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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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Quantitative Histomorphometrical Analysis in Distinguishing Non-Hodgkin Malignant Lymphoma, Large Cell Type with Nasopharyngeal Carcinoma Husain, Okky; Aminah Usman, Hermin; Yantisetiasti, Anglita; Handayani, Astri; S Hernowo, Bethy
Majalah Patologi Indonesia Vol. 33 No. 1, Januari 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.526

Abstract

Background Non-Hodgkin’s Malignant Lymphomas (NHMLs) with large cell morphology have similar histopathological appearance with Nasopharyngeal Carcinoma, undifferentiated type therefore ancillary examination such as Immunohistochemistry (IHC) are required. Quantitative histomorphometrical analysis able to identify subtle detail. The aim of this study is to measure the accuracy of quantitative histomorphometrical analysis to distinguishing NHML, large cell type with Nasopharyngeal Carcinoma.   Methods Up to 33 Hematoxylin and Eosin (HE) slides from NHML, large cell type, and 27 cases of Nasopharyngeal Carcinoma were photographed under 400 times magnification with a total of 7131 images. Background, nuclei, and extra-nuclear components between cells are segmented as mathematical objects. Objects’ properties were measured and represented as distribution factors (minimum, quartile 1, median, quartile 3, maximum, range, and interquartile range). Significant factors that can differentiate the study groups are measured with a fisher-exact statistical test. Models to predict NHML, large cell type from nasopharyngeal carcinoma were formulated with different numbers of factors. The HE diagnosis accuracy compared to IHC was measured   Results A sum of 7131 with 3893 from NHMLs, large cell type, and 3238 images of nasopharyngeal carcinoma were collected. After features selection, up to 76 properties factors are selected. Models' accuracy are ranging from 72.67% with a single factor and up to 89.9% with the whole selected factors.   Summary Models’ accuracy are higher (72.6-89.9%) compared to HE primary diagnosis (60%) in distinguishing NHML, large cell againts nasopharyngeal carcinoma. Quantitative histomorphometry can assist pathologist for early screening to distinguishing NHML, large cell type with Nasopharyngeal Carcinoma.
High Expression of Nicotinamide Adenine Dinucleotide Phosphate Oxidase 4 Correlates with High Grade of Clear Cell Renal Cell Carcinoma Rezeki, Dewi Sri; Laksmi, Lidya Imelda; Mariedina, Causa Trisna; Alferraly, T. Ibnu; Lukito, Joko S.; Betty, Betty
Majalah Patologi Indonesia Vol. 33 No. 2, Mei 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.581

Abstract

Background Clear cell renal cell carcinoma (ccRCC) is the most common histological subtype in renal cell tumors (RCT). This is a very aggressive cancer, often diagnosed at advanced stage leading to increase morbidity and mortality rates. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 4 (NOX-4) expression plays role in the regulation of several cancer types. The expression of NOX-4 is associated with a poorer degree of differentiation and a shorter survival in RCT. Therefore, NOX-4 expression is predictor of prognosis and potential therapeutic target. Research on the correlation of NOX-4 expression in RCTs is still very limited, while Correlation of NOX-4 expression in ccRCC does not exist yet.   Objective To assess the relationship between NOX-4 expression and ISUP grading in ccRCC.   Method In this study, 30 slide samples and ccRCC paraffin blocks were diagnosed histopathologically at Department of Anatomic Pathology of H. Adam Malik General Hospital from January 2012 to April 2022. All clinicopathological data were taken from medical records/pathology archives. The expression of NOX-4 immunohistochemical was assessed in nucleus and cytoplasm of tumor cells. The assessment was carried out semiquantitatively based on intensity and percentage of expressed tumor cells. The relationship between NOX-4 expression and ISUP grading was assessed using Fisher's exact test.   Results Of the 30 ccRCC samples, high grade ccRCC was found in 21 cases (70%) and strong expression of NOX-4 in cytoplasm and nucleus in 20 cases (66.7%). Strong expression of NOX-4 in high grade ccRCC was found in 17 cases (81.0%). A significant relationship was observed between NOX-4 expression and ISUP grading on ccRCC with a p-value of 0.030 (p<0.05) using Fisher's exact test.   Conclusion There is a significant relationship between NOX-4 expression and ISUP grading in ccRCC. Therefore, NOX-4 expression can be used for the prognosis of ccRCC and therapy development.
The Clinicopathological Profile and Recurrence of Meningioma at Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital Hastrina Mailani; Susanto, Eka
Majalah Patologi Indonesia Vol. 33 No. 1, Januari 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.598

Abstract

Background Meningioma represents the most frequent primary intracranial tumor, and some subtypes may demonstrate aggressive characteristics with a correspondingly elevated risk of recurrence. To predict the likelihood of recurrence, clinical and pathological parameters are essential. More aggressive treatment strategies and strict follow-up can be implemented using these parameters. Therefore, this study aims to determine clinicopathological characteristics of meningioma and its relationship with recurrence. Method This study adopted a retrospective cross-sectional approach using secondary data of meningioma cases from the archives of the Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital in 2019-2021. The clinical data were obtained through electronic medical records, and histopathological data assessment, including grade, mitosis, brain invasion, bone invasion, and dural invasion, was conducted through microscopic examination. Result The data indicate that a total of 219 cases of meningioma were reassessed. The mean age of patients was 45±11 years, and the majority (88.1%) were female. The mean tumor size was 5±1.8 cm, with the most common tumor location being the skull base (71%) and 38.6% of cases showed radiological evidence of bone invasion. Subtotal resection was the treatment of choice for most patients (67.8%). CNS WHO grade 1 was found in 91.8% of cases, while Mitotic index ≥4/10 HPF, microscopic evidence of bone invasion, brain invasion, and dural invasion were found in 5%, 33.6%, 3.2%, and 16.8%, respectively. A minimum follow-up of 6 months was fulfilled by 71 cases, and 28% experienced recurrence/progression. These findings showed a significant association between the extent of resection (p=0.007) and tumor size (p=0.02) with the incidence of recurrence. Conclusion Clinical parameters such as the extent of resection and tumor size play a role in predicting the likelihood of meningioma recurrence. The predictive factors knowledge for meningioma recurrence is important in determining treatment strategies and follow-up
Clinicopathological Characteristic of Radioactive Iodine-Refractory Differentiated Thyroid Carcinoma at Dr. Hasan Sadikin Hospital 2016-2021 Ayni, Tutik Nur; Agustina, Hasrayati; Hernowo, Bethy Suryawathy; Koesoemah, Raden Erwin Affandi Soeriadi; Azhar, Yohana
Majalah Patologi Indonesia Vol. 33 No. 1, Januari 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.606

Abstract

Background Initial therapy for differentiated thyroid carcinoma (DTC) is thyroidectomy with or without cervical lymph node dissection. Furthermore, radioactive iodine (RAI) is given to patients by considering risk stratification and other patient factors. Although most cases of DTC have a good prognosis after standard therapeutic approaches, the risks of local recurrence and distant metastases can be as high as 20% and 10%. Among these patients, two-thirds showed RAI-refractory. This is concerning because 10-year survival rate is less than 10%. This study aimed to analyze the clinicopathological characteristics of RAI-refractory DTC.   Methods This is a case-control study. Data was collected from the Department of Nuclear Medicine and Molecular Theranostics and Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung period 1 January 2016-31 December 2021.   Results Clinicopathological factors associated with RAI-refractory DTC are age, sex, aggressive histologic subtype, LVI (lymphovascular invasion), m-ETE (microscopic extrathyroid extension), TNM (tumor, nodal, metastasis) stage, and ENE (extranodal extension), with p-value <0.05. Meanwhile, there was no significant difference in the histologic type between RAI-refractory and non-RAI-refractory groups.   Conclusion In the pathology report, it is necessary to include prognostically relevant tumor histopathological characteristics. In addition to histologic type, histologic subtype, and tumor size, other features such as presence and extent of capsular invasion, LVI, microscopic and macroscopic ETE, ENE, and number and size of metastatic lymph nodes, have been shown to provide additional prognostic information and are required in standard pathology reports for DTC.
Association of α-SMA and EpCAM Expressions with Recurrence Risk Based on Histopathological Subtypes of Basal Cell Carcinoma Yona, Fajriza; Hilbertina, Noza; Mulyani, Henny; Bachtiar, Hafni
Majalah Patologi Indonesia Vol. 33 No. 1, Januari 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.613

Abstract

Background Basal cell carcinoma (BCC) is the most common skin malignancy in the world with a proportion 70%. Recurrent and aggressive variants are still challenging in diagnosis and treatment. Histopathologically, there are two group of BCC risk of recurrence, i.e low risk and high risk. Assessment the expression of alpha-smooth muscle actin (α-SMA) as a biomarker of cancer associated fibroblast cell in stroma and the expression of epithelial cell adhesion molecule (EpCAM) in tumor cells probably have role in the pathomechanism of BCC progression, suggest its can distinguish the risk of BCC recurrence. This research aims to determine the assosiation between the expression of α-SMA and EpCAM with the recurrence risk group of BCC histopathological subtypes. Methods This was a cross sectional study using 48 samples, with 24 low and high risk groups each. Histopathological subtypes were determined from Hematoxylin and eosin slide. The expression of α-SMA and EpCAM was examined by the immunohistochemical method which was assessed semiquantitatively. Statistical analysis was performed using the Chi-square test with p<0.05 was considered significant. Results Expression of α-SMA with the score 3 was found more in high risk BCC (85.7%), while a score of 1 was more in low risk BCC (100%). Loss of EpCAM expression was mainly found in high risk BCC (82.8%). Statistical analysis showed that there was a significant assosiation between the expression of α-SMA and EpCAM and the recurrence risk group of BCC histopathological subtypes with p value =0.000 for each. Conclusions This study concluded that increased of α-SMA expression and loss of EpCAM expression were associated with a high recurrence risk group of BCC histopathological subtypes.
Intra-adrenal Paraganglioma and Paraaortic Paraganglioma in 15 Years Old Boys Butarbutar, Christine Rosalina; Maker, Luh Putu Iin Indrayani; Sumadi, I Wayan Juli; Winarti, Ni Wayan; Ariyanta, Kadek Deddy; Asih, Made Widhi
Majalah Patologi Indonesia Vol. 33 No. 1, Januari 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.631

Abstract

Intra-adrenal paraganglioma (also called pheochromocytoma) is a chromaffin cell tumor that arises in the adrenal medulla and produces excess catecholamines. Paraganglioma can also be located in the extra-adrenal area. The incidence rate of intra-adrenal and extra-adrenal paraganglioma is about 1 case per 2.500-6.500 population, highest incidence at 40-50 years old, and distribution is the same in males and females. Intra-adrenal paraganglioma in pediatrics is more familial, bilateral, multifocal, and malignant. In children, the incidence rate of these tumors was 8.86%, the ratio of boys to girls was 2:1, and the average age of 11. This article reports a case, of a 15 years old boy with severe headaches, recurrent seizures, and a hypertension crisis (143/103-220/110 mmHg). MSCT scan of abdominal showed solid mass heterogeneous with central necrotic multiple in the supero-anterior of the left and right kidneys and on the right anterolateral aorta as high as CV L2, impressive adrenal gland mass and extra-adrenal, suspect pheochromocytoma. Performed surgery, routine histopathological examination, and Immunohistochemistry. Macroscopic examination showed an oval round shape mass of left and right adrenal tumors as well as the paraaortic, a smooth outer surface of the capsular, with yellowish brown color mass tumor at cut surface, supple consistency. Microscopic examination showing adrenal gland and paraaortic tissue with fibrous capsule contains proliferation of neoplastic cells forming a nested alveolar (Zellballen) pattern with a round oval to polygonal cells, granular eosinophilic cytoplasm, round oval nuclei, surrounded by sustentacular cells. Chromogranin A and S-100 are positive. The case was concluded by clinical findings, histopathological, and immunohistochemistry as intra-adrenal paraganglioma and paraganglioma of paraaortic.
Combination of Urachal and Omphalomesenteric Duct Remnant: A Rare Case Reports Maker, Luh Putu Iin Indrayani; Manna, Johana Sensy Leni; Darmajaya, I Made
Majalah Patologi Indonesia Vol. 33 No. 1, Januari 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.645

Abstract

Umbilical problems encountered in the pediatric population are often associated with retained umbilical cord structures or with failure of the umbilical ring to close at birth. This article reported a case of umbilical anomalies in 3-years old male, with a chief complaint of a lump on the umbilical area a urinary discharge from the umbilical since birth. Incidence of patent vitelointestinal duct (omphalomesenteric duct) varies from 1 in 5000-8000 while patent urachus are still rare, ranging from 1-2 per 100000. The combination of both anomalies is very rare, only 12 reported cases since 1898 until 2016. Ultrasound can play an important diagnostic role for these types of anomalies if performed by expert. In our case, the ultrasound was not able to confirm the diagnosis due to a lot of gas in the abdomen. Based on clinical data and histopathologic examination, the patient was diagnosed with combination of urachal and omphalomesenteric duct remnant.
Helicobacter pylori Increasing Spread of An Inflammation Cells and Gastric Mucosal Atrophy in Gastritis Patients Oktaviyanti, Ika Kustiyah; Widodo, Firman Aprilianto; Hafidza, Fadhil; Rosida, Lena; Wibowo, Agung Ary; Yuliana, Ida
Majalah Patologi Indonesia Vol. 33 No. 1, Januari 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.654

Abstract

Background Helicobacter pylori (H. pylori) is a bacterium which could reason chronic gastritis and then has the capability to purpose gastric mucosal atrophy. The modifications within the degree of gastric mucosal atrophy have been appreciably correlated with the degree of risk of gastric cancer. The purpose of the observe turned into to research the relationship among H. pylori and the spread of inflammatory cellular infiltration and gastric mucosal atrophy in gastritis patients in Banjarmasin. Method The study was carried out in September-November 2021 using a cross-sectional method with purposive sampling, that is as many as 87 samples of histopathological slides of gastritis patients in the anatomical pathology laboratory of Sari Mulia Hospital, Banjarmasin for the period 2019. Research analysis used Kolmogorov-Smirnov. Slide preparations were stained with immunohistochemistry (IHC) and hematoxylin-eosin (HE). Inflammatory cellular clearance was measured the use of a scale from revised Sydney system and gastric mucosal atrophy become measured the use of the OLGA staging system. Results The results showed as many as 40 (45.98%) H.pylori-positive patients with the most chronic inflammatory cell infiltration in 24 (60%) patients at grade 3 (p<0.001) and for gastric mucosal atrophy as many as 29 (72, 50%) of patients at various stages (p<0.001). Conclusion H. pylori has a significant relationship with inflammatory cell infiltration and gastric mucosal atrophy. H. pylori-positive causes a growth within the severity of inflammatory cellular irritation and mucosal atrophy in gastritis patients.
Relationship of Stromal Tumor Infiltrating Lymphocytes (STILs) with Grading Histopathology in Penis Squamous Cell Carcinoma Sihotang, Marisi Cintya Debby; Intan, T. Kemala; Alferraly, T. Ibnu; Betty, Betty; Soekimin, Soekimin; Delyuzar, Delyuzar
Majalah Patologi Indonesia Vol. 33 No. 2, Mei 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.580

Abstract

ABSTRACT Background:Penile squamous cell carcinoma is the most common penile malignance found in the world. Assessment of stromal tumor infiltrating lymphocytes (STILs) associated with grading against penile squamous cell carcinoma can provide a potential prognostic picture and help determine the action. Method:Cross-sectional analytical study with 32 samples of histopathological preparations diagnosed as penile squamous cell carcinoma at H. Adam Malik Hospital Medan. The assessment of stromal TILs was carried out by assessing the number of lymphocyte inflammatory cells in the peritumoral stroma and then determined the assessment score, zero score no lymphocytes (minimum), score one found 0-10% lymphocytes (moderately), score two found 20-40% lymphocytes (massive) , score three found 50-90% lymphocytes. Grading assessments are categorized into grade I (well differentiated), grade II (moderately differentiated), and grade III (poorly differentiated). Result:The most grading found was grade II (43.8%) and the most STILs found were score three (50.0%). There is a significant relationship between grading and STILs in penile squamous cell carcinoma (p value=0.0001) i.e. the higher the STILs score , the lower the tumor grade. Conclusion:There is a relationship between STILs and histopathological grading in Penile Squamous Cell Carcinoma so that it can be used as an indikasi prognosis in patients with penile squamous cell carcinoma.
Hypertrophy Determination of H9c2 Cardiomyoblast Cell Line Using Wright-Giemsa Staining: An Experience in Developing an Acceptable and Easy-to-handle In-vitro Protocol Fadhillah, Muhamad Rizqy; Arozal, Wawaimuli; Wibowo, Heri; Bustami, Arleni; Sukmawati, Dewi; Kusmardi, Kusmardi; Triana, Novi; Khatimah, Nurul Gusti
Majalah Patologi Indonesia Vol. 33 No. 2, Mei 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.682

Abstract

Introduction Cell-size area (CSA) becomes the standard parameter routinely tested in vitro for cardiac hypertrophy studies. Thus, staining is an essential tool for this purpose. As reported in a previous study, immunofluorescence staining is an established method for CSA. However, because it is expensive and requires a specialized microscope, e.g., immunofluorescence or confocal microscope, it is not applicable in a laboratory with limited equipment. Wright-Giemsa staining is a standard procedure in hematology laboratories and is inexpensive and convenient. Here, we shared our experience developing a CSA determination protocol using Wright-Giemsa in H9c2 cardiomyoblast. Methods The viability tests were performed on H9c2 to determine the effective dosage of angiotensin II and Irbesartan (standard drug). The H9c2 were divided into three groups: the control group (without either angiotensin II or irbesartan), the negative control (with angiotensin II), and the positive control (with angiotensin II and Irbesartan), triplicate for each group. The cells then are acclimatized overnight, serum-starved for one day, and incubated with angiotensin and irbesartan for 48 hours. Lastly, Wright-Giemsa was observed using a light microscope in three fields. The CSA was determined by three independent observers blindly, statistically different if the p<0.05 using ANOVA ways or Kruskal-Wallis. Results After the H9c2 induced by angiotensin-II 1 μM and Irbesartan 1μM, we found the CSA significantly differed among each group (p<0,0001). The negative control has a higher median and interquartile range (IQR) CSA (10.78 (6.79) um2) compared to the control group (median (IQR) 7.27 (4.91) um2) and positive control (median (IQR) 7.849(5.31) um2). Conclusion It can be concluded that the Wright-Giemsa might help determine the CSA for in-vitro hypertrophic studies.

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