Lymphadenopathy induced by anticonvulsant drugs and mimicking clinically and pathologically malignant lymphomas

Abstract

THE introduction of the various hy-S dantoin derivatives and analogues into the therapy of convulsive di~orders,~Q scattered reports have appeared in the literature of a peculiar lymphadenopathy directly related to this therapy. These reactions closely mimic various malignant lymphomas, both clinically and pathologically, and a diagnosis of lymphoma might be made by the unwary physician. It is for this reason that this report is being published. Most of the anticonvulsant drugs have been implicated in this reaction, with methoin (Mesantoin) being most frequently implicated. The lymphadenopathy may occur in conjunction with the more widely known reactions to these drugs, such as leukopenia, fever, and skin rashes, or it may appear in the absence of these other reactions. Only a few of the previous case reports included any histological description of the lymph nodes. In the past 5 years, 7 individuals whose clinical courses resembled those previously described have been admitted to either Barnes Hospital or St. Louis Children's Hospital, St. Louis, Mo., and biopsies of appropriate tissues have been performed. These patients form the basis of this report.