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Elderly Male Patient with Fibrotic Non Spesific Instertitial Pneumonia from Lung Biopsy by Video Assisted Thoracoscopy santony, Santony; Djajalaksana, Susanthy; Chozin, Iin Nur; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (316.507 KB) | DOI: 10.21776/ub.mrj.2020.002.02.3

Abstract

Background: NSIP is a rare disease, the incidence rate ranges from 1 to 9 per 100,000 population, where most cases of NSIP are idiopathic. NSIP definitive diagnosis is very difficult because it must be with a multidisciplinary approach and confirm from a pulmonary biopsy. On the course of his illnesses the possibility of Connective tissue diseases (CTDs) arising in NSIP during follow up period was about 10% of cases.Case Report: We reported one case at RS Dr. Saiful Anwar, an old adult male smoker, age 64 with fibrotic type Non Spesific Instertitial Pneumonia (NSIP). From clinical patients including anamnesis, physical examination and laboratory results and X-Ray chest, ILD suspicion was found. Bodypletstimography results show a corresponding decrease in DLCO with ILD. CT-Scan results obtained by crazy paving with pulmonary bronchiectasis traction in accordance with ILD susp Sussection NSIP and enforced from VATS biopsy results with conclusions according to NSIP description. Patients received corticosteroid therapy for 4 weeks and showed clinical improvement.Conclusion: In these patients the diagnosis of fibrotic NSIP has gone through a multidisciplinary approach including the pulmonology, radiologist and pathologist sections. Corticosteroid therapy in these patients gives good results and the patient is in stable condition. Periodic monitoring is necessary because of the risk of exacerbations and the incidence of CTD complications..
Sarcomatoid Carcinoma Of The Mediastinal : A Rare Case of Giant Mass Thymic Carcinoma Subtype Santoso, Agus Andreas; Parsama Putra, Ngakan Putu; Setiawan, Ungky Agus; Isharanto, Artono; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (12695.27 KB) | DOI: 10.21776/ub.mrj.2021.003.01.4

Abstract

ABSTRACTTitle: Sarcomatoid Carcinoma Of The Mediastinum: A Rare Case of Giant Mass Thymic Carcinoma SubtypeAuthor: Agus Andreas Santoso, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Ngakan Putu Persama Putra, MD, Pulmonologist Consultant, Ungky Agus Setiawan, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Hendy Setyo Yudhanto, MD, Pathology Anatomy Specialist.Introduction: Sarcomatoid carcinoma is a type of thymus carcinoma that contains partial or complete spindle cells. Incidence of Sarcomatoid Carcinoma 5-10% of all patients with thymic carcinoma. Carcinoma Sarcomatoid is a highly progressive tumor, most patients will die after 3 years of diagnosis despite aggressive multimodality therapy.Case Description: A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlarging lump in the neck and chest was felt for 1 month. Physical and supporting examination showed anterior superior mediastinal tumors and soft mass tissue in the right region of the Colli. Based on the Transthoracal FNAB Guiding ultrasound and FNAB the anterior colli region concluded that Thymoma, thyroid oncocytic adenoma and Nodular colloid goiter with azkanasy cell proliferation. The patient had Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma. Discussion: Sarcomatoid carcinoma is a type of thymic carcinoma that has both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This case was interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in this patient. 
Case Report Mediastinal Teratoma Resembling Vascular Tumor with Rapid Growth Accompanied by Vena Cava Superior Syndrome and Bilateral Paramalignant Pleural Effusion Rini, Ni Made; Pratiwi, Suryanti Dwi; Bayuadi, Imam Suseno; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.01.6

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Background: Teratomas are tumors originate from germ cells, consist of well differentiated tissue from more than one of three layers of embryonic cells: ectoderm, mesoderm and endoderm. Teratomas are generally slow-growing and asymptomatic. Mediastinal teratoma is the most common extra-gonadal germ cell tumor. Superior vena cava syndrome and bilateral paramaligant pleural effusion are complications which can occur in mediastinal teratomas. Case: We report a 37-year-old woman presented with shortness of breath since 1 month before admission, chest pain, cough, weight loss,  swolen of face, neck, and right arm. Chest x-ray showed mediastinal tumor. However, no mediastinal tumor had been detected by chest x-ray to examine her heart disease 3 years earlier. Chest computed tomography scan showed anterosuperior mediastinal tumor surrounding great blood vessels and bilateral pleural effusion. Computed tomography guided transthoracic fine needle aspiration biopsy revealed  tumor containing mature squamous epithelial component. Patient underwent open biopsy by sternotomy and histological assessment confirmed the diagnosis as mediastinal teratoma with vascular lesions predominantly resembling vascular tumor.Conclusion: Establishing the diagnosis of mediastinal teratoma is challenging and it requires multi modality approaches.  Keywords: Mediastinal teratoma, vena cava superior syndrome, bilateral paramalignant pleural effusion.
Case Report: 43-years old-Male with Pulmonary Sequestration which Mimics Lung Tumor and Aspergillosis Rumaratu, Simon Petrus Hardiyanto; Setyawan, Ungky Agus; Wardhana, Koernia Kusuma; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 4 No. 1 (2022): Vol. 4 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.01.4

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Background: Pulmonary sequestration is a very rare congenital abnormality of the lung, which was responsible for 0.15-6.4% of all cases of congenital lung formation disorders. Pulmonary sequestration is often seen as recurrent pneumonia, accompanied by complaints of chest pain, shortness of breath and hemoptysis. Conventional angiography is the gold standard for diagnosing pulmonary sequestration and for demonstrating arterial supply and venous drainage. The optimal therapy for pulmonary sequestration is operative resection to avoid infection and damage to the lung parenchyma. Case Report: We reported a case of 43-years old-male with pulmonary sequestration, previously diagnosed with a lung tumor with massive left pleural effusion and pneumonia. A series of diagnostic tests found no malignant cells. During FNAB with CT scan guiding, we found an image of a fungus ball, thus, he was diagnosed with Aspergillosis. The patient was planned to undergo VATS. There were complications during the operation, thus, a lobectomy with an open thoracotomy was performed, and an arterial anomaly was found from the abdominal aorta. The operation was successful and the patient was able to carry on with his normal activities.Conclusion: Establishing a definite diagnosis of pulmonary sequestration is very difficult, and in this case, it was done through lobectomy with thoracotomy and through a multidisciplinary approach.
CASE REPORT A 30-year-old Woman with Multiple-Sites Metastasis Lung Adenocarcinoma and Coronavirus-19 Disease (COVID-19) Naftali, Yokanan; Sugiri, Jani Jane Rosihaningsih; Pratiwi, Suryanti Dwi; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.5

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Background: Adenocarcinoma is the most common Non-Small Cell Lung Cancer (NSCLC) in non-smokers in Indonesia. It often metastasizes in multiple sites. Metastasis is a negative predictor for prognosis in lung adenocarcinoma. In this covid pandemic era we present a case of a 30-years-old woman with adenocarcinoma and multiple-sites metastasis, and Coronavirus-19 Disease (COVID-19). Case: A 30-year-old woman came to our hospital with multiple complaints of hearing loss, visual loss, and occasional shortness of breath. The patient had a history of wild-type EGFR adenocarcinoma and has been treated with 4 cycles of gemcitabine. She also presented with a lump in her neck. Further examination revealed multiple metastasis tumours in her brain, right eye, neck, and spine. Pleural fluid examination also showed a malignant pleural effusion. Nasopharyngeal swab using reverse transcriptase-polymerase chain reaction (rt-PCR) method revealed that she also suffers from COVID-19 with positive swab result. Despite adequate treatment, she rapidly deteriorates and passed away in hospital. Discussion: Management in this patient is complex due to multiple complications and limitation of management given in COVID-19 isolation ward. She presented with multiple equally complicated metastasis, in which treatment priority should be carefully assessed. Despite treatment by multiple specialists, her problems still persist and proved to be fatal. Conclusion: Although metastasis is common in adenocarcinoma, multiple metastasis is uncommon, and this case highlights the need of careful management priority in such patients in COVID-19 pandemic setting. Keywords: Adenocarcinoma, Multiple Metastasis, Lung Cancer, COVID-19
Effect of a high-calorie diet on pro- to anti-inflammatory macrophage ratio through fat accumulation in rat lung tissue Lestari, Indah Puji; Chozin, Iin Noor; Sartono, Teguh Rahayu; Sasiarini, Laksmi; Yudhanto, Hendy Setyo
Medical Journal of Indonesia Vol. 32 No. 4 (2023): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236991

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BACKGROUND A high-calorie diet increases the risk of obesity. Accumulation of fat causes inflammation, as seen by the increased ratio of pro- to anti-inflammatory macrophages in a high-calorie diet. The pro-inflammatory shift in macrophage polarization may result in hypoxia, fibrosis, emphysema, and asthma. This study aimed to determine the effect of a high-calorie diet on pro- to anti-inflammatory macrophage ratio through fat accumulation. METHODS This experimental study used in vivo test in 16 male Sprague-Dawley rats aged 10–12 weeks. The rats were divided into high-calorie and normal diet groups for 16 weeks. Obesity in rats was defined as having a body mass index (BMI) of >0.68 g/cm2. Examination of lung fat accumulation was done through oil red O staining, while pro- to anti-inflammatory macrophage ratio was tested through CD11c and CD206 expressions by immunohistochemical method. RESULTS The high-calorie diet group had higher BMI (0.72 [0.02] versus 0.62 [0.03]; p<0.001), lung fat accumulation (32.73 [10.55] versus 0.37 [0.38]; p<0.001), and pro- to anti-inflammatory macrophage ratio (0.83 [0.02] versus 0.24 [0.006]; p<0.001). The higher the fat accumulation, the higher the pro- to anti-inflammatory macrophage ratio (r = 0.933; p<0.001). CONCLUSIONS The ratio of pro- to anti-inflammatory was higher in the high-calorie diet group, indicating polarization of macrophages toward pro-inflammatory macrophages.
Persistent Pneumothorax in Neurofibromatosis Type-1 Simamora, Hustorio Aliongko; Djajalaksana, Susanthy; Chozin, Iin Noor; Erawati, Dini Rachma; Yudhanto, Hendy Setyo; Damanik, Gracelia Ruth Elisabeth; Dani, Adinda Amalia; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.64-70

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Introduction: Neurofibromatosis type 1 (NF-1) is a rare autosomal dominant disorder. While typically recognized by its cutaneous features, pulmonary involvement, including apical cysts and basal interstitial fibrosis consistent with interstitial lung disease (ILD), can occur in up to 20% of patients. These manifestations create a predisposition to complications such as spontaneous pneumothorax. While this is relatively uncommon, occurring in approximately 1.5% of patients with NF-1, it represents a serious and potentially life-threatening complication when it does occur. Case: A 52-year-old male with a 20-pack-year smoking history and active pulmonary tuberculosis (TB) presented with acute chest pain and dyspnea. Dermatological examination and skin biopsy confirmed the diagnosis of NF-1. A high-resolution computed tomography (HRCT) scan of the chest revealed multiple subpleural pulmonary cysts consistent with NF-1-related ILD, alongside findings suggestive of active TB. The patient was diagnosed with a secondary spontaneous pneumothorax (SSP), which proved to be persistent despite initial chest tube drainage, ultimately requiring surgical intervention. Conclusion: This case highlights that NF-1 is a significant underlying risk factor for persistent pneumothorax, particularly when co-existing with other conditions like active TB and a history of smoking. The chronic inflammation and parenchymal destruction associated with these comorbidities can exacerbate the inherent structural lung abnormalities in NF-1, leading to complex, difficult-to-manage clinical scenarios. Early recognition of pulmonary manifestations in patients with NF-1 is crucial for anticipating and managing severe complications.