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Lymphoma Associated with Phenytoin Therapy (Pseudo-Pseudolymphoma)

Description

A patient on chronic phenytoin (Dilantin) therapy is at increased risk for true lymphoma. Because a patient on chronic phenytoin therapy may develop a benign lymphoproliferative disorder (pseudolymphoma, see previous section), the presence of a true lymphoma is called a pseudo-pseudolymphoma.


 

The risk for developing a malignant lymphoproliferative disorder may be secondary to immunosuppression associated with the phenytoin therapy.

 

Malignant lymphoproliferative disorders that may occur in these patients include:

(1) Hodgkin's disease

(2) non-Hodgkin's lymphoma

 

Molecular techniques may show a clonal lymphoid population in the case of a non-Hodgkin's lymphoma. Some patients show evidence of Epstein Barr virus (EBV) in the tumor.

 

Stopping the phenytoin usually does not affect the status of the lymphadenopathy. Occasional patients may show a temporary reversal only later to progress.

 


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Specialty

ICD-10