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Parsama Putra, Ngakan Putu
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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. 
The Role of Bronchoscopy for Successful Removal of A Chronic Aspirated Foreign Body After Twenty Years Haris, Abdul; Parsama Putra, Ngakan Putu
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 (149.096 KB) | DOI: 10.21776/ub.mrj.2021.003.02.5

Abstract

Title: The Role of Bronchoscopy for Successful Removal of A Chronic Aspirated Foreign Body After Twenty YearsAuthor: Abdul Haris, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Ngakan Putu Parsama Putra, MD, Pulmonologist Consultant, Introduction:. A Man with complaints of chronic cough, and shortness of breath, with history of inhaled metal bullet 20 years ago. Chest x-ray thorax revealed a foreign body and pleural effusion.Case Description: Patient is a 58 years old male with complaints chronic cough and shortness breath, he had inhaled  metal bullet in 20 years ago. Chest x ray revealed a foreign body and pleural effusion dextra. Fiber optic bronchoscopy shon corpus alienum metal bullet in medial lobus dextra, and its was retrieved using basket forcepDiscussion: the diagnosis of foreign body aspiration as some patients may not offer a clear history of aspiration or may present late. In addition, malignancy, lung tuberculosis, chronic pneumonia can be misdiagnosed to patients, fiber optic bronchoscopy has been secure and effective procedure in the therapy of foreign body in the airway
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.362 KB) | DOI: 10.21776/ub.mrj.2021.003.02.4

Abstract

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.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (12695.27 KB) | DOI: 10.21776/ub.mrj.2021.003.01.4

Abstract

ABSTRACTTitle: Sarcomatoid Carcinoma Of The Mediastinum: A Rare Case of Giant Mass Thymic Carcinoma 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, most patients will die after 3 years of diagnosis despite aggressive multimodality therapy.Case Description: A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlarging 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 patient had Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma. Discussion: Sarcomatoid carcinoma is a type of thymic carcinoma that has both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This case was interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in this patient. 
Co-Authors Abdul Haris Andri Andri Djanggan Sargowo Erawati, Dini Rachma Isharanto, Artono Kurniawan, Kristo Retnani, Diah Prabawati Santoso, Agus Andreas Setiawan, Ungky Agus Sugiri, Yani Jane Yudhanto, Handy Setyo Yudhanto, Hendy Setyo