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All Journal Journal of Innovation and Applied Technology MNJ (Malang Neurology Journal) Universa Medicina Majalah Kesehatan FKUB Indonesian Journal of Medicine Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Respiratory Science Malang Respiratory Journal Indonesian Journal of Cancer International Journal of Radiology and Imaging Journal of Community Health and Preventive Medicine (JOCHAPM)
Dini Rachma Erawati
Department Of Radiology, Faculty Of Medicine, Universitas Brawijaya/Dr. Saiful Anwar General Hospital, Malang, Indonesia.
Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Gene Muatatuion Changes in Adenocarcinoma Lung Cancer Patient With Left Pyopneumothorax Nurandhini, Marsha; Suryanti Dwi Pratiwi; Yani Jane R. Sugiri; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 7 No. 1 (2025): March 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.01.06

Abstract

Introduction: Adenocarcinoma is the most common subtype of lung cancer, around 40% of lung cancer cases worldwide. It’s specific to epidermal growth factor receptor (EGFR) mutation. Lung cancer can be risk factor and increases the mortality rate of pyopneumothorax (12.8% higher in cancer patients). Case Illustration: A 69 year old woman, non smoker, who is diagnosed with lung adenocarcinoma (Exon 18 and 21 mutation) in May 2021 and came to emergency room with complaints of worsening shortness of breath. Cloudy-yellow pleural fluid was drained during thoracocentesis procedure. Imaging study using thorax CT scan showed a left lung mass obliterating bronchial segments 1/2, 3 and left hydropneumothorax. The patient was later diagnosed with pyopneumothorax and thorax drain procedure was performed. Antibiotic therapy was based on culture result. Through a following ctDNA (circulating tumor DNA) test, the mutations change to Exons 19 and 20 T790M. Discussion: Pyopneumothorax in this patient can occur due to disorder in the integrity of the host defense mechanisms, which then develops infection in the pleural cavity. The T790M mutation is found in 50-60% cases that are resistant to tyrosin kinase inhibitors (TKI). Third-generation TKI is main option for this condition, however, platinum-based chemotherapy can be considered, as in the case above, where third-generation chemotherapy cannot be given due to limitation of insurance coverage. Conclusion: Lung cancer can be associated with occurance of pyopneumothorax. Genetic mutation changes can occur due to resistance mechanisms. Giving platinum-based chemotherapy can be considered in such cases. Keywords: lung adenocarcinoma, genetic mutation, pyopneumothorax
Hydrocarbon Pneumonitis After Repeated Exposure and Gasoline Aspiration with Differential Diagnosis Lung Tuberculosis Setiadi, Satya; Rakhma, Sastia; Chozin, Iin Noor; Astuti, Tri Wahyu; Sugiri, Yani Jane R.; Yudhanto, Hendy Setyo; Erawati, Dini Rachma
Malang Respiratory Journal Vol. 7 No. 1 (2025): March 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.01.05

Abstract

Introduction: Chemical pneumonitis is an uncommon condition. Hydrocarbon pneumonitis is a kind of chemical pneumonitis. The features of this disease are atypical and may manifest either abruptly or persistently. Lung tuberculosis is an endemic illness in Indonesia, with an estimated 969,000 patients exhibiting diverse characteristics that may resemble chemical pneumonitis. Case Report: A 29-year-old gas station attendant with a history of recurrent exposure to gasoline vapours and episodes of asphyxiation while syphoning gasoline. A thoracic CT scan with contrast reveals several bilateral nodules with a tree-in-bud pattern, suggestive of pulmonary tuberculosis, with chemical pneumonitis as a differential diagnosis. Utilising clinical data, including occupational history, body plethysmography and spirometry results (moderate restrictive), laboratory findings, CT scan pictures, and Volatile Organic Compound analysis (elevated hydrocarbon levels), the patient is diagnosed with hydrocarbon pneumonitis. Discussion: The differential diagnosis was excluded through the analysis of sputum using molecular rapid test, IGRA test, LJ culture, and AFB of bronchial washing fluid. The administration of inhaled corticosteroids is a viable therapeutic option for this situation. Following six months of medication and exposure avoidance, the patient's condition has been improving. The patient was initially diagnosed with suspected lung tuberculosis based on a thoracic CT scan with contrast revealing bilateral multiple nodules exhibiting a tree-in-bud pattern. However, considering the patient's occupational history involving exposure to gasoline vapour and a history of choking on gasoline, the radiological findings ultimately confirmed a diagnosis of hydrocarbon pneumonitis. Case management may be determined by the severity level; however, due to its rarity, no primary treatment option exists. Conclusion: Hydrocarbon pneumonitis is infrequently encountered in comparison to pulmonary tuberculosis. Inhaled corticosteroids are a treatment alternative that yields clinical improvement. This example illustrates those rare diseases, such as hydrocarbon pneumonitis, can mimic pulmonary tuberculosis.
RADIOGRAPHIC APPROACH FOR EVALUATING LUNG ABSCESS IN A PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS Oktavinayu Sari Latif; Dini Rachma Erawati
International Journal of Radiology and Imaging Vol. 4 No. 01 (2025): 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.2025.004.01.1

Abstract

Systemic lupus erythematosus is a complicated autoimmune disease that presents in various organs, one of which is the lungs. We reported a 20-year-old female patient complaining of cough with phlegm, shortness of breath, chest pain radiating to the right shoulder, and a fever two weeks before admission. The patient was examined by thoracic radiography and thoracic CT scan with contrast. They found cavities with air-fluid levels and ground-glass opacity around them, with the results of sputum microbiological examination showing Klebsiella pneumoniae infection. The patient was then given antibiotic therapy. During an evaluation a month after therapy, the air-fluid level reduced, but the consolidation remained. The patient underwent sputum microbiological examination again and presented with MDR Klebsiella pneumoniae, which was then given therapy according to the results of antibiotic sensitivity. At the evaluation, the consolidation reduced, and the patient experienced clinical improvement. Risk factors for lung abscess in SLE patients are immune dysregulation, disease activity, and immunosuppressive therapy given to patients. Both conventional radiographs and CT scans have their place for approaching the diagnosis of lung abscesses in SLE patients. Thus, they should be performed to consider the appropriate management for SLE patients.
THE CORRELATION OF HEMOGLOBIN LEVELS AND EXTENT OF LESION IN THORAX RADIOGRAPHY EXAMINATION OF PULMONARY TUBERCULOSIS PATIENTS Muhammad Zacky Hafiyyan Maulana; Dini Rachma Erawati; Yuyun Yueniwati
International Journal of Radiology and Imaging Vol. 4 No. 01 (2025): 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.2025.004.01.3

Abstract

Hemoglobin is an important protein in erythrocytes that is useful for transporting oxygen throughout the body. Changes in hemoglobin levels are often associated with medical disorders, which are diagnostic indicators for several diseases, including pulmonary tuberculosis. Tuberculosis diagnosis is often carried out through a thorax radiography examination by looking at the extent of the lesion (minimal, moderate advanced, or far advanced). Low hemoglobin levels (anemia) are associated with biomarkers of tuberculosis severity. The objective of this research is to ascertain the correlation between hemoglobin levels and the extent of lesions in thorax radiography examination of patients with pulmonary tuberculosis. In this observational research, secondary data from patient medical records is analyzed. The subjects of this research were pulmonary tuberculosis patients at Dr. Saiful Anwar General Hospital, East Java, Indonesia. Using the Chi-square test, the data from 55 subjects were analyzed, and the findings showed a p-value < 0.001. With a p-value < 0.05, this research shows that hemoglobin levels are significantly correlated with the extent of lesions from thorax radiography examinations of pulmonary tuberculosis patients.
Aspergilloma: Clinical Manifestation After Tuberculosis Infection Winarni, Tika Wahyu; Erawati, Dini Rachma
International Journal of Radiology and Imaging Vol. 1 No. 01 (2022): 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 | Full PDF (346.004 KB) | DOI: 10.21776/ub.ijri.2022.001.01.2

Abstract

Aspergilloma is a mass-like fungus ball consisting of Aspergillus fumigatus. Aspergilloma occurs in patients with pulmonary structural abnormalities in which the presence of a previous cavity is the predisposing factor that most often results in Aspergillus colonization, especially in tuberculosis endemic countries. 28 y.o and  33 y.o female , complained of hemoptysis, chest pain, weight loss, and a history of TB treatment. The chest X-ray and CT scan revealed a solid lesion with an “Air-crescent sign” indicating Aspergilloma lesion. Patients were given symptomatic, anti-fungal drugs, and supported  by embolization procedure to reduce hemoptysis. The patient's condition began to improve after treatment. Imaging findings in x-rays and CT scans that point to Aspergilloma will help doctors in further management to provide a better prognosis for the patient.
ABNORMAL FREE GAS COLLECTION IN RADIOGRAPHY: A PICTORIAL REVIEW Tjakraatmadja, Ricardo; Erawati, Dini Rachma
International Journal of Radiology and Imaging Vol. 1 No. 01 (2022): 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 | Full PDF (424.62 KB) | DOI: 10.21776/ub.ijri.2022.001.01.3

Abstract

An abnormal free gas collection in the thorax and abdomen is a condition which is present of abnormal air in the thorax and abdominal cavity that normally not found. Radiological examination plays very important role to detect the presence of abnormal gas, the volume, the location, and the complication. Some of these conditions can represent classic radiological appearance that we can find in everyday practice.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (447.997 KB) | DOI: 10.21776/ub.ijri.2022.001.02.2

Abstract

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.
THE EVOLUTION OF RADIOLOGICAL IMAGES IN A 4-MONTH-OLD INFANT WITH CONGENITAL PULMONARY AIRWAY MALFORMATION: A CASE REPORT Sigiro, Rahel Margareth Febriana; Dini Rachma Erawati
International Journal of Radiology and Imaging Vol. 2 No. 01 (2023): 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.2023.002.01.2

Abstract

Congenital pulmonary airway malformation, formerly known as congenital cystic adenomatoid malformation, is a heterogeneous group of cystic and non-cystic pulmonary lesions marked with the overgrowth of primary bronchioles, which is associated with an abnormal bronchial tree that does not have cartilage. A 4-month-old boy came with a complaint of productive coughs since he was 3 weeks old, fever since the age of 2 months, and shortness of breath. The patient was once hospitalized due to pneumonia and suspected tuberculosis. After undergoing serial chest radiographs, the results showed multiple cysts that were dominant in the lower lobe of both lungs with surrounding infiltrates. Through the confirmation of a chest CT scan, there were small, multiple cysts with a size of <2 cm in both lungs, connected to the bronchial branch, accompanied by consolidation with an air bronchogram suggestive of type 2 congenital pulmonary airway malformation. Congenital pulmonary airway malformation is a rare case that usually requires serial chest radiographs to assist in the establishment of its diagnosis and a CT scan for a definitive diagnosis of its lesions. Keywords: CPAM, congenital, pulmonary malformation, imaging
CURVULARIA PULMONARY FUNGAL INFECTION ASSOCIATED WITH IMMUNOCOMPROMISED PATIENT: HOW CT SCAN COULD HELP IN MAKING DIAGNOSIS Kristina Paskalita Kero; Dini Rachma Erawati
International Journal of Radiology and Imaging Vol. 2 No. 02 (2023): 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.2023.002.02.5

Abstract

Pulmonary fungal infections can be found in immunocompetent and immunocompromised patients. The Curvularia species of fungi are rarely seen in humans. These fungi can be clinically significant and cause a range of disease processes, particularly in immunocompromised patients. We present a 24-year-old male patient diagnosed with SLE 5 years ago, complaining of fever five days before hospital administration concerning pneumonia. A CT scan revealed consolidation and multiple lung nodules compatible with a fungal pulmonary infection. The result of the sputum culture indicated Curvularia. A chest radiograph showed infiltrates with consolidation in the middle-lower lobes of both lungs. Early and second CT-scan findings revealed ground-glass opacity surrounding multiple irregular nodules (halo signs), cavitary nodules, and reverse halo signs. Afterward, the result of the patient’s sputum culture demonstrated fungal growth of the Curvularia species. The patient then underwent fungal treatment with fluconazole and voriconazole. The patient showed improvements, and a follow-up chest CT scan revealed the resolution of the lesion after fungal treatment. CT-scan examination, clinical condition, and microbiology culture can help diagnose Curvularia pulmonary fungal infection in immunocompromised patients.   Keyword: Phaeohyphomycosis; Curvularia; Halo sign; Reverse halo sign
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

Abstract

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
Co-Authors Adinda Amalia Dani Aditya Rahman, Perdana Aditya Sri Listyoko Aditya, Aldo Adolf Nggay, Andriana Agus Setyawan, Ungky Akbar, Jimmy Akbar Andri Andri Ari Irawan ARIFAH ARIFAH Astuti, Tri Wahyu Azmi, Mukhammad Binharyanto, Adlan Pratama Binharyanto Chozin, Iin Noor Chozin, Iin Nur Christian Surya Eka Putra Desfryda, Elynca Putri Djajalaksana, Susanthy Djanggan Sargowo Dwi Pratiwi, Suryanti Dwinadella, Sephia Eka Agustina, Dwi Rosa Elisabeth, Gracelia Elvira Sari Dewi Falyani, Silvy Amalia Gracelia Ruth Elisabeth Damanik Gregorio Satrio Pinunggul Handono Kalim hardiyanto, frenky Hendro Suryadi Hendy Setyo Yudhanto Hendy Setyo Yudhanto Hendy Setyo Yudhanto Hustorio Aliongko Simamora Iin Noor Chozin Imam Suseno Indah Sari, Fitri Isharanto, Artono Jane Sugiri, Yani Jani, Jane R Sugiri Jeffry Beta Tenggara Koernia Kusuma Wardhana Krisdiyanto, Peter Kristianto, Fransiskus Kristina Paskalita Kero Kusuma Wardhana, Koernia Kusworini Handono Listyoko, Aditya Sri Lyono, Albert Mahendra, Reza Aditya Maleachi, Reginald Mira Yuniarti Mohammad Faridza Setyo Hadikusumab Muhammad Zacky Hafiyyan Maulana Ngakan Putu Parsama Putra Noor Chozin, Iin Nurandhini, Marsha Nurdiana Nurdiana Nurima Diyah Oktavinayu Sari Latif Parsama Putra, Ngakan Putu Parsama, Ngakan Putu Putra Pratama, Mirza Zaka Pratiwi, Suryanti Dwi Pudjo, Herwindo Putri, Choirinnisa Meilia Ayu R. Sugiri, Yani Jane Rahayu Sartono, Teguh Rakhma , Sastia Rakhma, Sastia Retnani, Diah Prabawati Rezki Tantular Rezki Tantular Rini, Ni Made Rumaratu, Simon Petrus Hardiyanto santony, Santony Santoso, Agus Andreas Sari, Tita Luthfia Sastia Rakhma Semara Putra, Wayan Wahyu Setiadi, Satya Setiawan, Ungky Agus Setyawan, Ungky Agus Setyo Yudhanto, Hendy Sigiro, Rahel Margareth Febriana Soewondo, Widiastuti Sri Andarini Sugiri, Yani Jane R. Sugiri, Yani Jane Rosihaningsih Suryanti Dwi Pratiwi Susanthy Djajalaksana Susanthy Djajalaksana Susanti, Lia Sutedjo, Verawati Tantular, Rezki Tjakraatmadja, Ricardo Trimurtini, Asih Triwahju Astuti Ungky Agus Setyawan Wahono, Cesarius Singgih Wahyudy Prasetyo, Kevin Wantry, Kenty Wardhana, Koernia Kusuma Wardhana, Kurnia Winarni, Tika Wahyu Wisnu Barlianto Yani Jane R. Sugiri Yani Jane Sugiri Yudhanto, Hendi Setyo Yudhanto, Hendy Setyo Yusdianto, Adrian Yuyun Yueniwati Zaenal Kusuma