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"We report three rare cases of mucosal-associated lymphoid tissue (MALT) lymphoma. Two cases are of gastric MALT lymphoma and one is a case of transverse colon MALT lymphoma. The two cases of gastric MALT lymphoma were diagnosed by endoscopy which demonstrated an ulcer in the cardia and another in the corpus. The first case is in a 62-year-old male. The patients medical history revealed upper GI tract bleeding with melaena in 1993. At the time no diagnosis was made on endoscopy In August 2000, melaena recurred and endoscopy showed an ulcer in the cardio. Histology showed high-grade gastric MALT lymphoma. Based on Ann Arbor classification, the patient was classified as stage IE gastrointestinal lymphoma. H. pylori was negative. The patient received chemotherapy The second case is in a 53-year-old male. He suffered from gastric lymphoma for 3 years. He complained of annually recurring haematemesis before a definitive diagnosis was finally established. He suffered jiom stage IE low-grade well-differentiated lymphocytic MALT lymphoma. H. pylori was negative. Endoscopic procedure after H. pylori eradication showed ulcer regression though histology still showed low-grade MALT lymphoma and H. pylori as positive. The third case is in a 46-year-old male with a complaint of haematochezia. Colonoscopy showed intususception due to tumor in the transverse colon. Histologic examination showed chronic colitis and granulomatosa. lnvagination due to colon tumor was reported. Histologic examination of the biopsy specimen showed low-grade small cell lymphocyte-plasmocytoid lymphoma. "

"ABSTRACTParaneoplastic syndromes are a group of disorders associated with benign or malignant tumors but not related to mass effect or invasion directly. Paraneoplastic syndromes may affect any organic system of the human body, such as endocrine, neurologic, dermatologic, hematologic, rheumatologic. Paraneoplastic rheumatic syndromes are not quite common, about 7-10% of paraneoplastic syndromes, and may mimic rheumatic diseases. We present an interesting case of paraneoplastic arthritis in a woman with non-Hodgkins lymphoma."

"Salah satu pengobatan untuk limfoma non-Hodgkin adalah kemoterapi menggunakan CHOP (Siklofosfamid ,Doksorubisin, Vinkristin, Prednison). Efek samping dari kemoterapi ini adalah mual dan muntah dan hal ini dapat menggangu pengobatan karena menimbulkan ketidaknyamanan. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan antiemetik pada kemoterapi CHOP, dan faktor - faktor yang mempengaruhi keadaan pasien pasca kemoterapi.Penelitian ini menggunakan desain cross sectional dan bersifat retrospektif dan dengan cara observasional. Penelitian dilakukan pada pasien limfoma non-Hodgkin di Ruang Rawat Singkat RS. Kanker Dharmais selama periode Juni 2005-Mei 2006.Penelitian menunjukan bahwa pada pemberian antiemetik ternyata tidak ada hubungan antara jenis kelamin, usia pasien, seri kemoterapi, stadium kanker dan jenis antiemetik dengan kejadian tidak muntah pasca kemoterapi. (P>0,05). Ondansetron mempunyai kemungkinan kejadian tidak muntah 1,63 kali lebih besar dari granisetron dan 1,03 kali terhadap tropisetron. Sedangkan untuk granisetron mempunyai kejadian tidak muntah 0,64 kali lebih rendah dibanding tropisetron.

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One of the medical treatment for lymphoma non-Hodgkin is chemotherapy such as CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisone ). The side effect chemotherapy is nausea and vomiting, and the side efect can interfere with the medical treatment cause to occur uncomfortable. The purpose of this research is to know the pattern of antiemetic of CHOP chemotherapy and relation between factors influenced in nausea and vomiting with post chemoterapy condition.

The design of this research was cross sectional and have the quality retrospective with observational method. The research had done to lymphoma non-Hodgkin patients in one day care ward of Dharmais Cancer Hospital during June 2005-May 2006.

The research shown after receive antiemetic that there was no relationship between patient?s age, chemotherapy cycles, lymphoma stages and type of antiemetic with condition of non-vomiting 1,63 times higher than granisetron and 1,03 times than tropisetron. While granisetron had possibility of non vomiting 0,64 times than tropisetron."

"Kanker darah leukemia dan limfoma merupakan salah satu komorbid dari Coronavirus Disease 2019 (COVID-19 ) yang dapat mengurangi efektivitas vaksin. Perkembangan leukemia dan limfoma dapat dideteksi dengan menggunakan protein citrullinated histone H3 (CIT-H3) yang merupakan hasil sitrulinasi enzim peptidilarginin deiminase 4 (PAD 4) pada neutrofil. Protein CIT-H3 umumnya dapat dijadikan biomarker perkembangan kanker karena kadarnya yang mengalami kenaikan pada subjek leukemia dan limfoma. Kenaikan tersebut juga ditemukan pada subjek COVID-19. Tujuan dari penelitian ini adalah untuk mengetahui korelasi kadar CIT-H3 dengan parameter hematologi pada subjek leukemia dan limfoma berupa hemoglobin, leukosit, trombosit, limfosit, neutrofil, serta absolute neutrophil count (ANC). Penelitian dilakukan dengan menggunakan metode enzyme linked immunosorbent assay (ELISA) untuk memeriksa kadar CIT-H3 dari 40 sampel serum darah subjek leukemia dan limfoma yang telah divaksinasi COVID-19 minimal sebanyak dua kali atau telah mengalami infeksi COVID-19 sebelumnya. Hasilnya didapatkan bahwa kadar CIT-H3 berkorelasi positif dengan parameter ANC (r= 0,04, p= 0,34) pada karakteristik komorbid subkelompok subjek dengan komorbid. Dapat disimpulkan bahwa terdapat korelasi positif antara kadar CIT-H3 dan ANC.

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Leukemia and lymphoma blood cancer are comorbidities of Coronavirus Disease 2019 (COVID-19) which can reduce the effectiveness of vaccines. Metastases of leukemia and lymphoma can be detected using citrullinated histone H3 (CIT-H3) protein which is the result of citrullination of the peptidylarginine deiminase 4 (PAD 4) enzyme present in neutrophils. The CIT-H3 protein can generally be used as a biomarker for cancer metastases because of the increase in its levels in leukemia and lymphoma subjects. This increase was also found in the subject of COVID-19. This study aimed to determine the correlation of CIT-H3 levels with hematological parameters in leukemia and lymphoma subjects such as hemoglobin, leukocytes, platelets, lymphocytes, neutrophils, and absolute neutrophil count (ANC). The research was carried out using the enzyme-linked immunosorbent assay (ELISA) method to examine CIT-H3 levels from 40 blood serum samples from leukemia and lymphoma subjects who had been vaccinated against COVID-19 at least twice or had experienced previous COVID-19 infection. The results showed that CIT-H3 levels were positively correlated with ANC parameters in the comorbid characteristics of the subgroup of subjects with comorbidities (r= 0,04, p= 0,34). It can be concluded that there is a positive correlation between CIT-H3 levels and ANC."

"Ruang lingkup, bahan dan cara penelitian : Telah dilakukan penelitian retrospektif di laboratorium Patologi Anatomik FKUI/RSUPNCM. Sampel diambil dari Arsip Bagian Patologi Anatomik. Diffuse large B-cell lymphoma (DLBCL) atau limfoma malignum sel B jenis sel besar dinilai ulang untuk menentukan tiga suptipe DLBCL berdasarkan klasifikasi Kiel, yaitu varian sentroblastik, varian imunoblastik dan varian anaplastik. Dari blok paraffin ketiga varian tersebut dilakukan pulasan HE dan pulasan imunohistokimia p53 dengan menggunakan antibodi monoklonal p53 dan pulasan imunohistokimia Ki-67 dengan menggunakan antibodi monokional Ki-67. Perhitungan positifitas p53 dan positifitas Ki-67 pada sel yang berwama coklat tua dari 1000 sel secara acak. Untuk mengetahui perbedaan ekspresi p53 dan ekspresi Ki-67 pada ketiga varian dilakukan uji Tukey dan Duncan. Hasil dan kesimpulan : Dan 28 kasus DLBCL didapatkan 10 kasus varian sentroblastik, 8 kasus varian imunoblastik dan 10 kasus varian anaplastik. Hasil uji Tukey dan Duncan menunjukkan bahwa ekspresi p53 pada ketiga varian DLBCL yaitu varian sentroblastik, varian imunoblastik dan varian anaplastik terdapat perbedaan bermakna. Hasil uji Anova rnenunjukkan bahwa ekspresi Ki67 pada ketiga varian DLBCL yaitu varian sentroblastik, varian imunoblastik dan varian anaplastik tidak ditemukan perbedaan.

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Scope of study and Method : The study was carried out in Anatomical Pathology Laboratory Faculty of Medicine University of Indonesia/RSUPNCM- retrospectively. We collected the sample from Anatomical Pathology Laboratory Faculty of Medicine University of Indonesia/RSUPNCM archives. To defined three of DLBCL, we estimated repeatedly- according to Kiel classification, i.e. centroblastic, immunoblastic and anaplastic variants. We stained three of variant paraffin block with HE and p53 immunohistochemistry staining with p53 monoclonal antibody and Ki-67 immunohistochemistry staining with Ki-67 monoclonal antibody. We estimated p53 and Ki-67 positivity on dark brown cell from 1000 cells, randomly. On this study we used the Tukey and Duncan test, to find the differentiation of p53 and Ki-67 expression on three variants. Result and Conclusion : We found 10 cases of centroblastic variants, 8 cases of immunoblastic variant and 10 cases of anaplastic variant from 28 cases DLBCL. The Tukey and Duncan test showed that there is significant differentiation of p53 expression on three DLBCL variants. The Anova test showed that there is no differentiation of Ki-67 expression on three DLBCL variants."

"Latar belakang: Primary mediastinal large B cell lymphoma (PMBCL) adalah limfoma sel B berasal dari sel B medulla timus yang memiliki sifat unik dan agresif. Jaringan tumor PMBCL paling sering didapat berupa jaringan core biopsy. Gambaran histopatologik PMBCL berupa spektrum dengan fenotip dan genetik mirip dengan limfoma Hodgkin klasik terutama subtipe nodular sklerosis. Hal-hal tersebut dapat menimbulkan kesulitan diagnosis sehingga diperlukan pemeriksaan imunohistokimia untuk penegakan diagnosis dan penentuan pengobatan. Beberapa penelitian menemukan MAL merupakan salah satu penanda PMBCL. Tujuan penelitian ini adalah mengetahui perbedaan ekspresi MAL pada PMBCL dan limfoma Hodgkin klasik mediastinum.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 15 kasus PMBCL dan 15 kasus limfoma Hodgkin klasik mediastinum yang sudah dilakukan pulasan imunohistokimia dari Januari 2011 sampai Mei 2018. Dilakukan pulasan MAL dan penilaian menggunakan perhitungan persentase >10% sel tumor. Hasil: Ekspresi MAL positif pada  2(13,3%) dari 15 kasus PMBCL dan limfoma Hodgkin klasik mediastinum sebanyak 8(53,3%) kasus dari 15 kasus dengan sensitivitas 20% dan spesifisitas 35%. Pada uji statistik chi-square didapatkan ekspresi MAL antara PMBCL dan limfoma Hodgkin klasik berbeda bermakna dengan nilai  p=0,020.Kesimpulan: Ditemukan ekspresi MAL antara PMBCL dengan limfoma Hodgkin klasik mediastinum berbeda bermakna.

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Background: Primary mediastinal large B-cell lymphoma (PMBCL) is an aggressive and unique large B-cell lymphoma arising in mediastinum of putative thymic B-cell origin. Core biopsy is most commonly diagnostic procedure in PMBCL mass. Morphology of PMBCL has spectrum and similarities in phenotype and genetic with classical Hodgkin lymphoma especially nodular sclerosis variant. Hence specific immunohistochemistry is needed to diagnose PMBCL. Several studies found MAL is one of some markers for PMBCL. The aim of this study is to determine the differences of MAL expression in PMBCL and thymic classical Hodgkin lymphoma.Material and method: This was a cross-sectional study with 15 cases of PMBCL and 15 cases thymic classical Hodgkin lymphoma that had been performed immunohistochemistry at RSCM from January 2011 to May 2018. All cases stained by MAL antibody and evaluated using percentage > 10% cell tumors.Result: MAL positive expression can be found in  2 (13,3%) of 15 cases PMBCL and  8 (53,3%) of 15 cases classical Hodgkin lymphoma with 20% sensitivity dan 35% specificity. The chi-square test showed  significant difference between MAL expression in PMBCL and thymic classical Hodgkin lymphoma. (p=0,020). Conclusion: There was signification difference between MAL expression in PMBCL and thymic classical Hodgkin lymphoma."

"ABSTRACTBackground: the expression of CD30, CD15, CD50, and PAX5 are used to help in confirming diagnosis of HL and sALCL; however data on the proportion of these markers have not been available. The study was aimed to identify the proportion of CD30, CD15, CD50 and PAX5 expressions and characteristics of patients with HL and sALCL at Dharmais National Cancer Center Hospital between 2005 and 2015. Methods: a retrospective observational study was conducted using data from medical records and histopathological results of HL and sALCL adult patients who sought treatment at the hospital between 2005 and 2015. Immunohistochemistry (IHC) examinations were performed and data on the proportion of positive CD30, CD15, CD50, and PAX5 expressions were analyzed descriptively.Results: a total of 45 patients were recruited in this study, with the majority (42 patients, 93.3%) were HL patients and only 6.7% were sALCL patients. The median age of HL patients was younger than sALCL patients; 35 (18-72 years old) versus 54 (49-61 years old). Moreover, the immunohistochemistry examination demonstrated that the positive CD15, CD30, CD50, and PAX5 expressions were found respectively in 37.5%, 88.9%, 31.2%, and 31.2% patients with HL; while in patients with sALCL, in spite of their small sample size, positive CD30, CD15, CD50 and PAX5 expressions were found in 100%; 66,7%; 50%; and 50%, respectively. Overall, CD15, CD50, and PAX5 positive expressions were found in 39.5%, 32.4%, and 32.4% patients who had HL and sALCL; while positive expression of CD30 was found in 89.5% of them. Conclusion: present study shows that almost 90% patients have positive CD30 expression;Â while the positive expressions of CD15, CD50, and PAX5 are found in less than 40% patients. It indicates that CD30 is an important diagnostic marker for HL and sALCL and it may improve treatment strategy."

"Latar Belakang : Diffuse Large B Cell Lymphoma (DLBCL) merupakan limfoma non Hodgkin agresif dengan prevalensi yang cukup tinggi di Indonesia dan prognosis nya cukup buruk. Latar belakang genetik yang melibatkan gen MYC dan BCL2 berperan penting dalam menentukan progresifitas penyakit ini dimana MYC sebagai gen proliferasi dan BCL2 sebagai gen antiapoptosis. Penelitian yang menggabungkan overekspresi MYC dan BCL2 dengan respon RCHOP dan event free survival (EFS) 24 bulan masih terbatas.Tujuan : Melihat hubungan antara overekspresi MYC dan BCL2 dengan respon imunokemoterapi RCHOP dalam 6 bulan dan EFS 24 bulan pada pasien DLBCL. Metode Penelitian : Penelitian ini merupakan studi kohort retrospektif dengan mengkoleksi data dari rekam medis pasien periode Januari 2014- Oktober 2021 di Rumah Sakit Dr. Cipto Mangunkusumo dengan jumlah 100 pasien. Perhitungan ekspresi MYC dan BCL2 dengan menggunakan metode perhitungan H score. Cut off dari ekspresi MYC dan BCL2 didapat dari kurva ROCHasil Penelitian : Dari total 100 pasien DLBCL terdapat 46 pasien (46%) berjenis kelamin laki-laki dan perempuan 54 pasien (54%), dengan usia terbanyak pada kelompok umur < 60 tahun sebanyak 83%. Over ekspresi MYC, BCL2 2 dan kombinasi MYC dan BCL2 ditemukan berturut-turut pada 12 pasien (12%), 30 pasien (30%), 38 pasien (38%). Berdasarkan respon terapi, pasien dengan overekspresi BCL2 memiliki kemungkinan yang lebih tinggi untuk mendapatkan respon terapi non-CR dibandingkan low ekspresi. (RR = 2.119 with IK95%: 1.163- 3.872, p=0.015. Pasien dengan overekspresi MYC dan kombinasi overekspresi BCL2 dan MYC tidak memberikan respon non-CR yang lebih tinggi dibandingkan dengan low ekspresi ( RR= 0.363, IK95% 0.057-2,289, p = 0.281 dan RR=1,029, CI95% 0.63-1.673, p= 0.909). Dinilai dari EFS 24 bulan, pasien dengan overekspresi MYC, BCL2 dan kombinasi overekspresi MYC dan BCL2 secara statistik tidak signifikan mendapatkan EFS yang lebih rendah dari low ekspresi, dengan HR berturut-turut ( HR= 0.797, IK95% 0.381-1,668, p = 0.547, HR= 1.021, IK95% 0.610-1,708, p = 0.937, HR= 1.029 IK95% 0.634-1,673, p = 0.909). Pasien DLBCL dengan skor IPI tinggi secara statistik signifikan memiliki EFS 24 bulan yang lebih rendah dibandingkan dengan skor IPI rendah ( RR= 2.258 dengan IK95% 1,234-4.130, p = 0.008). dan didapatkan skor IPI risiko tinggi berhubungan secara signifikan dengan overekspresi MYC dengan p value 0.017.Kesimpulan : Pasien DLBCL dengan overekspresi H score BCL2 bertendensi untuk memberikan respon terapi non-CR terhadap RCHOP. Overekspresi MYC bertendensi untuk memberikan skor IPI berisiko tinggi. Skor IPI tinggi mempunyai kekuatan untuk memberikan survival rendah pada era imunokemoterapi.

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Background : Diffuse Large B Cell Lymphoma (DLBCL) is a aggressive non hodgkin lymphoma with a fairly high prevalence in Indonesia and failry poor prognosis. Genetik background gene MYC and BCL2 played an important roles in determining the progression of this disease. This was indicated by overexpresion of MYC as a proliferative gene and BCL2 as anti apoptosis gene. This has been limited research on the relation of MYC and BCL2 overexpression to the immunochemotherapy RCHOP response in six months dan 24 months event free survival ini DLBCL pasien.

Objective : To determine the relationship between MYC and BCL2 overexpression on the response to immunochemotherapy RCHOP in 6 months and 24 months event free survival in DLBCL patients.

Methods : This research is a retrospective cohort study design, by collecting patients medical records data from periode 2014-2021 at Dr. Cipto Mangunkusumo National Hospital with total number of 100 patients. Expressions of MYC and BCL2 using the H score. MYC and BCL2 expression thresholds were calculated

from the ROC curve.

Results : From a total of 100 patients DLBCL there were 46 male patients (46%) and 54 female patients (54 %), with the most age being in the < 60 years group as many as 83 %. Overekxpression of MYC was found in 12 patients (12%), while overexpression of BCL2 was found in 30 patients (30%) and double expressor was found in 38 patient (38%). Based on therapy response, patients with overexpression of BCL2 had a higher chance of giving a non-CR respon compared those with low expression. Patients with overexpression of MYC and double expressor had no a higher chance of giving a non-CR response compared those with low expression ( RR= 0.363 CI95% 0.057-2,289, p = 0.281 and RR=1,029, CI95% 0.63-1.673, p= 0.909). Assessed by 24 months survival, patients with MYC and BCL2 overexpression and double expressor were statistically non significantly worse than those with low-expression ( HR= 0.797, CI95% 0.381-1,668, p = 0.547, HR= 1.021, IK95% 0.610-1,708, p = 0.937, HR= 1.029 CI 95% 0.634-1,673, p = 0.909). Higher IPI score were statistically significantly worse 24 months survival ( HR= 2.258 CI 95% 1,234-4.130, p = 0.008) and statistically significant had a correlation with MYC overexpression.

Conclusion : DLBCL patients with BCL2 overexpression have a tendency to give a non-CR response to RCHOP. In patients with overexpression MYC had a correlation with higher IPI score and DLBCL patients with higher IPI score have a tendency to have lower 24 months survival."

"Limfoma sinonasal merupakan kelainan yang jarang dijumpai yang mencakup jenis sel NK/T atau sel B. Penelitian2 terdahulu menunjukkan adanya perbedaan angka kejadian limfoma NK/T (LNKT) yang sesuai daerah geografis serta kaitan yang sangat tinggi dengan infeksi virus Epstein Barr. Penelitian yang dilakukan terhadap 4l kasus penyakit limfoproliferatif sinonasal yang tersimpan di arsip Bagian Patologi Anatomik Fakultas Kedokteran Universitas Indonesia dalam kurun waktu 1994-2002 menunjukkan 35 kasus merupakan limfoma sinonasal. Pulasan imunohistokimia membuktikan 20 kasus (57%) sebagai LNKT dan 15 kasus (43%) limfoma sel B jenis sel besar. LNKT menunjukkan laki2 lebih banyak dari wanita (L:W=4:1) serta usia yng lebih muda (median 37 tahun); sedangkan limfoma sel B lebih banyak pada wanita (1:1.5) serta usia yang lebih tua (median 49 tahun). Hasil pemeriksaan genom virus Epstein Barr dengan cara hibridisasi in situ menggunakan pelacak EBER-1 menunjukkan 90% LNKT positif dan negatif pada semua limfoma sel B. Tulisan ini merupakan laporan limfoma sinonasal yang pertama dari Indonesia yang menunjukkan predominasi relatif limfoma sel B dibandingkan dengan beberapa negara Asia lainnya. Tidak adanya kaitan dengan virus Epstein Barr pada limfoma sel B juga berbeda dengan penemuan di negara Asia lain (positivitas 25-4l%) . Predominasi limfoma sel B tanpa kaitan dengan virus Epstein Barr mengarah pada kemungkinan adanya faktor etiologik yang spesifik untuk Indonesia. (Med J Indones 2004; 13: 71-6)

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Sinonasal lymphoma is a rare disease with NK/T-cell (NKTC)　or B-cell immunophenotype. Previous study revealed the geographic difference in frequency of NKTC lymphoma (NKTCL) and almost constant association with Epstein-Barr virus (EBV) infection. Through review of 41 cases with sinonasal lymphoproliferative diseases registered in the Department of Anatomical Pathology, University of Indonesia during the period 1994 to 2002, thirty-five were accepted as sinonasal lymphoma. Immunohistochemistry revealed that 20 cases (57%) were NK/T-cell type and 15 (43%) B-cell type with large cell morphology, i.e.,diffuse large B-cell lymphoma. NKTCL showed a marked male preponderance (M/F= 4:1) and younger onset of disease (median age, 37 years), and B-cell lymphoma showed a relative female preponderance (1:1.5) and older disease onset (median age, 49 years). In situ hybridization using EBER-1 probe revealed that 90 % of NKTCL were EBV-positive, but none of B-cell lymphoma were EBV-positive. This is the first report on sinonasal lymphoma in Indonesia showing relative predominance of B-cell lymphoma compared to other Asian countries and Peru (14-24 %). Lack of EBV-association in Indonesian sinonasal B-cell lymphoma showed a marked contrast to that in other Asian countries (EBV positive rate, 25-41 %). Predominance of sinonasal B-cell lymphoma without EBV genome might suggest presence of specific etiologic factors in Indonesia. (Med J Indones 2004; 13: 71-6)"