Hermawan, Yosua Kevin
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Type-A Thymoma: A Case Report Hermawan, Yosua Kevin; Yaniswari, Ni Made Dwita
Jurnal Respirologi Indonesia Vol 44, No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.677

Abstract

Background: Thymoma is a neoplasm that arises from the thymus gland. Around one-third of the patients are asymptomatic. Five subtypes of thymoma differentiate from the cell’s morphology based on the World Health Organization (WHO). Type-A thymoma comprises oval or spindle epithelial cells.Case: We presented a 49-year-old woman with a persistent cough and shortness of breath when performing heavy tasks. Chest radiography showed opacity on the mediastinum. Chest computed tomography with contrast revealed a tumor in the anterior part of the mediastinum and pericardial effusion. The patient underwent an Ultrasonography (USG) guided transthoracic needle aspiration (TTNA) and the histopathology examination showed a type-A thymoma. The patient was referred to a cardiothoracic surgeon for further management.Discussion: Type-A thymoma has a good prognosis and is rarely associated with myasthenia gravis. It has a less malignant nature compared to type B2 thymoma. However, it still can cause respiratory problems through the mass effect of the tumor itself. Surgery is usually the treatment of choice. Radiotherapy and chemotherapy can also be considered if complete resection is hard to achieve.Conclusion: Type-A thymoma has a less malignant nature and has a good prognosis. In this case, the tumor caused compression into the right lung resulting in the partial collapse of the right middle lobe and pericardial invasion were taken into consideration due to pericardial effusion.
Chronic Pulmonary Aspergillosis with Tracheobronchial Involvement Hermawan, Yosua Kevin; Pranata, Anak Agung Ngurah Satya; Putra, Wayan Wahyu Semara; Sunaka, I Wayan; Novitasari, Novitasari; Angelina, Cokorda Rio
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.249-256

Abstract

Introduction: Aspergillosis is a fungal infection commonly found in human lungs and takes several forms. Chronic pulmonary aspergillosis (CPA) commonly affects individuals with underlying disease, most usually lung tuberculosis (TB). Aspergillosis can cause the formation of a fungus ball in the lung cavity and can also manifest in the tracheobronchial area, although this is rarely seen in immunocompetent patients. Case: A 23-year-old woman came with persistent cough, hemoptysis, and shortness of breath for 4 months. The patient also had a significant weight loss and a history of lung TB 3 years ago. She had completed her lung TB medication. Physical examination showed increased respiratory rate and rhonchi on the left lung. GeneXpert showed no Mycobacterium tuberculosis (MTB) detected. The chest X-ray showed a cavity on the left superior lobe of the lung. Bronchoscopy showed multiple plaques along the trachea, carina, and left main bronchus. A chest computed tomography (CT) scan with contrast enhancement was performed, and a fungus ball was found inside the cavity in the left upper lobe of the lung. The patient was given intravenous fluconazole as therapy and continued with oral fluconazole when discharged. A second bronchoscopy was performed, and improvement was shown. Conclusion: Early detection and treatment should be applied to CPA patients since some studies showed poor prognosis and low five-year survival rates.
Type-A Thymoma: A Case Report Hermawan, Yosua Kevin; Yaniswari, Ni Made Dwita
Jurnal Respirologi Indonesia Vol 44 No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.677

Abstract

Background: Thymoma is a neoplasm that arises from the thymus gland. Around one-third of the patients are asymptomatic. Five subtypes of thymoma differentiate from the cell’s morphology based on the World Health Organization (WHO). Type-A thymoma comprises oval or spindle epithelial cells.Case: We presented a 49-year-old woman with a persistent cough and shortness of breath when performing heavy tasks. Chest radiography showed opacity on the mediastinum. Chest computed tomography with contrast revealed a tumor in the anterior part of the mediastinum and pericardial effusion. The patient underwent an Ultrasonography (USG) guided transthoracic needle aspiration (TTNA) and the histopathology examination showed a type-A thymoma. The patient was referred to a cardiothoracic surgeon for further management.Discussion: Type-A thymoma has a good prognosis and is rarely associated with myasthenia gravis. It has a less malignant nature compared to type B2 thymoma. However, it still can cause respiratory problems through the mass effect of the tumor itself. Surgery is usually the treatment of choice. Radiotherapy and chemotherapy can also be considered if complete resection is hard to achieve.Conclusion: Type-A thymoma has a less malignant nature and has a good prognosis. In this case, the tumor caused compression into the right lung resulting in the partial collapse of the right middle lobe and pericardial invasion were taken into consideration due to pericardial effusion.