Karsinoid Atipikal Mediastinum Primer: Laporan Kasus
Laporan Kasus
DOI:
https://doi.org/10.56260/sciena.v4i2.203Keywords:
Karsinoid atipikal, neoplasma neuroendokrin timus, mediastinumAbstract
Tumor karsinoid atipikal yang berasal dari mediastinum sangat jarang; hanya beberapa kasus yang telah dilaporkan dalam literatur. Tumor yang agresif secara klinis ini termasuk ke dalam kelompok tumor neuroendokrin. Tumor karsinoid/neuroendokrin timus adalah neoplasma epitel neuroendokrin yang berasal dari timus dengan gambaran inti derajat rendah; karsinoid tipikal memiliki <2 mitosis/2 mm2 dan tidak memiliki nekrosis, sedangkan karsinoid atipikal mempunyai karakteristik 2-10 mitosis/2 mm2 dan/atau fokus nekrosis. Kami melaporkan kasus seorang pria berusia 26 tahun dengan keluhan sesak napas yang semakin bertambah sejak dua minggu sebelum dirawat di rumah sakit. Pemeriksaan radiologis menunjukkan massa isodens yang tidak homogen di mediastinum anterior. Pasien didiagnosis dengan karsinoma timus Masaoka Koga stadium IVA. Secara mikroskopis, jaringan core biopsi menunjukkan pulau sel dengan inti bulat hingga oval dengan gambaran kromatin salt and pepper dan adanya fokus nekrosis. Jumlah mitosis 2–10 mitosis/2 mm2 terkonfirmasi dengan uji Ki-67. Pemeriksaan imunohistokimia menunjukkan sel tumor terpulas positif dengan sinaptofisin, kromogranin, dan CD117. Pemeriksaan histopatologi mengonfirmasi tumor karsinoid atipikal mediastinum primer. Meskipun prognosisnya buruk, penegakan diagnosis yang cepat, multidisciplinary team (MDT) serta pemberian terapi multimodal diketahui dapat memperpanjang harapan hidup.
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