Peran Penting Pewarnaan Imunohistokimia dalam Membedakan Karsinoma Sel Skuamosa Basaloid (KSSB) Paru-Paru dari Karsinoma Neuroendokrin (KNE)

Deka Miftalia Anugrah Putri

Abstract


Latar belakang: Karsinoma sel skuamosa basaloid (KSSB) paru primer merupakan keganasan agresif yang sering menjadi jebakan diagnostik pada spesimen biopsi kecil karena tumpang tindih sitomorfologi yang nyata dengan Karsinoma Neuroendokrin Derajat Tinggi. Tujuan: Laporan ini bertujuan menekankan peran esensial algoritma imunohistokimia (IHK) untuk menyelesaikan ambiguitas diferensasi sel tersebut. Metode: Seorang laki-laki perokok berusia 63 tahun dengan massa sentral paru dievaluasi menggunakan pemeriksaan morfologi dan analisis imunohistokimia target yang meliputi p40, Cytokeratin, Synaptophysin, Chromogranin A, dan Ki-67. Hasil : Secara mofologi, lesi menyerupai Karsinoma Neuroendokrin Derajat Tinggi pada spesimen biopsi. Namun, analisis IHK menunjukan hasil positif inti yang kuat dan difus untuk p40 serta positif sitoplasma untuk Cytokeratin, sementara marka neuroendokrin Synaptophysin dan Chromogranin A negatif total, meskipun indeks Ki-67 mencapai 70%. Profil ini menegakan diagnosis KSSB paru primer sehingga memandu pengalihan terapi keregimen kemoterapi karsinoma paru sel non-kecil secara tepat. Kesimpulan: Mengandaikan morfologi konvensional saja pada spesimen terbatas sangat mengecoh. Oleh karena itu, panel imunohistokimia yang tepat mutlak diperlukan untuk menegakan diagnosis KSSB paru primer secara akurat.


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DOI: https://doi.org/10.18860/jim.v10i2.43689

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