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Journal : Malang Respiratory Journal

Chemotherapy Resistance in Remutation of Epidermal Growth Factor Receptor Wild Type Becomes a Positive Type and Back Becomes a Wild Type in A Patient with Lung Adenocarcinoma Kurniawan, Kristo; Sugiri, Yani Jane; Parsama Putra, Ngakan Putu; Yudhanto, Handy Setyo
Malang Respiratory Journal Vol 3, No 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (201.575 KB) | DOI: 10.21776/ub.mrj.2021.003.01.5

Abstract

Introduction: Lung cancer is the most common type of cancer worldwide (11.6%) and the leading cause of death due to cancer throughout the world. One type of lung cancer that is often found is Adenocarcinoma, 35-40%. Mutations in EGFR often occur in patients with pulmonary Adenocarcinoma, especially in Asia. Chemotherapy selection for pulmonary adenocarcinoma patients based on the status of their EGFR mutations. Positive EGFR mutations can get treatment with Tyrosine Kinase Inhibitors. Giving chemotherapy can affect changes in EGFR mutation status. Patients with chemotherapy treatment can experience resistance to chemotherapy either primary or acquired resistance through a variety of mechanisms.Case Description: we reported one case of a 56-year-old man with pulmonary adenocarcinoma who had a positive change in EGFR-type from wild type mutations and then returned to a wild type. Patients were initially diagnosed with wild-type pulmonary adenocarcinoma from EGFR examination of tissue biopsy and given conventional chemotherapy. During the evaluation, progression occurred so that the status of the EGFR mutation was examined using ct-DNA and the result was mutation deletion exon 19 so that the patient obtained Gefitinib. Due to progressive return, the patient again examined EGFR status from tissue biopsy obtained using pleuroscopy and obtained an EGFR wild type. Patients again get conventional chemotherapy.Discussion Changes in the status of EGFR mutation in pulmonary adenocarcinoma patients and chemotherapy resistance can occur in patients with chemotherapy treatment. 
Adhesiolysis and Decortication for Reccurent Hydropneumothorax Associated with Pleural Tuberculosis Musthafa, Muhamad Yusuf; Sugiri, Yani Jane; Bayuadi, Imam Suseno
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 (201.21 KB) | DOI: 10.21776/ub.mrj.2021.003.02.2

Abstract

Introduction: Pleural tuberculosis is a pleural infection of tuberculosis caused by Mycobacterium tuberculosis which commonly manifests as hydropneumothorax. Initial treatment with anti-tuberculosis drugs is aimed to prevent progression of the disease and relieve patient’s symptoms. Indication of adhesiolysis and decortication is to remove layer of fibrous tissue and allow the lung to reexpand.Case: A 60 year old woman with shortness of breath, cough, and right-sided chest pain. She had a history of treatment with first-line anti-tubercular drugs for a year stop in September 2016. She was identified with recurrent right-sided hydropneumothorax by chest imaging and thorax CT-scan. Adhesiolysis and decortication were performed on her. Two months later she was diagnosed again with recurrent right-sided hydropneumothorax. VATS (Video-Assisted Thoracoscopic Surgery) revealed fistula involving inferior lobe of the lung. Then, she was treated with second-line anti tuberculosis drugs. After four times reccurent hydropneumothorax, patient showed significant improvement in clinical condition, radiology finding, and lung function test after she finished the tuberculosis treatment.Discussion: Definitive diagnosis of pleural tuberculosis is by the finding of mycobacterium tuberculosis in pleural biopsy, or Mtb culture, and it was difficult to perform. In this case pleural fluid analysis revealed that cause of recurrent right-sided hydropneumothorax was tuberculosis infection.Summary: A 60 year old woman with four times reccurent right-sided hydropneumothorax, and the pleural fluid analysis suggested it was tuberculosis infection. Providing anti-tuberculosis medication based on clinically diagnosed tuberculosis based on flowchart of tuberculosis diagnosis from national tuberculosis programmed are essential to prevent progression of the disease.
Patient with Infiltrating Ductal Cell Carcinoma Mammae with Lung Tuberculosis and Nontuberculous Mycobacteria Indah Sari, Fitri; Sugiri, Yani Jane; Nurhidayati, Dwi Yuni
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 (220.849 KB) | DOI: 10.21776/ub.mrj.2021.003.02.3

Abstract

Introduction:. Infection caused by NTM has a prevalence which varies between 4.1 and 14.1 per 100,000 patients per year. Female has a higher prevalence of NTM disease than male, which is increasing with age, and more common in Western and Southeast Asian countries.Case Description: A 42-year-old female patient has the clinical symptoms of hemoptysis, asphyxia, angina, fever, nocturnal hyperhidrosis, loss of weight and appetite for nearly 10 years. Based on the physical examination, radiology, microbiology and anatomic pathology, this patient has been diagnosed with Ca mammae with Pulmonary TB, and currently is infected by recurrent NTM.Discussion: Symptoms of nonspecific NTM often complicate the diagnosis of TNM. General symptoms such as chronic cough, increased sputum production, dyspnea, fever that is not too high, weakness, weight loss so that it overlaps with other pulmonary symptoms. In NTM, radiologicalmanifestations generally show bronchiectasis, nodular lesions, cavitary lesions and parenchymal consolidation. The choice of therapy in disease caused by NTM depends on three factors: the type of clinical presentation, the species of NTM causing the disease and the immune status of the patient.