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A 13-year-old girl presented with fever, nausea and projectile vomiting and altered sensorium. On physical examination, the meningeal signs were presented without focal neurological deficits and Grade Ⅱ papilledema was presented on fundus examination. The patient was found to be positive for Japanese encephalitis virus in cerebrospinal fluid. Focal neurological deficit in the form of right hemiparesis was noticed at day 6 of hospitalisation. Multiple lesions with minimal enhancement with perilesional edema were observed in cerebral cortex in contrast with enhanced magnetic resonance imaging of the brain, giving rise to starry sky appearance. No tests for neurotuberculosis were found positive. Serum IgG enzyme-linked immunosorbent assay test was negative for Cysticercosis, but magnetic resonance spectroscopy was suggestive of cysticercal meningitis. During treatment, she had intermittent episodes of nausea and vomiting with waxing and waning sensorium. Subsequently, it was planned to start Albendazole after steroids coverage and anticonvulsants but the patient did not improve and succumbed to her illness.

Abstract This case highlights the need for both tissue biopsy for diagnosis in suspected CNS malignancy and comprehensive immune profiling for accurate subclassification.

Plasmablastic Lymphoma (PBL) is an aggressive variant of diffuse large B-cell lymphoma with a low survival rate. It is associated with Human Immunodeficiency Virus (HIV) infection but also affects patients with autoimmune diseases as chronic lymphocytic leukaemia, systemic lupus erythematosus and with long-term immunosuppression for heart and kidney transplants, ulcerative colitis. It has been reported in immunocompetent and HIV negative patients, determining the diagnosis more challenging. A rare case of bleeding gingival hyperplastic PBL in the left posterior mandibular area in a 61-year-old HIV negative male patient is reported. Histological assessment showed that oral mucosa was infiltrated by a monomorphic population of large lymphoid elements with morphological characteristics similar to immunoblasts with a “starry sky” appearance. Immunohistochemical markers were positive for CD138, Kappa and Lambda light chains, and negative for CKAE1/3, Synaptophysine, Chromogranin, CD56, and CD20. The detection of the primary oral manifestation of PBL remains challenging in immunocompetent patients and this case report aims to broaden the knowledge of the possible oral clinical aspects of PBL.

Latar belakang. Limfoma Burkitt merupakan bentuk keganasan pada anak yang jarang ditemukan dibandingkan keganasan lain. Angka kematian limfoma Burkitt sangat tinggi, namun prognosis menjadi sedikit lebih baik karena banyak pilihan kemoterapi. Tujuan. Mengetahui gambaran limfoma Burkitt pada anak di RSUPN Cipto Mangunkusumo Jakarta. Metode. Penelitian dilakukan secara retrospektif dengan mengambil data dari rekam medik Divisi Hematologi- Onkologi RSUPN Cipto Mangunkusumo periode Januari 2001 hingga Desember 2006. Semua pasien yang datang ke Poliklinik rawat jalan dan ruang rawat inap dengan diagnosis Limfoma Burkitt diikutsertakan dalam penelitian. Hasil. Tercatat 7 kasus limfoma Burkitt, terdiri dari 6 laki-laki dan 1 perempuan. Usia termuda 1 tahun 5 bulan sedangkan usia tertua 14 tahun 10 bulan. Enam kasus mendapat kemoterapi, yaitu 4 kasus mendapat kemoterapi dan operasi 2 kasus. Dari 7 kasus yang tercatat satu orang meninggal dunia. Kesimpulan. Limfoma Burkitt adalah penyakit keganasan pada anak yang jarang ditemukan.