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Malang Respiratory Journal Department of Pulmonology Respiratory Medicine Universitas Brawijaya mrj@ub.ac.id
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Malang Respiratory Journal
Published by Universitas Brawijaya
ISSN : 27457842     EISSN : 27226492     DOI : https://doi.org/10.21776/ub.mrj
Core Subject : Health, Science, Education,
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other
Malang Respiratory Journal is the official open-access journal of Department of Pulmonology Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. It publishes articles two times per year. It is a peer reviewed publication of Indonesian Pulmonology and Respiratory journals and accepting articles for publication from around the world. MRJ only publishes articles in the English version. The objective of this journal is publishing the selected clinical and basic research relevant to Pulmonology and Respiratory. It covers the following topics such as infection, thoracic oncology, asthma and COPD, interventional pulmonology and respiratory emergency, occupational and environmental pulmonology, and clinical immunology. It is an international journal dedicated to provide new information that could give a new insight for alternative solutions, diagnosis, therapy and prevention for researchers and practitioners in Pulmonology Respiratory Medicine.
Arjuna Subject : Kedokteran - Kedokteran Paru dan Pernafasan
Articles 72 Documents
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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.

Page 8 of 8 | Total Record : 72

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