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Adenoid Cystic Carcinoma Nasal Sudarmanto, Yohanes; Soehartono; Angelina, Aina; Yudhanto, Hendy; Putri, Anggie
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Latar belakang: Keganasan sinonasal memiliki angka kejadian yang jarang. Adenoid cystic carcinoma (ACC) merupakan tumor ganas tersering kedua di daerah sinonasal, memiliki karakteristik pertumbuhan lambat namun berpotensi metastasis jauh dan rekurensi yang tinggi. Tatalaksana utama penyakit adalah tindakan pembedahan radikal dilanjutkan radioterapi. Pemilihan pendekatan tindakan pembedahan bergantung pada stadium dan lokasi tumor. Prognosis keganasan sinonasal kurang baik, berhubungan dengan tipe histologis tumor, kejadian invasi perineural, perivaskular, dan metastasis jauh, lokasi tumor, usia pasien dan modalitas terapi. Tujuan: Melaporkan satu kasus ACC nasal dengan metastasis regional cervical yang dilakukan tindakan pembedahan dan dilanjutkan radioterapi. Laporan Kasus: Laki-laki, 70 tahun, datang ke klinik THTKL RSUD dr. Saiful Anwar Malang dengan keluhan benjolan di dalam hidung kanan disertai buntu hidung dan riwayat mimisan selama 1 tahun. Pasien dilakukan tindakan pembedahan dengan pendekatan rinotomi lateral menggunakan insisi Moure. Histopatologi jaringan operasi adalah ACC tipe cribiform. Kesimpulan: Tindakan pembedahan dilanjutkan radioterapi masih menjadi baku emas tatalaksanan ACC nasal. Evaluasi berkala jangka panjang harus dilakukan untuk deteksi dini rekurensi lokoregional dan kejadian metastasih jauh pasca tindakan pembedahan dan radioterapi.

Rare Case : Lymphangioleiomyomatosis in a 28 year-old woman with spontaneous bilateral pneumothorax Matabei, Shannon Conversia Pdabo; Djajalaksana, Susanthy; Chozin, Iin; Erawati, Dini; Wardhana, Koernia; Yudhanto, Hendy; Rahman, Perdana; Chen, Chung-Yu
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.04

Introduction: Lymphangioleiomyomatosis (LAM) is an extremely rare disease with no known exact cause, in which there are abnormalities in the development of smooth muscle cells. This condition manifests in multiple organs, one of which is the lungs. Prevalence of LAM is 1 in 1,000,000, most commonly found in women of reproductive age. Pneumothorax occurs in two-thirds of LAM patients. It is possibly underdiagnosed in Indonesia. Case report: A 28-year-old woman came to the Emergency Department with sudden severe shortness of breath. Chest X-ray shows bilateral pneumothorax predominantly on the left side, and a chest tube was installed. Thorax MSCT revealed multiple cysts in all areas of lungs, while abdominal USG and MRI discovered masses in uterus and right adrenal. Left bullectomy-thoracotomy and lung biopsy were performed, with histopathology result supporting LAM. The patient was stable post surgery. LAM is associated with mutations in TSC1 or TSC2 genes, resulting in cystic changes caused by LAM cells proliferation in the lungs. In this patient, bilateral pneumothorax resulted from multiple subpleural cysts which eventually ruptured. Diagnosis of LAM was established by radiological imaging and lung biopsy. Surgical and non-surgical interventions were performed to address the acute manifestations of LAM. Unfortunately, Sirolimus which is the recommended long-term medication for LAM is not yet available in Indonesia. Conclusion: LAM is a rare disease. It’s important for clinicians to be familiar with this condition, aware of its progression and possible recurrence of pneumothorax, in order to provide appropriate interventions.

Adenoid Cystic Carcinoma Nasal Sudarmanto, Yohanes; Soehartono; Angelina, Aina; Yudhanto, Hendy; Putri, Anggie
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.2.8

Background: Sinonasal neoplasms are uncommon. Adenoid cystic carcinoma (ACC) is the 2nd commonest sinonasal malignancy, characterized by an indolent and slow growth but relatively high local recurrence and distant metastasis rate. Surgical management followed by adjuvant radiation therapy is the mainstay of treatment for sinonasal ACC. Surgical approach is modified according to the tumor size and location.In general, prognosis of sinonasal neoplasms is poor. Factors that contribute the overall prognosis such as type of histopathological findings, absent of perineural or perivascular invasion and distant metastases, site of tumour, age of patient and treatment modality. Aim: To report a case of nasal ACC with regional metastases treated with surgical management followed radiation therapy. Case Report: A 70-years-old man came to the ENT clinic at RSUD dr. Saiful Anwar Malang with right nasal obstruction and history of right epistaxis for 12 months. The patient underwent surgical using lateral rhinotomy approach with Moure’s incision, histopatological specimen revealed a cribiform type ACC. Conclusion: Surgical management and adjuvant radiation therapy is the gold standard for sinonasal ACC Longterm evaluation is a mandatory according to the high incidence of local recurrence and distant metastases of sinonasal ACC.

A Confirmed Case of Idiopathic Pulmonary Fibrosis - Probable Usual Interstitial Pneumonia Pattern through Lung Biopsy Kristiani, Maria; Djajalaksana, Susanthy; Erawati, Dini; Yudhanto, Hendy; Bayuadi, Imam
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.2022.004.01.2

Background: Although classified as a rare disease, the global burden of disease study reports showed that interstitial lung disease is ranked 40th in the diseases with high mortality, and its prevalence had increased by 86% since 1990. The most common interstitial lung disease”idiopathic pulmonary fibrosis (IPF)”has low survival rates”2-3 years after diagnosis”and is irreversible. Establishing a definite diagnosis of IPF is very difficult because it needs a multidisciplinary approach, as an establishment based on the description of HRCT and lung biopsy is needed. The goal of therapy is to prevent the progression of fibrosis. Case: We report a case of an adult woman, 46 years old with idiopathic pulmonary fibrosis (IPF) with Probable Usual Interstitial Pneumonia (UIP) pattern at dr. Saiful Anwar Hospital. History taking, physical examination and laboratory and chest Xray examination of the patient found a suspicion of ILD. CT-scan showed fibrosis in both lungs, honeycomb appearance with pulmonary bronchiectasis traction, which fit the description of IPF, and thus suspended the diagnosis of ILD. VATS pulmonary biopsy confirmed the diagnosis of IPF. The patient experienced a decrease in clinical conditions, as her complaint was worsening in the last month, in accordance to the state of acute exacerbations. Conclusion: In this patient, the diagnosis of IPF with Probable UIP pattern was made through a multidisciplinary approach, including the pulmonology, radiology and anatomical pathology department. Keywords: IPF, IPF, Probable UIP Pattern, IPF Diagnosis

Lobectomy Procedure in Reccurent Hemoptysis and History of Tuberculosis Treatment with Suspected Lung Mycosis Kartikasari, Ulfah; Sugiri, Yani; Bayuadi, Imam; Erawati, Dini; Yudhanto, Hendy
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.2022.004.01.5

Background : Hemoptysis is one of the often symptoms that complained in respiratory disease with fungal Infection. Jakarta reported that prevalency of Invasive Pulmonary aspergillosis is 7,7% and Pneumocystis pneumonia is 14.5%. Lung mycosis is still difficult to diagnosed so the management of therapy is often too late. The risk factors of lung mycosis in these patient are immunocompromised conditions with Diabetes Melitus, history of Tuberculosis treatment and COPD. The diagnosis criteria of systemic/invasive mycosis are proven, probable and possible. Proven criteria diagnosed is based on host factor, clinical finding and mycology whereas possible criteria diagnosed is based on host factor and clinical finding without mycology.Case Report: We report one case at Dr. Saiful Anwar hospital, Man, 43 years old with History of Tuberculosis Treatment and suspected as Lung Mycosis with chef complained hemoptoe recurrent in last 2 months, shortness of breath, cough, right chest pain, fever, night sweating and decrease of body weight 1-2kg in a month. From the physical examination we found percussion dullness and decreased of lung sound in the right upper thorax examination and laboratory results and chest xray there are suspicion of Aspergillosis. The results of XpertMtb/Rif sputum examination obtained that no Mycobacterium tuberculosis, sputum KOH was not found fungus, cytological sputum was obtained as Class II, and in bacterial sputum culture obtained Klebsiella pneumonia. The patient performed a bronchoscopic examination and continued with open thoracotomy surgery and lobectomy.Conclusion: In these patient the diagnosis of lung mycosis with suspicious of Aspergillosis has gone through a multidisciplinary approach covering the pulmonology, radiology, microbiology and anatomical pathology. Collaboration between doctors, researchers, and the pharmaceutical industry is required to resolve the problem of fungal diseases and can increase the profile of these diseases.

Mediastinal Lymphohemangioma (Case Report): A (Report of a) Rare Case with Difficult Diagnosis ramadhan, fitratul; Pratiwiw, Suryanti; Isharanto, Artono; Erawati, Dini; Yudhanto, Hendy
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.2022.004.01.1

Mediastinal lymphohemangioma is a very rare, benign, congenital malformation. Mediastinal lymphohemangioma originates from local proliferation of lymphatic vessels. This disorder is accountable for 4.5% among all mediastinal tumors. Most lymphohemangiomas are found in the neck and axillary region among children, whereas only 1% are found in the mediastinum and tend to occur in individuals aged over 20 years old. A proper understanding is needed to be able to make a diagnosis and perform effective management of mediastinal lymphohemangiomaIn this case report, a woman with a diagnosis of mediastinal lymphohemangioma, established through a multidisciplinary approach covering the fields of pulmonology, thoracic and cardiovascular surgery, radiology, and anatomical pathology.Keywords: Mediastinal Lymphohemangioma, Core Biopsy, Thoracotomy

A Thymoma (Case Report): Importance of Comorbidity, Lifestyle, and Thymoma Size in Treatment Success Suryaman, Rachmat; Djajalaksana, Susanthy; Setyawan, Ungky; Wardhana, Koernia; Erawati, Dini; Yudhanto, Hendy
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.2022.004.02.4

Thymoma is a rare malignancy with an incidence of 0,15 case per 100.000 population and is the most commonly diagnosed anterior mediastinal malignancy. With 12,5% 15-year survival rate, and is often accompanied by autoimmune disease such as myasthenia gravis, pure red blood cell aplasia, and hypogammaglobulinemia, better understanding of factors affecting prognosis is needed to improve patient quality of life and survival.

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

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

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

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