Phenytoin-induced pseudolymphoma: Reevaluation using modern molecular biology techniques
Journal
Epilepsia
Journal Volume
37
Journal Issue
1
Pages
104-107
Date Issued
1996
Author(s)
Abstract
Patients receiving phenytoin (PHT) may develop pseudolymphoma or, rarely, malignant lymphoma. Previously, distinguishing the two diseases based solely on histopathology has been difficult. The recent introduction of molecular biological techniques has provided a powerful tool to reassess this problem. A 17-year-old girl developed systemic lymphadenopathy after receiving PHT for 1 year for generalized tonic-clonic seizures (GTCS). Biopsy of a cervical lymph node showed diffuse proliferation of large lymphoid cells mimicking a large cell lymphoma. Immunophenotypic, immunoglobulin gene rearrangement, and cytogenetic studies, however, showed polyclonal B-cell proliferation, consistent with PHT-induced pseudolymphoma. After PHT discontinuation, lymphadenopathy resolved in 1 month and no recurrence developed in the subsequent 10 months. Obtaining a history of drug use is crucial to recognizing this group of patients. Molecular biology and chromosome studies have become the definitive basis differentiating pseudolymphoma from malignant lymphoma in patients receiving chronic PHT therapy.
SDGs
Other Subjects
phenytoin; adolescent; article; b lymphocyte; case report; cervical lymph node; drug withdrawal; female; grand mal epilepsy; human; human tissue; lymph node biopsy; lymphadenopathy; lymphocyte proliferation; priority journal; pseudolymphoma; Adolescent; Biopsy; Blotting, Southern; Chromosome Aberrations; Diagnosis, Differential; Epilepsy, Tonic-Clonic; Female; Gene Rearrangement, B-Lymphocyte; Humans; Immunophenotyping; Lymphoma; Phenytoin
Type
journal article