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All Journal Journal of Innovation and Applied Technology MNJ (Malang Neurology Journal) Universa Medicina Indonesian Journal of Medicine Jurnal Respirasi (JR) Respiratory Science Malang Respiratory Journal Indonesian Journal of Cancer International Journal of Radiology and Imaging

Erawati, Dini Rachma

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Author-ID : 1801500

Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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CT FINDINGS OF THREE GIANT MEDIASTINAL TUMORS IN YOUNG AGE Arifah, Arifah; Erawati, Dini Rachma
International Journal of Radiology and Imaging Vol. 1 No. 02 (2022): International Journal of Radiology and Imaging
Publisher : Department of Radiology, Medical Faculty, University of Brawijaya

Background : Mediastinal teratoma and other mediastinal tumors are very challenging to be distinguished from other mediastinal tumors. Mediastinal tumors can be optimally evaluated with computed tomography (CT). In this paper we present three young male patients with similar symptom of chronic chest pain and chronic cough. Materials and Methods: Conducting a literature review and medical records. Results : All patients in this case are young age male, below two decades. All chest CT shows giant mass, but they have different enhancing pattern, different amount of solid, cystic, calcification component. To make correct diagnosis of the mediastinal mass is important because of treatment planning difference, surgery or chemoteraphy. The first case shows benign teratoma with characteristic of heterogenous mass with large amount of fat, with presence of solid and calcification component. The second case shows malignant germ cell tumor with feature of heterogenous mass with predominantly solid component and small amount of fat. It also shows metastatic process in lung and bone. The third case shows Hodgkin lymphoma with slight enhanced mass that narrowed pulmonary artery and caused pericardial effusion. Conclusion: Various features of mediatinal tumors can be distinguished with CT modality.

MEDIASTINITIS, WHAT SHOULD WE KNOW: A CASE REPORT OF PNEUMOPYOTHORAX WITH SUSPECTED MEDIASTINITIS IN A 67-YEAR-OLD MALE Aditya, Aldo; Erawati, Dini Rachma
International Journal of Radiology and Imaging Vol. 3 No. 01 (2024): International Journal of Radiology and Imaging
Publisher : Department of Radiology, Medical Faculty, University of Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776//ub.ijri.2024.003.01.4

Mediastinal disease consists of various diagnoses that have different characteristics, and the severity is not the same. The mediastinal disease diagnosis is often delayed because of the non-specific and sometimes vague presentation and clinical symptoms. One of the commonly missed diagnoses is acute mediastinitis, which is usually presented with fever, pleuritic or retrosternal chest pain, and an inflammatory syndrome. Careful clinical evaluation and radiological correlation are essential when diagnosing mediastinitis, as well as the need to differentiate it from mediastinal infiltration due to malignancy. In this case report, we describe a 67-year-old male, who was referred with pyothorax, cough, and 10 kg of weight loss in the last 1 month. The patient then underwent a CT examination with contrast to establish the diagnosis. Finally, the patient was diagnosed with pneumopyothorax with suspicion of mediastinitis and abscess formation. The lessons learned from this case include the need for recognizing features of mediastinitis, such as fat stranding and fluid collection, which may contain gas locules, in the mediastinal region. The aim of this case report is to increase awareness of early signs of mediastinitis so that prompt management can be initiated as early as possible. Keywords: Mediastinitis, pneumopyothorax, CT thorax

D-Dimer and Brixia Score to Mortality in COVID-19 Patients Falyani, Silvy Amalia; Pratiwi, Suryanti Dwi; Setyawan, Ungky Agus; Erawati, Dini Rachma; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.99-106

Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious severe and acute respiratory syndrome caused by the SARS-CoV-2 virus. A variety of factors can increase a patient's risk of death, including coagulopathy characterized by increased D-dimer levels. Brixia scores could be one of the determinants of COVID-19 severity, as assessed by chest radiographs. This study aimed to analyze chest radiographic severity based on the Brixia score at the degree of coagulation based on D-dimer in mortality of COVID-19 patients who were hospitalized. Methods: This cohort retrospective study was conducted at Dr. Saiful Anwar General Hospital, Malang, using an observational cross-sectional design. The study included 300 medical records of COVID-19 patients who passed away while hospitalized. The data were analyzed using the Wilcoxon test, and the results were also tested for Spearman correlation to determine the relationship between variables. Results: Significance results of median D-dimer were found by age and severity of COVID-19 (p-values 0.015 and 0.002), and median Brixia scores by age, gender, severity of COVID-19, and length of treatment (p-values 0.001, 0.001, 0.001, and 0.005). The results were also compared with normal values, which were significant (p = 0.000). Spearman correlation test results between the final D-dimer and the initial Brixia score (p = 0.005). Conclusion: The research results display a retrospective study of the correlation between D-dimer and Brixia score values "‹"‹and outcomes in COVID-19 patients. Higher D-dimer values"‹ "‹and Brixia scores on admission were shown to be associated with mortality.

The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female Patient hardiyanto, frenky; Pratiwi, Suryanti Dwi; Erawati, Dini Rachma; Isharanto, Artono; Retnani, Diah Prabawati; Pudjo, Herwindo
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Title: The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing Â Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female PatientAuthor: Frenky Hardiyanto, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Suryanti Dwi Pratiwi, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Diah Prabawati R, MD, Patology Anatomy Specialist, Herwindo P, MD, Internal Medicine Specialist.Introduction:. A woman with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x-rays and ct thorax revealed a mass in mediastinum.Case Description: Patient is a 24 years old female with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x rays and CT thorax revealed a mass in mediastinum. Open biopsy on right neck mass and transthoracic FNAB resulting of chronic inflammation, so the patient was diagnosed with glandular tuberculosis and Mediastinal Tumor. Patient was getting worse after one month consuming OAT. Patient was consulted to Cardiovascular and thorax Surgery Department. Patient was performed thoracotomy and debulking. Anatomical pathology was examined from debulking mass, the result of immunohistochemistry was found nodular mediastinal gray zone lymphoma.Discussion: this case it is very difficult to enforce the diagnosis. Patients have done neck FNAB, transthoracic FNAB, open biopsy right neck mass and FOB have not been able to establish diagnosis. Until finally done thoracotomy and debulking in this patient, from immunohistochemistry results obtained nodular sclerosis Hodgkin lymphoma. Collaboration from pulmonologist, radiologist, cardiovascular and thorax surgeon, and patology anatomy specialistÂ is needed to confirm the diagnosis in these patients.Keywords: mediastinal tumor, mediastinal gray zone lymphoma

Lung Adenocarcinoma Metastases to Mediastinal with Malignant Pericardial Effusion Andri, Andri; Parsama Putra, Ngakan Putu; Sargowo, Djanggan; Erawati, Dini Rachma; Retnani, Diah Prabawati
Malang Respiratory Journal Vol. 3 No. 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Lung adenocarcinoma with malignant pericardial effusion and also metastases to mediastinum has great impact on morbidity and mortality of patient and it is rare case. Most adenocarcinoma in the mediastinum are metastases from the lung, gastrointestinal tract, pancreas, kidney or even the pituitary gland. Cardiac metastases in lung cancer may occur due to retrograde lymphatic spread or by hematogenous dissemination of tumour cells. Pericardium is frequently involved in direct cardiac invasion by adjacent lung cancer. Pericardial effusion, pericarditis, and tamponade are common and life threatening presentation in such cases. A 42-years-old male with superior mediastinal mass has malignant pericardial effusion, cytology shows adenocarcinoma. The patient undergo transthoracic fine needle aspiration biopsy. The result from biopsy is adenocarcinoma. This is a rare case, patient with primary lung adenocarcinoma and malignant pericardial effusion also metastases to mediastinum. To determine the diagnosis requires a comprehensive clinical evaluation and multidisciplinary approach.

Immunocytochemistry as a Diagnostic Procedure of Pleural Mesothelioma Trimurtini, Asih; Astuti, Triwahju; Yudhanto, Hendy Setyo; Erawati, Dini Rachma
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Background: Mesothelioma is a primary malignant tumor arising from the mesothelial surface of the pleura, peritoneal, tunica vaginalis, and pericardium. Most cases of mesothelioma originate from the pleura. Most patients have a history of asbestos exposure. A common diagnostic problem is distinguishing mesothelioma from adenocarcinoma since both tumors invade the pleura. Immunocytochemistry of calretinin and TTF-1 can be used to establish the diagnosis of mesothelioma.Case: Male, 56 years old presented with chest pain, shortness of breath, cough, and weight loss since 5 months before hospitalization. The patient had a history of occupational exposure to asbestos for 30 years. The movement and breath sounds were decreased as well as dull upon percussion at the right chest. A chest X-ray revealed a right lung tumor with pleural effusion. Thorax CT scan suggested pleural mass in right hemithorax, infiltration to intercostal muscles, and destruction of the 7th right rib, right perihilar lymphadenopathy, right pleural effusion, and liver nodules according to mesothelioma T4N1M1 Stage IV. Infiltrative stenting of the right and inferior lobe of the right lung, infiltrative and obstructive stenting of the medius lobe suggestive of a chronic malignancy and inflammation were found on FOB. Cytologic examination of pleural fluid, sputum, and Washing-and-brushing of FOB were a class II (no malignant cells). USG-guided transthoracic FNAB revealed adenocarcinoma with differential diagnosis of mesothelioma. Immunocytochemistry with calretinin showed positive results and TTF-1 showed a negative result. These confirmed the diagnosis of pleural mesothelioma T4N1M1 Stage IV. The patient showed a stable response from carboplatin/gemcitabine treatment.Keyword : Mesothelioma, Immunocytochemistry, TTF-1, Calrenitin

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

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

ABSTRACTTitle:Â Sarcomatoid CarcinomaÂ Of The Mediastinum: AÂ Rare Case of Giant MassÂ Thymic CarcinomaÂ 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, mostÂ patients will die after 3 years of diagnosis despite aggressive multimodality therapy.Case Description:Â A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlargingÂ 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 patientÂ hadÂ Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma.Â Discussion:Â Sarcomatoid carcinoma is a type of thymic carcinomaÂ that hasÂ both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This caseÂ wasÂ interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in thisÂ patient.Â

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

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.Â Case: We report a 37-year-old woman presented with shortness of breath since 1 month before admission, chest pain, cough, weight loss,Â 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 revealedÂ 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.Â Â Keywords: Mediastinal teratoma, vena cava superior syndrome, bilateral paramalignant pleural effusion.

Rare Case Giant Cystic Mediastinal Tumor (Mature Teratoma) in 57 years old Woman Akbar, Jimmy Akbar; Parsama, Ngakan Putu Putra; Erawati, Dini Rachma; Wardhana, Koernia Kusuma; Yudhanto, Hendi Setyo
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.02.6

Background : Incidence of mediastinal teratoma 8,5Â -Â 13,6% of all patients in mediastinal tumor. Teratomas are most common in young adults. Mediastinal teratoma is rarely present clinical manifestation. The clinical manifestation present along with increasing size of mass and also reported with chest pain, back pain, shortness of breath and febrile caused by chronic pneumonia. Rupture of a mediastinal teratoma can cause pleural effusion, empyema and cardiac tamponade. CT is first modality of choice for tumour diagnosis. Â Mature teratoma is a type of benign tumor, most patients will recovery after complete resection.Case Report : We report one case at Dr. Saiful Anwar hospital, an elderly woman,Â 57 yearsÂ old with mediastinal teratoma, whose formerly differential diagnosed with empyema. On the diagnostic test found no evidence of empyema but leads to loculated cloudy pleural effusion. Physical and supporting examination showed anterior mediastinal tumors. Based on theÂ CT-Scan and thorax sonography concluded that is a cystic mass on anterior right hemithorax dextra. The patient performed thoracotomy and eksploration with the final diagnosis of giant cystic mediastinum tumour, with the histopathology is mature teratoma.Â Â Conclusion: In this patient, the diagnosis of mediastinalÂ cystic mature teratoma Â with loculated pleural effusion proven through a multidisciplinary approach covering the pulmonology, thoracic and cardiovascular surgery, radiology and histopathology.Â Key words : Mediastinal tumour, Mature teratoma

Co-Authors Aditya, Aldo Akbar, Jimmy Akbar Andri Andri ARIFAH ARIFAH Astuti, Tri Wahyu Chozin, Iin Noor Chozin, Iin Nur Desfryda, Elynca Putri Djajalaksana, Susanthy Djanggan Sargowo Dwinadella, Sephia Elvira Sari Dewi Falyani, Silvy Amalia Handono Kalim hardiyanto, frenky Imam Suseno Isharanto, Artono Jeffry Beta Tenggara Kristianto, Fransiskus Kusworini Handono Listyoko, Aditya Sri Mahendra, Reza Aditya Maleachi, Reginald Mira Yuniarti Nurdiana Nurdiana Parsama Putra, Ngakan Putu Parsama, Ngakan Putu Putra Pratama, Mirza Zaka Pratiwi, Suryanti Dwi Pudjo, Herwindo Putri, Choirinnisa Meilia Ayu Rakhma , Sastia Rakhma, Sastia Retnani, Diah Prabawati Rini, Ni Made Rumaratu, Simon Petrus Hardiyanto santony, Santony Santoso, Agus Andreas Sari, Tita Luthfia Setiadi, Satya Setiawan, Ungky Agus Setyawan, Ungky Agus Soewondo, Widiastuti Sri Andarini Sugiri, Yani Jane R. Sugiri, Yani Jane Rosihaningsih Sutedjo, Verawati Tjakraatmadja, Ricardo Trimurtini, Asih Triwahju Astuti Wahono, Cesarius Singgih Wardhana, Koernia Kusuma Winarni, Tika Wahyu Wisnu Barlianto Yudhanto, Hendi Setyo Yudhanto, Hendy Setyo Yuyun Yueniwati Zaenal Kusuma

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