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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
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.
Articles 37 Documents
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (800.64 KB) | DOI: 10.21776/ub.mrj.2020.002.01.3

Abstract

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.
A Young Women with Infected Polycystic Lung Disease That Affects the Quality of Life Suwandi, Gede Sasmika; Djajalaksana, Susanthy
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 (312.654 KB) | DOI: 10.21776/ub.mrj.2021.003.02.6

Abstract

Introduction: Polycystic lung disease (PLD) is a group of diseases with heterogeneous pathophysiological processes. The demographics and clinical symptoms vary widely. The etiology of PLD is related to neoplasms, genetics, lymphoproliferative disorders, infections, interstitial diseases, smoking, and developmental disorders. In HRCT, cystic, nodular, ground glass opacities and pneumothorax can be found. Tissue biopsy and immunohistochemistry are needed to determine the type of PLD. Age is very influential towards the survival rates, rapid decline in lung function often occurs at a young age, thus, causing long-term complications in the cardiovascular systemCase Description: A 14-years-old woman complained of shortness of breath and cough was diagnosed with Poly cystic lung disease with Lung TB as secondary infection. CT Scan Thorax showed multiple cavities with consolidation, abdominal ultrasound of the ovary found a simple cystic lesion. The patient underwent TB treatment. After evaluation, clinical symptoms improved, but the patient is often absent from school, thus, indicating disruption in quality of life. Spirometry data showed decreased pulmonary function ad modum restriction, and moderate obstruction. The patient is planned to undergo several examinations such as Bodypletysmography, Bronchoscopy, and VATS to obtain tissue samples, so a diagnosis can be made. Considering the age of the patient—who is still young—definitive therapy as a continuation is expected to improve the patient's quality of life.Conclusion: The diagnosis of PLD in the patient still requires further examination. Other tests, such as biopsy followed by immunohistochemical examination, can be used to confirm the type of PLD. Currently, the patient is undergoing TB treatment and routine control to the clinic. Ater treatment, the clinical symptoms alleviated, but shortness of breath is still present, especially felt after walking fast and carrying heavy loads. Spirometry was done as an evaluation of pulmonary function, showing moderate restriction and obstruction. It is clear that PLD affects the quality of life in this patient.
A Rare Case of Chylothorax Manifestation of Gorham’s Disease, Lymphangioma and Tuberculosis Agil Dananjaya; Ungky Setyawan; Ngakan Putra; Dini Erawati; Artono Isharanto; Eviana Norahmawati; Istan Irmansyah
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.1

Abstract

Background: Chylothorax is a rare condition caused by accumulation of chyle in the pleural cavity (2-3%). More rare causes are Gorham's disease and tuberculosis Case: A 31-year-old male complained of swelling left arm and shortness of breath with recurrent pleural effusion. Pleural fluid analysis showed chylous. Bone survey showed osteolytic lesions of multiple bones as Gorham's disease. Thoracic CT showed left lung mass, atelectasis, massive fluidothorax, ipsilateral supraclavicular lymphadenopathy, destructive left scapula. Needleaspiration of left humerus revealed lymphangioma. Expert Mtb-Rif examination revealed Mtb detected. We assessed Gorham'sdisease, lymphangioma and lung tuberculosis with complication recurrent chylothorax and was treated anti-tuberculosis, anti-osteolytic and thorax catheter insertion. Conclusion: Difficult and rare case of chylothorax in one patient with Gorham’s disease and tuberculosis, is a poor prognosis. Keywords: Chylothorax, Gorham's Disease, Tuberculosis
Exogenous Lipoid Pneumonia Tiar Oktavian Effendi; Ungky Setyawan; Ngakan Putra; Dini Erawati
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.3

Abstract

Background : Lipoid pneumonia is a rare disease and usually reported as sporadic cases. Exogenous lipoid pneumonia is a more common form of lipoid pneumonia. Untypical characteristics makes incidence rate of this cases are often imprecise. The diagnosis is made from a history of lipid containing material aspiration, radiologic imaging, and histopathological examination. There is no treatment of choice because diagnosis of this cases are rarely made. Case Report : We report one case at Dr. Saiful Anwar hospital, a 35 years old man with accidental kerosene ingestion and aspiration. Based on examination of the patient, laboratory results, radiological imaging, and BAL fluid analysis and cytology, diagnosis of exogenous lipoid pneumonia was made. Our treatment of choice was combination of antibiotic, corticosteroid and BAL to manage this patient. After 2 weeks of treatment, there were improvements on clinical and radiological imaging. Conclusion: Exogenous lipoid pneumonia is a rare disease. Using antibiotic, corticosteroid, and BAL through bronchoscopy can be a therapeutic option that provides clinical and radiological improvement. Key words : Lipoid Pneumonia, Exogenous Lipoid Pneumonia, Treatment of Lipoid Pneumonia
A Rare Case: Adenocarcinoma Bronchogenic Dextra Std IVB on Gefitinib (15 months) accompanied by Decreased Visual Acuity, Bilateral Sensorineural Deafness and Psychiatric Disorders with No Radiological Evidence of Brain Metastasis Caesar Ensang Timuda; Suryanti Dwi Pratiwi; Dessika Rahmawati; Dearisa Yudhantara; Dini Erawati; Dyah Indrasworo; Seskoati Prayitnaningsih
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.2

Abstract

Background: Leptomeningeal disease occurs in 3-5% of patients with lung cancer, mainly adenocarcinoma subtype. Adenocarcinoma is the most common histological finding in Asian women. Case: A 51-year-old woman with right-sided bronchogenic adenocarcinoma T4N3M1c Std IVB mutation(+) developed decreased vision, severe bilateral sensorineural deafness and psychiatric disorders after receiving Gefitinib 15 months. There was no evidence of brain metastasis from brain MRI. From evaluation of chest CT-scan, we found the disease was progressive and no Mutation Detected from ctDNA, so Gefitinib was discontinued. Conclusion: We found some difficulties in evaluating side effects of therapy and disease progression due to patient's condition in the form of decreased total vision, severe sensorineural deafness, and psychiatric disorders. However, because no radiological evidence of brain metastases was found, we suspect this patient suffered from leptomeningeal disease. Keywords: Lung Cancer, Adenocarcinoma, Gefitinib, Leptomeningeal Disease
A Thymoma (Case Report): Importance of Comorbidity, Lifestyle, and Thymoma Size in Treatment Success Rachmat Suryaman; Susanthy Djajalaksana; Ungky Setyawan; Koernia Wardhana; Dini Erawati; Hendy Yudhanto
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.4

Abstract

Thymoma is a rare malignancy with an incidence of 0,15 case per 100.000 population and is the most commonly diagnosed anterior mediastinal malignancy. With 12,5% 15-year survival rate, and is often accompanied by autoimmune disease such as myasthenia gravis, pure red blood cell aplasia, and hypogammaglobulinemia, better understanding of factors affecting prognosis is needed to improve patient quality of life and survival.
CASE REPORT A 30-year-old Woman with Multiple-Sites Metastasis Lung Adenocarcinoma and Coronavirus-19 Disease (COVID-19) Yokanan Naftali; Jani Jane Rosihaningsih Sugiri; Suryanti Dwi Pratiwi; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.5

Abstract

Background: Adenocarcinoma is the most common Non-Small Cell Lung Cancer (NSCLC) in non-smokers in Indonesia. It often metastasizes in multiple sites. Metastasis is a negative predictor for prognosis in lung adenocarcinoma. In this covid pandemic era we present a case of a 30-years-old woman with adenocarcinoma and multiple-sites metastasis, and Coronavirus-19 Disease (COVID-19). Case: A 30-year-old woman came to our hospital with multiple complaints of hearing loss, visual loss, and occasional shortness of breath. The patient had a history of wild-type EGFR adenocarcinoma and has been treated with 4 cycles of gemcitabine. She also presented with a lump in her neck. Further examination revealed multiple metastasis tumours in her brain, right eye, neck, and spine. Pleural fluid examination also showed a malignant pleural effusion. Nasopharyngeal swab using reverse transcriptase-polymerase chain reaction (rt-PCR) method revealed that she also suffers from COVID-19 with positive swab result. Despite adequate treatment, she rapidly deteriorates and passed away in hospital. Discussion: Management in this patient is complex due to multiple complications and limitation of management given in COVID-19 isolation ward. She presented with multiple equally complicated metastasis, in which treatment priority should be carefully assessed. Despite treatment by multiple specialists, her problems still persist and proved to be fatal. Conclusion: Although metastasis is common in adenocarcinoma, multiple metastasis is uncommon, and this case highlights the need of careful management priority in such patients in COVID-19 pandemic setting. Keywords: Adenocarcinoma, Multiple Metastasis, Lung Cancer, COVID-19
A Case Report : Bronchopleural Fistula Dextra with Pyopneumothorax Dextra as Complication of Lung Tuberculosis Kevin Wahyudy Prasetyo; Jane R Sugiri Jani; Rachma Erawati Dini; Kurnia Wardhana
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.2

Abstract

Background: Bronchopleural fistula is a rare case that might be caused by trauma, post lung resection surgery, and non traumatic cause such as lung Tuberculosis infection. Bronchopleural fistula is a serious complication of lung TB which almostly related to pleural cavity infection. This fistula condition may be accompanied with empyema that can cause secondary spontaneous pneumothorax. The diagnosis of fistula is established by combination of clinical symptoms regarding lung TB infection, radiology, laboratory, microbiology, dan histopathologi examinations. Management of bronchopleural fistula includes chest tube insertion to treat pyopneumothorax problem, fistula repair surgery, and underlying disease and its comorbid. Case: We report one case located at Dr. Saiful Anwar hospital, a 36 year old woman with symptoms of dyspneu and chronic cough with purulent sputum. Based on the clinical data, laboratory results, radiological imaging, sputum examination, and plerual fluid analysis and cytology, diagnosis of bronchopleural fistula together with pyopneumothorax as complication of lung TB was made. Management of this patient comprises of chest tube insertion, fistula repair surgery, antibiotic, and OAT. Conclusion: Bronchopleural fistula is a rare case found. Proper surgical management and treating underlying disease such as lung TB might improve clinical outcome and reduce mortality rate. Keywords: Bronchopleural fistula, Pyopneumothorax, Lung TB
The Case Report : Challenges in the Management of Pneumothorax for COVID-19 Patient Adinda Pramitra Permatasari; Sastia Rakhma; Ngakan Putu Parsama Putra
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.1

Abstract

INTRODUCTION : Pneumothorax has been reported in minority of COVID-19 cases. Spontaneus Pneumothorax is an uncommon complication of COVID-19. The incidence and risk factors are still unknown. Here we will review where there are challenges with case of Pneumothorax in COVID-19 patients. CASE ILLUSTRATION : We report one case at Dr. Saiful Anwar hospital, a 42 years old man was diagnosed with Spontaneous Pneumothorax and tested positive for COVID-19 via nasopharyngeal swab. Management in this case requires consideration from emergency treatment, risk of virus transmission and the aerolization of the procedure. Invasive procedure such as insertion chest tube and pharmacologic therapy be the treatment in this case. After 2 weeks of treatment, there was improvement on clinical and radiological imaging. DISCUSSION : Various strategies to reduce the risk of exposure to COVID-19 infection on Spontaneus Pneumothorax. This literature discusses about the risk factor that lead to Pneumothorax with COVID-19 and the management of Pneumothorax cases in COVID-19 patients. CONCLUSION: Spontaneous Pneumothorax is a rare complication of COVID-19. Management in this case requires consideration from emergency treatment, risk of virus transmission and the aerolization of the procedure. Key words : Pneumothorax; COVID-19; Chest Tube
Successful Embolization in Recurrent Hemoptysis Caused by Pulmonary Aspergilloma: A Case Report: Successful Embolization in Recurrent Hemoptysis Caused by Pulmonary Aspergilloma Muli Yaman; Jane Sugiri; Ngakan Putra; Dewi Santosaningsih; Achmad Aslam
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.4

Abstract

Background: Aspergilloma is a fungal infection that can cause recurrent hemoptysis. One of the treatment modalities is embolization, which has a success rate of 85% to 100%, although the recurrence rate may reach 10% to 33%. Case Illustration: A 29-year-old female came to the emergency ward with recurrent hemoptysis. She had a history of tuberculosis with completed treatment 7 years ago. Chest radiography showed left lung tuberculosis with emphysematous lung. Chest CT with contrast revealed an air-crescent sign, and culture from bronchoalveolar lavage (BAL) showed Aspergillus spp. Then, she was diagnosed with pulmonary aspergilloma. Embolization was performed in the left internal mammary artery, and the blushing was decreased by 80%. However, the hemoptysis was still recurrent; a second embolization was performed in the left supreme intercostal artery, costocervical trunk artery, and bronchial artery, resulting in no blushing. The patient had no further episodes of hemoptysis, and her antifungal therapy was changed from fluconazole to voriconazole. Discussion: Recurrent hemoptysis can be caused by pulmonary aspergilloma. Embolization is usually done to reduce bleeding before surgery. The patient had performed embolization 2 times with no further episodes of hemoptysis. Surgical resection as a definitive treatment was recommended in this case, but the patient refused. Therefore, the patient’s management was optimized using voriconazole and embolization for the hemoptysis. Conclusion: Management of recurrent hemoptysis in patients with aspergilloma may include embolization and antifungal treatment which give improved clinical outcomes. Keywords: recurrent hemoptysis, embolization, aspergilloma, tuberculosis

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