Abstract Ref Number = APCP890
TETRAPARASE IN A BOY WITH EXTRADURAL MIMICKING INTRADURAL EXTRAMEDULAR SPINAL NON HODGKIN LYMPHOMA A CASE REPORT
Dewinda Candrarukmi,Fadhilah Tia Nur,Muhammad Riza,Rachmi Fauziah Rahayu,Brian Wasita
Departement of Child Health Moewardi Hospital Surakarta Neurology Subdivision Departement of Child Health Moewardi Hospital Surakarta Hematology Subdivision Departement of Child Health Moewardi Hospital Surakarta Neuroradiologi Subdivision Departement of Radiology Moewardi Hospital Surakarta Departement of Patology Anatomy Moewardi Hospital Surakarta
Background : Spinal cord tumors account for less than 10%of pediatric central nervous system tumors. Extradural tumors are responsible for 39.5% of all pediatric spinal tumors. Non-Hodgkin lymphoma (NHL) is reported for about 60% of lymphomas in children. Non-Hodgkin lymphoma occurs in the spinal cord is extremery rare, it is approximately 4%.
Case Presentation Summary : A 8 years old boy, with weakness on both legs and arm. It started from hands, arms then legs occurring 2 weeks prior admission. Physical examination revealed neither fever nor lymphadenopathy, normal sensory, decreased motor strength in the upper and lower extremities, increased physiological reflex, positive clonus and babinsky reflex. Contrasted cervical MRI showed an extramedular intradural solid lesion extending from the right neural foraminae at cervical vertebrae 2-7, to thorachic 1-3. The laminectomy was performed with excision of the extradural tumor, from cervical vertebrae 4-7 to thoracic 1-4. Microscopic examination obtained round tumor cells with starry sky image, and immunophenotypic feature demonstrated B cell positive for CD 20. The patient was then diagnosed with B-cell NHL.
Learning Points/Discussion : Primary B-cell NHL is a rare neoplasm in the spine. Althought this is uncommon site, NHL should be included in the differential diagnosis in patient with spinal tumor.
Keywords: tetraparase spinal tumor non hodgkin lymphoma extradural intradural extramedular