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Journal : Malang Respiratory Journal

The Role of Surgical Resection as A Salvage Therapy and Immunohistochemical Stain to Confirm Mediastinal Yolk Sac Tumor Eka Agustina, Dwi Rosa; Pratiwi, Suryanti Dwi; Retnani, Diah Prabawati; Isharanto, Artono; Erawati, Rachma Dini
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (800.64 KB) | DOI: 10.21776/ub.mrj.2020.002.01.3

Abstract

Background: Mediastinal germ cell tumors are uncommon, representing less than 1% of all malignancies. They mostly occur in young men after puberty and have a poor prognosis with over all long term survival rate 42%. Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an anterior mediastinum tumor and VCSS The CT scan of the chest showed an anterosuperior mediastinal mass which compress the superior vena cava. The result from transthoracic FNAB with USG guidance showed an extragonadal germ cell tumor which resemble an Embryonal Carcinoma from mediastinum. The AFP serum level was elevated. Patient underwent a radiotherapy and a surgical debulking. The biopsy showed an Endodermal Sinus Tumor (Yolk Sac). Immunohistochemical stain for cytokeratin was positive in the tumor cells while stain for CD30 was negative. These were confirming the diagnosis of primary mediastinal yolk sac tumor. Patient received a combination chemotherapy for a total 6 cycles.Conclusion: Some procedures like biopsy, tumor marker, immunohistochemical stain, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining chemotherapy with surgical therapy or radiotherapy could increase the survival outcome of patients.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1427.792 KB) | DOI: 10.21776/ub.mrj.2020.002.02.5

Abstract

Title: The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing  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 specialist  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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.362 KB) | DOI: 10.21776/ub.mrj.2021.003.02.4

Abstract

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.
Successful Therapy on Patients with Yolksac and Embrional Carcinoma by Surgery and Chemotherapy Prasetya, Fahmi Adhi; Djajalaksana, Susanthy; Retnani, Diah Prabawati; Isharanto, Artono; Normahayu, Indrastuti; Okta, Shinta
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.2020.002.01.5

Abstract

Background: Malignant mixed germ cell tumors account for 13-25% of all non seminoma germ cell tumors, almost all cases were found in males (85%), increased in the third decade, and had an average survival rate of 40-45%. With modern management the average 5-year survival rate can be over 80%.Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an malignant epithelial tumor derived from mediastinal or lung. The CT scan of the chest showed an lobulated solid mass of iso-hipodens on the anterior superior mediastinum, mass encompassing the aortic arch, left pulmonalis artery, subclavian artery. The result from transthoracic FNAB with USG guidance showed an malignant epithelial tumor derived from mediastinal or lung, impression of an adeno squamous carcinoma. The AFP, LDH, and NSE serum level was elevated. Patient underwent a surgical sternotomy and tumor debulking. The biopsy showed an malignant mixed germ cell tumor (yolksac and embrional carcinoma). These were confirming the diagnosis of malignant mixed germ cell mediastinal tumor (yolksac and embrinonal carcinoma). Patient received a combination bleomycin, etoposid, cisplatin 3 series chemoteraphy  and evaluated.Conclusion: Some procedures like biopsy, tumor marker, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining surgical therapy (surgical sternotomy and tumor debulking) with chemotherapy could increase the survival rate of patients.
Co-Authors Aina Angelina Amelinda Natania Nurasih Andreas Putra Christiawan Purba Andri Andri Anggie Sasmita Kharisma Putri Anggun Putri Yuniaswan Anugrah Putri, Deka Miftalia Aprilia, Andrea Arief Andy Soebroto Arif Widiatmoko Ariyanta Dafa Diputra Barasabha, Thareq Berlian Anggraeni Putri Boco Pranowo, Tri Pradesa Christiawan Purba, Andreas Putra Dani, Adinda Amalia Dewi, Rose Khasana Diah Prabawati Diputra, Ariyanta Dafa Djajalaksana, Susanthy Djanggan Sargowo Dwi Hadi Sulistyarini Dwi Jayasa, Pande Made DYAH FAUZIAH, DYAH Eka Agustina, Dwi Rosa Ekasari, Dhany Prafita Erawati, Dini Rachma Erawati, Rachma Dini Ervina, Rita Eviana Norahmawati Eviana Norahmawati Fadli, Muhammad Luqman Fitria Mayasari Hamka Muhammad Nasir Laitupa Hanggara, Dian Sukma Hardika, Arif Satria hardiyanto, frenky Harun Al Rasyid Harun Al Rasyid Harun Al Rasyid Hendy Setyo Yudhanto Herman Saputra hermanto, djoko heri Herwinda Brahmanti Hery Susilo Hidayat Sujuti Holipah Holipah Ihda Dian Kusuma Ihda Dian Kusuma Indrastuti Normahayu, Indrastuti Isharanto, Artono Karyono Mintaroem Kenty Wantri Anita Kenty Wantri Anita, Kenty Wantri Larasaty, Nanda Shaskia Lilasari, Sekar Puspita Lita setyowatie Lita Setyowatie Lita Setyowatie, Lita Lucky Pratama Muhammad Agung Putra Yudha Nurasih, Amelinda Natania Okta, Shinta Pande Made Dwi Jayasa Parsama Putra, Ngakan Putu Pinahayu, Griesinta Trianty Andria Prasetya, Fahmi Adhi Pratiwi, Suryanti Dwi Prawitasari, Suci Pudjo, Herwindo Putra Pandu Adikara Putra Yudha, Muhammad Agung Putri Rachma Safitri Putri, Anggie Sasmita Kharisma Putri, Berlian Anggraeni RA Rose Khasana Dewi Rachmad Sarwo Bekti Rahmadiani, Nayla Rahmawati, Yustian Devika Rumahorbo, Cicilia Angelica Safitri, Putri Rachma Setiyaningsih, Fera Yuli Shinta Oktya Wardhani, Shinta Oktya Sugiatno, Belladikna Brillianty Susilo, Hery Tazakka, Achmad Aidil Thareq Barasabha Widiatmoko, Arif Widiatmoko, Arif Yosephine, Septina Yudanto, Hendy Setyo Yudhanto, Hendy Setyo Yulian, Inneke Yuniasih, Dwi Intan Yuniaswan, Anggun Putri Yustian Devika Rahmawati