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All Journal Malang Respiratory Journal Jurnal Klinik dan Riset Kesehatan
Erawati, Dini
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Severe Abdominal Pain Due To Gastrointestinal Obstruction in Patient With Lung Adenosquamous Metastases in Colon Zata Dini; Pratiwi, Suryanti; Setyawan, Ungky; Budianto, Aries; Yudhanto, Hendy; Erawati, Dini
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.5

Abstract

Background: Lung cancer is the most common cause of cancer-related death globally. Moreover, metastatic cancer from the lungs frequently occurs and is commonly identified at the first diagnosis. The primary cancer must be identified in order to establish the most effective treatment. However, colonic metastases are rare with incidence of 0,1%. Aim: This report describes an unusual case of colonic metastases from lung adenocarcinoma. Methods: Patient (58-year-old male) was examined with Fiber Optic Bronchoscopy and core biopsy in the lungs, and the results were suspicious for squamous cells. The patient had severe abdominal pain and bloating for 1 week and had signs of gastrointestinal obstruction in his second visit. The result of urgent laparotomy was adenosquamous and the result of immunohistochemical examination was negative P40 and positive Napsin A in both lungs and colon. Results: The lung biopsy result indicated squamous cell and the ceccum showed adenosquamous. The immunohistochemical examination using P40 and Napsin A of both lung and ceccum specimens indicated that the lung was the primary source of metastases to the colon. Conclusion: The patient suffered from a squamous cell lung tumor and reported severe abdominal pain due to metastases to the colon with adenosquamous results.
A Case Report : Thymoma Mimicking Teratoma Clinically and Radiographic Appearance Eka Pratiwi; Djajalaksana, Susanthy; Pratiwi, Suryanti; Isharanto, Artono; Erawati, Dini; Yudhanto, Hendy
Malang Respiratory Journal Vol. 6 No. 1 (2024): March 2024 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.01.03

Abstract

Background: Thymoma is a rare tumor of thymic epithelial cells in anterior mediastinum. The etiology of thymoma is not known with certainty. Thymomas are difficult to distinguish from teratomas or other mediastinal tumors. Diagnosis of thymoma or teratoma is based on clinical symptoms, CXR, Thorax CT Scan, biopsy for definite diagnosis, and requires IHC examinations to be able to differentiate it from other mediastinal tumors. Case Presentation: A 62-year-old female, came with complaints of shortness of breath since 5 months when walking long distances accompanied by a dry cough for 1 week, and weight loss of 4 kgs in 10 months. Patient came from Lawang Hospital with results of AFP 1.59, B-HCG 3.8, CXR showed mediastinal mass, CT Scan Thorax showed solid mass with fat component and calcification in the right side of anterior mediastinum, suspected of a mature teratoma. Patient then underwent Tumor Excision Per Median Sternotomy by Cardiothoracic Surgeon on October 19, 2022, sampled a round tissue sized 7.5x7x6 cm with smooth surface, intact capsule likes teratoma. Discussion: PA examination was performed, with result of Germ Cell Tumor, we continued with Calretinin, CD99, SMA, S100, and Melan A IHC examinations. The results of the last IHC examination found, Type A Thymoma Cells. Patient is currently stable and recommended for radiotherapy. Conclusion: A patient with a thymoma mimicking a mature teratoma macroscopically and radiographically is an interesting case based on the results of thymoma type A from Immunohistochemistry examination but perform macroscopic likes teratoma. Keywords: Thymoma, Teratoma, Clinically, Radiographic
Management of Pneumomediastinum Patients in COVID-19: Rare Cases Santosa, Andrew; Djajalaksana, Susanthy; Listyoko, Aditya; Erawati, Dini
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.04

Abstract

Background: Spontaneous pneumomediastinum in patients with confirmed cases of Covid-19 is a very rare clinical finding in the world, especially in Indonesia. This is considered an indication of concern for a more serious medical problem. Aim: This case report discusses the management of COVID-19 patients with pneumomediastinum. Case: A 30 year old man came to the hospital with the main complaint of shortness of breath and cough. The patient was diagnosed with a confirmed case of Covid-19 and received therapy using High Flow Nasal Cannula (HFNC) as a therapeutic modality. After 5 days in the hospital, the patient's shortness of breath felt increasingly severe, and he began to feel chest pain and swelling around the chest area which spread to both sides of his neck. A thorax x-ray examination showed pneumomediastinum and subcutaneous emphysema, then a chest CT scan was performed and the results showed pneumomediastinum which was thought to be caused by esophageal rupture. After we communicated with the Thoracic Surgery Department, conservative therapy was recommended. Conclusion: Covid-19 infection can cause hypoxaemic respiratory failure and acute respiratory distress syndrome, both of which can be deadly. Supplementation of high-flow nasal cannula (HFNC) oxygen therapy can be very beneficial for patients, but can cause dangerous side effects such as pneumomediastinum. Pneumomediastinum (PM) is the presence of open air in the mediastinal cavity. In this case, we suspect that the pneumomediastinum was the result of Covid-19-related alveolar damage and esophageal rupture, and not due to the use of HFNC. Pneumomediastinum complications need to be detected early, so that management can reduce associated morbidity and mortality. Keywords: Pneumomediastinum; COVID-19, HFNC
Co-Authors Agil Dananjaya Aries Budianto Bayuadi, Imam Chen, Chung-Yu Chozin, Iin Djajalaksana, Susanthy Dwi Pratiwi, Suryanti Effendi, Tiar Oktavian Eka Pratiwi Ensang Timuda, Caesar Eviana Norahmawati Indrasworo, Dyah Irmansyah, Istan Isharanto, Artono Kartikasari, Ulfah Kristiani, Maria Listyoko, Aditya Matabei, Shannon Conversia Pdabo Paksi Satyagraha Pratiwi, Suryanti Pratiwiw, Suryanti Putra, Ngakan Rahman, Perdana Rahmawati, Dessika Ramadhan, Fitratul Rizqi, Putri Santosa, Andrew Seskoati Prayitnaningsih Setyawan, Ungky Sugiri, Yani Suryaman, Rachmat Wardhana, Koernia Yudhantara, Dearisa Yudhanto, Hendy Zata Dini