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All Journal Malang Respiratory Journal
Setyo Yudhanto, Hendy
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology 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

Abstract

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.
Tuberculous Dactilitis in Young Male, a Rare Case Yusdianto, Adrian; Tantular, Rezki; R. Sugiri, Yani Jane; Rahayu Sartono, Teguh; Rachma Erawati, Dini; Setyo Yudhanto, Hendy
Malang Respiratory Journal Vol. 5 No. 2 (2023): September Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.02.02

Abstract

Introduction : Chylothorax is an uncommon medical condition caused by the accumulation of chylous fluid in the pleural space. Chylothorax has no predilection for sex or age. The prevalence after various cardiothoracic surgeries is 0.2% to 1%. Mortality and morbidity rates are around 10%. Respiratory distress may occur due to compression of the lung by the accumulated fluid. Management and approaches to treating the condition require multidisciplinary therapy, starting from non-pharmacological, pharmacological, to interventional management. Case Report : A 57-year-old Man patient was referred to the emergency room with chief complaint of shortness of breath. Reduced breathing sound on both lung fields. No previous history of cancer or thoracic surgery were found. X-ray examination had found bilateral pleural effusion. Thoracocentesis and pleural fluid analysis was performed with total of 6800 cc serosanguinous, whitish fluid was extracted from both of the lung. The patient was diagnosed with chylothorax. Lymphangiography and embolization was performed on the leak on left thoracic duct (T10) from right lymph node. Antibiotic was also given to treat the community acquired pneumonia that could be one of the possible etiology on this patient. Dietary modification with low fat diet and Ocreotide was also given to this patient as one of the treatment modalities. Discussion : The diagnosis of Chylothorax on this patient was established based on pleural fluid analysis and evidenced by lymphangiography examination by the presence of a leak in the thoracic lymphatic duct. Various modalities to  diagnose this condition have been carried out with inconclusive results. Non-pharmacological, pharmacological and radiological interventions with embolization through lymphangiography are proven to be able to stop leaks and reduce symptoms in this patient. Conclusion : Chyle leak to the pleural space may compress the lung and cause respiratory distress. Combinaton of thoracocentesis, embolization of the leakage, dietary intake modification and administration of ocreotide may help prevent further chylous fluid accumulation.
Rare Case: 65 Year Old Man with Anteromedial Mediastinal Tumor (Thymic Carcinoma) Mimicking Lung Cancer Lyono, Albert; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Isharanto, Artono
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.02

Abstract

Background: Thymic carcinoma are very rare and often accompanied by metastases to other organs, pericardial effusion and pleural effusion where the 5-year survival rate is about 55%. Thymic carcinoma has several subtypes, squamous cell carcinoma and undifferentiated carcinoma. Case Report: A 65-year-old man coincidentally showed a mediastinal tumor on CXR while infected with COVID-19. Spirometry shows mild obstruction and restriction. Thorax CT scan suggests an anterior-middle mediastinal mass with left pleural effusion. The patient underwent a core biopsy followed by VATS tumor excision. Immunohistochemistry CK(+) and Vimentin(-) suggest a solid type adenocarcinoma, then Napsin A(-), TTF1(-), P40(+) suggest squamous cell carcinoma. The patient was diagnosed with left anteromedial mediastinal tumor (Thymic carcinoma: Squamous cell carcinoma) Masaoka stage III, left pleural effusion. The patient was treated with first line chemotherapy Carboplatin-Etoposide 6 series resulting stable disease followed by maintenance chemotherapy etoposide 6 series. The last RECIST suggests a solid malignant mass in the left lung (stable disease). Discussion: Surgery with radiotherapy is treatment for resectable cases but for unresectable cases chemotherapy with or without radiotherapy is preferred. The patient was unresectable case treated with chemotherapy. Thymic carcinoma has a poor response to chemotherapy with overall response rate around 22-36% but this patient has stable disease with chemotherapy. Conclusion: 65 years-old man without respiratory complaints diagnosed with unresectable thymic carcinoma and left pleural effusion, underwent chemotherapy with result stable disease up to 9 months continued maintenance therapy and become a resectable tumor. Keywords: Thymic carcinoma, Squamous Cell Carcinoma
Rare Case: Enteric Type Lung Adenocarcinoma with Exon 21 Mutation Mimicking Thymic Adenocarcinoma: Rare Case: Enteric Type Lung Adenocarcinoma with Exon 21 Mutation Mimicking Thymic Adenocarcinoma Adolf Nggay, Andriana; Dwi Pratiwi, Suryanti; Jane Sugiri, Yani; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Elisabeth, Gracelia
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.04

Abstract

Background: Enteric type lung adenocarcinoma is a very rare variant of pulmonary adenocarcinoma, with a prevalence of about less than 1% of all cases(2). Due to the similarity in its symptoms, physical examination findings, and additional tests, it is very difficult to distinguish it from thymic adenocarcinoma, which can lead to delayed diagnosis and treatment(6). Case Report: A 58-year-old male presented with shortness of breath. Chest X-ray revealed a mass in the right suprahilar region, which was subsequently confirmed as a mediastinal tumor by contrast-enhanced chest CT scan. The patient underwent open thoracotomy biopsy, and macroscopic examination suggested thymic carcinoma. Histopathological findings revealed atypical cells with bronchoscopic washing and brushing cytology results classified as class II, and Ultrasound guided TTNA only showed debris cells. Diagnostic confirmation took 1.5 years, with immunohistochemistry results showing CK(+), CD45(-), P40(-), Vimentin(-), Napsin A(-), CK7(+), CK20(+), leading to a final diagnosis of enteric-type lung adenocarcinoma with EGFR exon 21 mutation. Conclusion: An accurate diagnosis of enteric-type pulmonary adenocarcinoma requires a multidisciplinary team approach and specific immunohistochemistry (CK7, CK20) to enable precise treatment planning. Keyword: Enteric Tipe Lung Adenocarcinoma, Thymic Adenocarcinoma, Immunohistochemistry
Rare and challenging case: a young woman with a pulmonary malignant peripheral nerve sheath tumor mimicking mesothelioma Irawan, Ari; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Setyo Yudhanto, Hendy; Kusuma Wardhana, Koernia; Rachma Erawati, Dini
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.03

Abstract

Introduction: Malignant peripheral nerve sheath tumor (MPNST) is a rare and highly aggressive tumor that develops from peripheral nerves which is closely related to neurofibromatosis type 1 (NF1). It has a very small percentage of occurrence in the lung. Here, we would like to report a case of pulmonary MPNST mimicking mesothelioma that was treated with cisplatin-pemetrexed. Case Illustrations: A 17-year-old female with no history of NF1, complaints of shortness of breath, and weight loss. A thoracic CT-scan and pathology were initially consistent with suspected mesothelioma. A unique finding in this case, was demonstrated positive vimentin and CD56, also loss of nuclear SOX10 and H3K27me3 expression in spindle cells. After a multidisciplinary board discussion, the diagnosis of MPNST was assumed. She underwent a palliative chemotherapy regimen. Discussion: Pulmonary MPNST with or without NF1 seems infrequent. Its clinical findings are usually nonspecific with a complex histological appearance. Establishing the diagnosis of MPNST is challenging, therefore pathological examination and immunohistochemistry (IHC) become the gold standard. The expression of SOX10 has poor sensitivity, also the loss of S100 expression may indicate de-differentiation of Schwann cells, hence, it may be less specific for MPNST diagnosis. Nevertheless, the loss of H3K27me3 marker has a great diagnostic value. The most effective treatment is complete surgical resection to achieve negative margins. However, in our case, the tumor has metastasized and is unresectable, so she was treated with the cisplatin-pemetrexed chemotherapy regimen and obtained stable disease results on the RECIST-CT examination after 3-series-chemotherapy. Conclusion: MPNST is a rare case with difficulties in diagnosis due to nonspecific clinical and histological features, therefore, IHC plays an important role in providing its diagnosis. Chemotherapy might be a good approach for treating an unresectable MPNST, but, still, there is no gold standard for palliative care guidelines.
Co-Authors Adolf Nggay, Andriana Agus Setyawan, Ungky Ari Irawan Djajalaksana, Susanthy Dwi Pratiwi, Suryanti Elisabeth, Gracelia Indah Sari, Fitri Isharanto, Artono Jane Sugiri, Yani Kusuma Wardhana, Koernia Lyono, Albert R. Sugiri, Yani Jane Rachma Erawati, Dini Rahayu Sartono, Teguh Susanti, Lia Tantular, Rezki Yusdianto, Adrian