Page 251 - Abstract Book KONIKA 18

Hemato-Oncology

P-HO-046
Primary Lymphoma of Bone in A 9-year-old Girl

Santa Ulina, Bidasari Lubis, Olga R .Siregar
Department of Child Health, Faculty of Medicine Universitas Sumatera Utara, Adam Malik General Hospital,
Medan, North Sumatera, Indonesia
Abstract
Background Primary non-Hodgkin’s lymphoma of bone, often more simply referred to as primary lymphoma
of bone (PLB), is a rare presentation of non-Hodgkin’s lymphoma in children. Primary lymphoma of bone
is a rare entity, especially in children; most reports with complaints not being able to walk and come to
orthopedic division. Objective To report a case of primary lymphoma of bone in 9 years old girl. Case EGM,
a girl aged 9 years and 23 days, a patient in January 2019 went to Harapan Siantar Hospital because she
was pale. The patient was then referred to Haji Adam Malik General Hospital and diagnosed with Beta-
Thalassemia. In February 2019, the patient feels discomfort and pain in his left leg. The patient is bedridden
and unable to walk. He went to Haji Adam Malik General Hospital several times for regular transfusions
since then. In April 2019 patient came with cannot move both lower legs and consult with an orthopedic. In
June, the Orthopedic department had a joint conference to resolve the chief complaint about both feet, and
in July 2019 did a biopsy and the results showed NHL malignant smear. Conclusion Patients with primary
lymphoma of bone often misdiagnosis because clinical symptoms are not typical.
Keyword: Non-Hodgkin; bone lymphoma; primary lymphoma

P-HO-047
Management of Acute Ischemic Stroke in Children: A Case Report

Rivaldi Ardiansyah, Amanda Soebadi , Fitri Primacakti
Department of Child Health Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital,
Jakarta, Indonesia

Abstract
Background Acute ischemic stroke (AIS) in a children is a rare medical emergency with an incidence of
only 1.6 per 100,000 per year. Although not as prevalent in children as in adults, stroke is an important
cause of mortality and disability in children. Objective To emphasize the importance of early diagnosis,
anticoagulant treatment, and investigation of etiology in AIS. Case A 9-year-old obese boy, admitted to
emergency room 19 hours after the sudden onset of face dropping, right-sided weakness, and speech difficulty.
There was no history of other symptoms either evidence of congenital heart disease, malignancy, or sickle
cell disease. His father died due to ischemic stroke at young age. Expressive aphasia, normotension, right
hemiparesis, increased physiological reflexes, marked pathological reflex, facial and abducent palsy were
documented on physical examination. Brain CT-Scan showed acute ischemia at left basal ganglia. Oxygen
immediately given to the patient, avoidance of fluid overload, hypoglycemia, and enoxaparin was given
subcutaneously. Electrocardiogram, echocardiogram, thrombophilia, antiphospholipid syndrome, and lupus
profile were normal. Dyslipidemia was found on laboratory examination. MRI-MRA performed 2 weeks
later revealed chronic infarct from left basal ganglia to left cortex cerebri and arterial stenosis at left cerebri
media and cerebri anterior artery. Patient consulted to medical rehabilitation and neurosurgery department
for further multidisciplinary management. During hospitalization, aphasia and motoric ability improved.
Long-term anticoagulation with warfarin was initiated. Conclusion Management of AIS should be carried
out aggressively include early diagnosis to reduce morbidity, anti-coagulation therapy, medical rehabilitation,
and investigation of underlying predisposing factor of AIS.
Keywords: Acute ischemic stroke; anticoagulation; predisposing factor

KONIKA XVIII Abstract Book 203