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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.

Author-ID : 809253

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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Lobectomy of Single Pulmonary Nodul Increased Quality of Life and Lung Function in 1 and 3 month After Surgery Susanti, Lia; Djajalaksana, Susanthy; Indah Sari, Fitri; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Kusuma Wardhana, Koernia
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.2025.007.02.05

Introduction: Since a single pulmonary nodule (SPN) usually doesn't cause any respiratory symptoms, it is frequently found by accident. On a chest X-ray, the incidence of SPN is 0.1-0.2%, and on a contrast-enhanced CT scan of the thorax, it is 13%. In populations at high risk, the incidence rises to 9–33%. Contrast-enhanced CT scans are essential for early detection in order to assess and choose a course of treatment. About 40–50% of SPNs are malignant, with adenocarcinoma being the most prevalent subtype, making for 47% of all instances of lung cancer. Surgical intervention is advised in the early stages. Case Report: A 62-year-old nonsmoker arrived with haemoptysis and a persistent cough. A contrast-enhanced CT scan revealed a solid lesion of 2.8 cm x 2.7 cm x 2.4 cm, classified as stage IA. A chest X-ray revealed a tiny mass measuring 1.5 cm x 1 cm. Following a lobectomy, the patient's pathology revealed Non-Small Cell Lung Carcinoma (NSCLC), specifically adenocarcinoma. To rule out organ metastases, immunohistochemistry (IHC) assays were used. Conclusion: Lobectomy for SPN adenocarcinoma stage IA improves lung function and quality of life at one and three months post-surgery.

Active Male Smoker with Active Pulmonary Tuberculosis, COPD, Covid-19, Klebsiella Pneumonia, Multiple Bullae and Secondary Bilateral Pneumothorax Mohammad Faridza Setyo Hadikusumab; Susanthy Djajalaksana; Rezki Tantular; Dini Rachma Erawati
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.2025.007.02.02

Introduction: The first reported case in the world of an active male smoker with active pulmonary tuberculosis, chronic obstructive pulmonary disease (COPD), Covid-19, Klebsiella pneumonia, multiple bullae and secondary bilateral pneumothorax. The clinical presentation of secondary bilateral pneumothorax is highly variable, ranging from mild shortness of breath to tension pneumothorax and can result in very severe conditions. This case report aims to discuss the clinical challenges, diagnostic, and treatment approach, as well as follow-up of a male smoker diagnosed with active pulmonary TB, COPD, Covid-19, Klebsiella pneumonia, multiple bullae, and secondary bilateral pneumothorax. Case: Patient’s history, physical examination, supportive examination, and management strategies were documented and analyzed. A 47-year-old male active smoker with a history of shortness of breath in the last 2 weeks which has gotten worse since the last 1 day. The patient came to Lawang Hospital, an x-ray showed left tension pneumothorax, then was referred to Saiful Anwar Hospital. CXR from Saiful Anwar Hospital shows bilateral pneumothorax with left tension pneumothorax. The patient underwent two chest tube insertions with an interval of 2 days between insertions. The covid-19 PCR results were positive. Sputum bacteriological test showed Klebsiella pneumoniae infection. Thorax CT-scan with contrast showed multiple cysts and bullae on bilateral hemithorax and bilateral ground glass opacity on tree in bud with suspected active pulmonary TB. The bacteriological examination for tuberculosis was negative with a suspicion of COPD due to an active smoking habit. The patient is still being treated with anti-tuberculosis drugs, antibiotics, and antivirals, and showed improvement. Conclusion: Cases of secondary bilateral pneumothorax with active pulmonary TB, COPD, Covid-19, Klebsiella pneumonia, multiple bullae in active smoking patients with subtle clinical features are quite rare, which frequently results in misdiagnosis during thoracic assessments and may exacerbate the patient's condition. Clinicians must remain vigilant for potential underlying diseases in such cases.

D-Dimer and Brixia Score to Mortality in COVID-19 Patients Falyani, Silvy Amalia; Pratiwi, Suryanti Dwi; Setyawan, Ungky Agus; Erawati, Dini Rachma; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.99-106

Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious severe and acute respiratory syndrome caused by the SARS-CoV-2 virus. A variety of factors can increase a patient's risk of death, including coagulopathy characterized by increased D-dimer levels. Brixia scores could be one of the determinants of COVID-19 severity, as assessed by chest radiographs. This study aimed to analyze chest radiographic severity based on the Brixia score at the degree of coagulation based on D-dimer in mortality of COVID-19 patients who were hospitalized. Methods: This cohort retrospective study was conducted at Dr. Saiful Anwar General Hospital, Malang, using an observational cross-sectional design. The study included 300 medical records of COVID-19 patients who passed away while hospitalized. The data were analyzed using the Wilcoxon test, and the results were also tested for Spearman correlation to determine the relationship between variables. Results: Significance results of median D-dimer were found by age and severity of COVID-19 (p-values 0.015 and 0.002), and median Brixia scores by age, gender, severity of COVID-19, and length of treatment (p-values 0.001, 0.001, 0.001, and 0.005). The results were also compared with normal values, which were significant (p = 0.000). Spearman correlation test results between the final D-dimer and the initial Brixia score (p = 0.005). Conclusion: The research results display a retrospective study of the correlation between D-dimer and Brixia score values "‹"‹and outcomes in COVID-19 patients. Higher D-dimer values"‹ "‹and Brixia scores on admission were shown to be associated with mortality.

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

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

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

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.

Immunocytochemistry as a Diagnostic Procedure of Pleural Mesothelioma Trimurtini, Asih; Astuti, Triwahju; Yudhanto, Hendy Setyo; Erawati, Dini Rachma
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Background: Mesothelioma is a primary malignant tumor arising from the mesothelial surface of the pleura, peritoneal, tunica vaginalis, and pericardium. Most cases of mesothelioma originate from the pleura. Most patients have a history of asbestos exposure. A common diagnostic problem is distinguishing mesothelioma from adenocarcinoma since both tumors invade the pleura. Immunocytochemistry of calretinin and TTF-1 can be used to establish the diagnosis of mesothelioma.Case: Male, 56 years old presented with chest pain, shortness of breath, cough, and weight loss since 5 months before hospitalization. The patient had a history of occupational exposure to asbestos for 30 years. The movement and breath sounds were decreased as well as dull upon percussion at the right chest. A chest X-ray revealed a right lung tumor with pleural effusion. Thorax CT scan suggested pleural mass in right hemithorax, infiltration to intercostal muscles, and destruction of the 7th right rib, right perihilar lymphadenopathy, right pleural effusion, and liver nodules according to mesothelioma T4N1M1 Stage IV. Infiltrative stenting of the right and inferior lobe of the right lung, infiltrative and obstructive stenting of the medius lobe suggestive of a chronic malignancy and inflammation were found on FOB. Cytologic examination of pleural fluid, sputum, and Washing-and-brushing of FOB were a class II (no malignant cells). USG-guided transthoracic FNAB revealed adenocarcinoma with differential diagnosis of mesothelioma. Immunocytochemistry with calretinin showed positive results and TTF-1 showed a negative result. These confirmed the diagnosis of pleural mesothelioma T4N1M1 Stage IV. The patient showed a stable response from carboplatin/gemcitabine treatment.Keyword : Mesothelioma, Immunocytochemistry, TTF-1, Calrenitin

Well Differentiated B3 Thymoma complicated with Vena Cava Superior Syndrome undergo Debulking and Chemotherapy Semara Putra, Wayan Wahyu; Noor Chozin, Iin; Wantry, Kenty; 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 | DOI: 10.21776/ub.mrj.2020.002.01.4

Background: Thymoma is a rare neoplasm. This incident is comparable to 390 new cases reported per year. Genetic factors are believed to be one of the factors of B3 thymoma and thymus carcinoma. Multimodality of thymoma therapy (surgery, radiation and chemotherapy) gives better results.Case Report: Mr A, 29 years old, with initial diagnosis of stage IV thymoma (according to Masaoka) with SVKS then undergo debulking, followed by chemotherapy with a regimen of Cisplatin + Vincristin, Cyclophospamid, Doxorubicin, Prednison every 21 days as much as 6 times. Subjective responses indicated by reduced complaints of chest pain and loss of swelling of the right arm. Semisubjective response indicated by increase of body weight. Objective response is progressive, so can be continued with second line chemotherapy or radiotherapy.Conclusion: The prognosis of patient with well differentiated thymic carcinoma stadium iv (thymoma b3) complicated with vena cava superior syndrome was poor because of the objective response of the chemotherapy was progressive, and the relapse case was higher.

Elderly Male Patient with Fibrotic Non Spesific Instertitial Pneumonia from Lung Biopsy by Video Assisted Thoracoscopy santony, Santony; Djajalaksana, Susanthy; Chozin, Iin Nur; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Background: NSIP is a rare disease, the incidence rate ranges from 1 to 9 per 100,000 population, where most cases of NSIP are idiopathic. NSIP definitive diagnosis is very difficult because it must be with a multidisciplinary approach and confirm from a pulmonary biopsy. On the course of his illnesses the possibility of Connective tissue diseases (CTDs) arising in NSIP during follow up period was about 10% of cases.Case Report: We reported one case at RS Dr. Saiful Anwar, an old adult male smoker, age 64 with fibrotic type Non Spesific Instertitial Pneumonia (NSIP). From clinical patients including anamnesis, physical examination and laboratory results and X-Ray chest, ILD suspicion was found. Bodypletstimography results show a corresponding decrease in DLCO with ILD. CT-Scan results obtained by crazy paving with pulmonary bronchiectasis traction in accordance with ILD susp Sussection NSIP and enforced from VATS biopsy results with conclusions according to NSIP description. Patients received corticosteroid therapy for 4 weeks and showed clinical improvement.Conclusion: In these patients the diagnosis of fibrotic NSIP has gone through a multidisciplinary approach including the pulmonology, radiologist and pathologist sections. Corticosteroid therapy in these patients gives good results and the patient is in stable condition. Periodic monitoring is necessary because of the risk of exacerbations and the incidence of CTD complications..

Sarcomatoid Carcinoma Of The Mediastinal : A Rare Case of Giant Mass Thymic Carcinoma Subtype Santoso, Agus Andreas; Parsama Putra, Ngakan Putu; Setiawan, Ungky Agus; Isharanto, Artono; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

ABSTRACTTitle:Â Sarcomatoid CarcinomaÂ Of The Mediastinum: AÂ Rare Case of Giant MassÂ Thymic CarcinomaÂ SubtypeAuthor: Agus Andreas Santoso, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Ngakan Putu Persama Putra, MD, Pulmonologist Consultant, Ungky Agus Setiawan, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Hendy Setyo Yudhanto, MD, Pathology Anatomy Specialist.Introduction: Sarcomatoid carcinoma is a type of thymus carcinoma that contains partial or complete spindle cells. Incidence of Sarcomatoid Carcinoma 5-10% of all patients with thymic carcinoma. Carcinoma Sarcomatoid is a highly progressive tumor, mostÂ patients will die after 3 years of diagnosis despite aggressive multimodality therapy.Case Description:Â A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlargingÂ lump in the neck and chest was felt for 1 month. Physical and supporting examination showed anterior superior mediastinal tumors and soft mass tissue in the right region of the Colli. Based on the Transthoracal FNAB Guiding ultrasound and FNAB the anterior colli region concluded that Thymoma, thyroid oncocytic adenoma and Nodular colloid goiter with azkanasy cell proliferation. The patientÂ hadÂ Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma.Â Discussion:Â Sarcomatoid carcinoma is a type of thymic carcinomaÂ that hasÂ both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This caseÂ wasÂ interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in thisÂ patient.Â

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

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