Malang Respiratory Journal https://mrj.ub.ac.id/index.php/mrj Universitaas Brawijaya en-US Malang Respiratory Journal 2745-7842 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 https://mrj.ub.ac.id/index.php/mrj/article/view/46 <p><strong>Background</strong>: Leptomeningeal disease occurs in 3-5% of patients with lung cancer, mainly adenocarcinoma subtype. Adenocarcinoma is the most common histological finding in Asian women.</p> <p><strong>Case:</strong> 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.</p> <p><strong>Conclusion: </strong>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.</p> <p><strong>Keywords: </strong>Lung Cancer, Adenocarcinoma, Gefitinib, Leptomeningeal Disease</p> Caesar Ensang Timuda Suryanti Dwi Pratiwi Copyright (c) 2022 Malang Respiratory Journal http://creativecommons.org/licenses/by-sa/4.0 2022-09-30 2022-09-30 4 2 A Rare Case of Chylothorax Manifestation of Gorham’s Disease, Lymphangioma and Tuberculosis https://mrj.ub.ac.id/index.php/mrj/article/view/44 <p><strong>Background:</strong> 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</p> <p><strong>Case:</strong> 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.</p> <p><strong>Conclusion: </strong>Difficult and rare case of chylothorax in one patient with Gorham’s disease and tuberculosis, is a poor prognosis.</p> <p><strong>Keywords: </strong>Chylothorax, Gorham's Disease, Tuberculosis</p> Agil Dananjaya Copyright (c) 2022 Malang Respiratory Journal http://creativecommons.org/licenses/by-sa/4.0 2022-09-30 2022-09-30 4 2 A Thymoma (Case Report): Importance of Comorbidity, Lifestyle, and Thymoma Size in Treatment Success https://mrj.ub.ac.id/index.php/mrj/article/view/49 <p style="font-weight: 400;">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.</p> Rachmat Suryaman Copyright (c) 2022 Malang Respiratory Journal http://creativecommons.org/licenses/by-sa/4.0 2022-09-30 2022-09-30 4 2 Exogenous Lipoid Pneumonia https://mrj.ub.ac.id/index.php/mrj/article/view/45 <p><strong>Background : </strong>Lipoid pneumonia is a rare disease and usually reported as sporadic cases. <em>Exogenous lipoid pneumonia </em>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.</p> <p><strong>Case Report : </strong>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.</p> <p><strong>Conclusion: </strong>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.</p> <p><strong>Key words : </strong>Lipoid Pneumonia, Exogenous Lipoid Pneumonia, Treatment of Lipoid Pneumonia</p> Tiar Oktavian Effendi Copyright (c) 2022 Malang Respiratory Journal http://creativecommons.org/licenses/by-sa/4.0 2022-09-30 2022-09-30 4 2