective study. Data was collected from archive of Anatomical Pathology Department, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital in 2014-2020. The data collected included clinical data, hematoxylin-eosin (HE) and IHC slides and were reassessed by the researcher and supervisor. The histopathological characteristics data was analyzed statistically using statistical package for the social sciences version 25.0 with Chi-Square test. Results PMBCL and LHNS have similar histopathological features, included the characteristics of tumor cells and infiltration of many fibrosis and inflammatory cells, but difference in architecture, tumor cell types, clear cytoplasmic tumor cells, inflammatory cell and fibrosis types, with p value <0.001. The characterized differences of PMBCL showed diffuse architecture, some cells with RS-like cell structure, clear/pale cytoplasm, lymphocyte cell infiltration, and compartmental fibrosis. Whilst, LHNS showed nodular architecture, Reed Sternberg cells, mixed inflammatory cell infiltration, and band-like fibrosis. PMBCL showed CD20, PAX5, MUM1 strongly positive, CD30 weakly positive, and CD15 negative, while LHNS showed negative CD20, CD30 and MUM1 strongly positive, PAX5 weakly positive, and CD15 positive.
Extranodal NK/T-cell Lymphoma, Nasal Type (Angiocentric T-cell Lymphoma): Laporan Kasus dan Kajian Diagnosis Histopatologik Prasetyo, Awal; Istiadi, Hermawan; Puspasari, Dik
Majalah Patologi Indonesia Vol. 32 No. 1, Januari 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i1.566

Abstract

Extranodal NK/T-cell lymphoma, nasal type (ENKL) is a lymphoid neoplasm, which in the past has been grouped as a type of granulomatous diseases, is an aggressive non-Hodgkin’s lymphoma. The aggressiveness of ENKL is characterized clinically by nonrelenting destruction of the midline structures of the palate and nasal fossa. The histopathological diagnosis of this disease is difficult to enforced despite the malignant clinical course recognizably because of extensive tissue necrosis and multiple biopsies are often required. ENKL has an ominous prognosis, as the average survival rate is between 6 and 25 months. This case report describes the difficulties in making histopathological diagnosis of a 52-year-old male patient who presented with nasal obstruction and foul smelling, destructive and ulseratif lesion over for 3 months duration, and failed to treat with antibiotics and anti-inflammatories drugs. The diiferential diagnosis of the multiple biopsies was nasal cavity granuloma, NK/T cell lymphoma and Wegener granulomatosis. After immunohistochemical panel analysis of Pansitokeratin (AE1/3), LCA, CD3 and CD56, the patient be confirmed had an ENKL, nasal type which in the past also known as angiocentric T-cell lymphoma.
The Role of Bone Marrow Biopsy Morphology and Clinical Characteristics in Facing the Challenges of Diagnosing Primary Myelofibrosis, Polycythemia Vera, and Essential Thrombocythemia at Cipto Mangunkusumo Hospital Rifani, Liyona; Stephanie, Agnes; Sukrisman, Lugyanti; Mira Lubis, Anna; Francisca Ham, Maria
Majalah Patologi Indonesia Vol. 32 No. 1, Januari 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i1.567

Abstract

BackgroundMyeloproliferative neoplasm (MPN) is a neoplasm characterized by the proliferation of one or more myeloid cells and their derivatives. The limitations of molecular examination in Indonesia make the diagnosis of MPN based on clinical and histopathological examination very crucial. The aim evaluate the clinicopathological profile of primary myelofibrosis (PMF), polycythemia vera (PV), and essential thrombocythemia (ET) and identify the typical morphological characteristics of bone marrow biopsy.MethodsA retrospective study of cases diagnosed with MPN was conducted at the Department of Anatomic Pathology FMUI/RSCM in 2015-2019. Clinical data and evaluation of bone marrow morphology consisting of cellularity, erythroid myeloid ratio, cluster and megakaryocyte morphology, blast cells, fibrosis, osteosclerosis, and sinus dilatation were analyzed.ResultsA total of 172 cases were diagnosed as MPN BCR-ABL1-negative (PMF: 74; ET: 56; PV: 42). On routine blood examination, there was an increase in hemoglobin (Hb) and hematocrit (Ht) in PV, a decrease in Hb in PMF and an increase in platelets in ET (p<0.001). Splenomegaly is mostly found in PMF. Myeloid erythroid ratio was decreased in PV, normal in ET and increased in PMF (p<0.001). Megakaryocytes were arranged in loose clusters in 88.1% of PV cases and 96.4% of ET, dense clusters were found in 91.9% of PMF cases. Staghorn-like megakaryocytes were found in all ET cases and bulbous/cloud-like megakaryocytes were found in 97.3% of PMF cases. Most cases of PV (90.5%) and all cases of ET showed pre-fibrotic bone marrow (grade 0-1), while 77% of PMF cases showed fibrosis grade 2-3.ConclusionIn diagnosing PV, ET, and PMF, correlation between clinical data, laboratory, and bone marrow histomorphological evaluations, especially cellularity, myeloid:erythroid ratio, cluster and megakaryocyte morphology, degree of fibrosis, osteosclerosis, and sinus dilatation is required.
Hubungan Ekspresi Transforming Growth Factor-β1, Fibroblast Activated Protein, pola Tumor-Associated Collagen Signature dan derajat Tumor-Infiltrating Lymphocytes terhadap Grading International Society of Urological Pathology pada Clear Cell Renal Cell Ca Kharismawaty, Dina; Delyuzar, Delyuzar; Betty, Betty; S Lukito, Joko; Chrestella, Jessy
Majalah Patologi Indonesia Vol. 32 No. 1, Januari 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i1.568

Abstract

BackgroundClear cell renal cell carcinoma (ccRCC) is a very aggressive cancer and is often diagnosed at an advanced stage. The stromal component around the tumor is thought to have contributed greatly to these findings.MethodsAnalytical study with cross sectional design on 23 histological specimens diagnosed by ccRCC based on data from medical records/pathology archives in 2012-2021. Each specimen was stained with hematoxylin and eosin, TGF-β and FAP immunohistochemistry and Masson's trichrome. Fisher's exact test (p<0.05) was used to assess the association between the expressions of all variables with the ISUP grading.ResultsMost cases were high grade ccRCC (87%) samples, of which 73.9% samples expressed strong TGF-β, 82.7% samples expressed positive intratumoral FAP, 78.3% samples expressed positive stromal FAP, 47.8% showed a TACS-3-pattern, 56.5% of samples with positive stromal TILs and 47.8% of samples with negative intratumoral TILs. There was no significant association between all of these variables and the ISUP grading of the ccRCC (p<0.05).ConclusionExpression of TGF-β1, intratumoral and stromal FAP, TACS pattern and the degree of intratumoral and stromal TILs were not significantly associated with ISUP grading in ccRCC.
Profil Klinikopatologik Metastasis Kelenjar Getah Bening pada Karsinoma Ovarium di Departemen Patologi Anatomik FKUI/RSCM 2016-2018 Hayati, Amal; Tjahjadi, Hartono
Majalah Patologi Indonesia Vol. 32 No. 1, Januari 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i1.569

Abstract

Background Ovarian cancer is one of the most common malignancies in women. In Indonesia, this incidence is the third highest after breast and cervical cancer. The prognosis for ovarian carcinoma is generally poor. Ovarian cancer patients have low survival rate since most of them diagnosed at advanced stage. The tumor spread to retroperitoneum lymph nodes is important to evaluate considering that metastasis to lymph nodes will upstage the tumor to stage III. Tumor histological type, grade and CA 125 serum level considered as risk factors for lymph node metastases. Methods This study was a cross-sectional descriptive study to determine the profile of lymph node metastases in ovarian carcinoma at the Anatomical Pathology Department FKUI-RSCM for 3 years. The assessment criteria included demographic, clinical, and histopathological features of tumor mass and retroperitoneum lymph nodes. Results Analysis of demographic data in 54 cases of ovarian carcinoma found 47 patients (87%) aged ≥40 years. Unilateral tumors found in 42 cases (77.8%) and bilateral tumors found in 12 cases (22.2%). Patients generally diagnosed at stage III as many as 17 cases (31.4%). Elevated levels of tumor marker CA 125 (≥35 u/ml) found in 41 cases (76%). A total of 19 cases of ovarian carcinoma had spread to lymph nodes, with 8 cases (42%) of which were serous carcinomas. Lymph node metastases found in 16 cases (80%) of high-grade ovarian carcinoma and 12 cases (60%) of advance-staged tumors. Macrometastatic tumor deposit patterns found in 180 lymph nodes and micrometastases found in 10 lymph nodes. Two subjects diagnosed for lymph node metastases only from micrometastasis deposit in lymph nodes. Conclusion Lymph node metastases in ovarian carcinoma are more frequently found in serous carcinoma, high grade carcinoma, and cases with elevated CA125 serum level. Lymph nodes evaluation should be conducted carefully to detect micrometastasis deposit.
Reoperasi dan Non Reoperasi Penyakit Hirschsprung Dikaitkan dengan Profil Klinikopatologik Ujung Proksimal Reseksi di Departemen Patologi Anatomik FKUI/RSCM Tahun 2015 sampai 2019 Permata Warastridewi, Arie; Krisnuhoni, Ening
Majalah Patologi Indonesia Vol. 32 No. 2, Mei 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i2.615

Abstract

Background Hirschsprung’s disease (HD) is a developmental disorder of the enteric nervous system, which is characterized by the absence of ganglion cells in the submucosal and myenteric plexuses. The success of surgery is influenced by many factors, one of which is the presence of histopathological abnormalities in the proximal part of the HD rectosigmoid resection. The aim of this study is to determine whether there are any histological characteristics associated with Hirschsprung's disease that would necessitate reoperation at the Department of Anatomical Pathology Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital (FMUI/CMH). Methods This was an analytical study using a cross-sectional design and secondary data from the Department of Anatomical Pathology Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital (FMUI/CMH) archives between 2015 and 2019. At the proximal end, histopathological examinations were performed to determine mature ganglion, nerve thickening, normal ganglion number, perineural inflammation, and serositis. The patient's age at the time of surgery, gender, the type of surgery, and the patient's age at the time of reoperation were all recorded. Results From the 64 resection cases, 15 reoperation resection cases and 49 non-reoperation resection cases were obtained. Of the 15 reoperation cases, the histopathological investigation revealed fifteen cases of mature ganglion, ten cases of nerve thickening, and fourteen cases of normal ganglion. There was no perineural inflammation in fifteen cases, and no serositis in fourteen cases. A p value of 0.026 was obtained for the patient's age at the time of the operation. Conclusion There are several factors that determine pasients with Hirschsprung disease who undergo reoperation after resection. The age of the patient at the time of resection is one of the factors that can affect the occurence of reoperation in patients with Hirschsprung disease.
Hubungan Ekspresi Sex Determining Region Y Box 2 (SOX2) dengan Grading Histopatologi, Invasi Vaskular Intramural dan Ekstramural pada Adenokarsinoma Kolorektal Rizki, Diana; Delyuzar, Delyuzar; Alferraly, T. Ibnu; Betty, Betty; Soekimin, Soekimin; S. Lukito, Joko
Majalah Patologi Indonesia Vol. 32 No. 2, Mei 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i2.617

Abstract

Background Incidence and mortality of colorectal carcinoma (CRC) worldwide varies widely (10 times). Ninety percent colorectal malignancies are adenocarcinomas. Expression SOX2 is associated with high tumor grade, invasion, metastasis as well as a prognostic predictor of colorectal adenocarcinoma. Objective: Analyze the association of SOX2 immunohistochemistry expression with histopathological grading, intramural and extramural vascular invasion in colorectal adenocarcinoma. Methods Analytical study using a cross-sectional approach on 35 samples from the Anatomic Pathology Unit, H. Adam Malik Hospital, Medan. Immunohistochemical staining of SOX2 mouse monoclonal antibody (Bioassay Technology Laboratory) was performed and expression assessed as low (0-3) and high (4-6). Differences in expression were analyzed by Chi-square and Mann-Whitney correlation tests. Results The most patients with colorectal adenocarcinoma were at age of 51-60 years (34.3%), male sex was more common (60%), the most tumor location was in the rectum (40%), the most depth of invasion was T3 (74.3%) , low grade was more common (60%), more intramural vascular invasion was found (40%), and the highest expression of SOX2 was found to high expression which mostly in the nucleus and cytoplasm (84.6%) There was no significant association between SOX2 expression and histopathological grading (p= 0.884) and there was no significant association between SOX2 expression and vascular invasion, both intramural and extramural (p= 0.390). Conclusion There was no significant association between SOX2 expression and histopathological grading and vascular invasion, both intramural and extramural.
Hubungan Kepadatan Limfosit Intratumoral dan Tipe Histopatologik Karsinoma Tiroid di Departemen Patologi Anatomik FKUI/RSCM Kamarudy Lay, Fanny; Stephanie Harahap, Agnes; Francisca Ham, Maria
Majalah Patologi Indonesia Vol. 32 No. 2, Mei 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i2.618

Abstract

Background The presence of tumor-infiltrating lymphocytes (TILs) has been widely explored as one of the factors that can affect the success of immunotherapy in various cancers. This study aims to investigate the TILs in various types of thyroid carcinoma (TC) and its association with the aggressive histopathological type compared to the less aggressive histopathological type of TC. Methods The population covered by this retrospective study was TCs diagnosed at the Department of Anatomic Pathology, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo National Central General Hospital, period 2015-2019. The research sample was divided into group of TCs with aggressive histopathological type and less aggressive histopathological type with a total of 25 samples for each group. TILs was calculated in 10 high power fields (HPF) with 400 kali magnification. The analyses were conducted using Mann-Whitney and Kruskal Wallis test. Results TILs count was found with a median value of 43 (3-660) in the aggressive histopathological group and 36 (9-387) in the less aggressive histopathological group (p:0.96, CI:95%). The highest TILs was found in anaplastic thyroid carcinoma (ATC) and papillary thyroid carcinoma (PTC) with anaplastic components. TILs count was also found with a median value of 17.5 (3-75) in male and 48 (9-660) in female (p:0.02, CI:95%). Conclusion There was no significant association between TILs and histopathological types of TC (aggressive and less aggressive). However, there is a tendency for high TILs in ATC and PTC with anaplastic components. There is also a significant difference in TILs between male and female gender.
Correlation between Microvessel Density Based on CD31 Immunohistochemical Expression and Clinicopathology of Invasive Breast Carcinoma Bitaria Febrawati, Eka; Alferraly, T. Ibnu; Betty, Betty
Majalah Patologi Indonesia Vol. 32 No. 2, Mei 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i2.619

Abstract

Background Breast carcinoma is the most common malignancy in women worldwide. Tumor size, metastases, lymph node involvement (KGB), stage and histopathological grade are significant prognostic factors in invasive breast carcinoma. Microvessel density (MVD) assessment is used to measure angiogenesis which helps predict tumor behavior and the effect of antiangiogenic therapy. MVD is a quantitative calculation of intratumoral capillary blood vessels which reflects the results of the process of angiogenesis. The aim of this study was to analyze the relationship between MVD based on CD31 immunohistochemical expression and the clinicopathology of invasive breast carcinoma. Method Cross sectional analytic study with 42 samples diagnosed with invasive breast carcinoma at H. Adam Malik General Hospital Medan. MVD is the number of small blood vessels in terms of size and diameter (arterioles and venules) with a round lumen that is positively stained with CD31 at 10 large visual fields, categorized as low if <45 blood vessels/10 LPB and high if ≥45 blood vessels/10 LPB. The relationship between MVD and several clinicopathological parameters was analyzed using the Chi-Square, Fisher's Exact and Mann-Whitney tests. Results There was a significant relationship between tumor size (p=0.029), metastasis (p=0.014), stage (p=0.002), histopathological grade (p=0.0043), LVI (p=0.002), TILs (p=0.007). Large tumor size, metastases, high histopathological stage and grade, positive LVI and high TILs were significantly associated with MVD. However, there was no significant relationship between KGB involvement (p=0.570) and MVD. Conclusion MVD is significantly related to tumor size, metastases, stage, histopathological grade, LVI and TILs, and not significantly related to lymph node involvement. MVD plays a role in the angiogenesis of invasive breast carcinoma clinicopathology.

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