EBV-positive non-Hodgkin's lymphoma developing after phenytoin therapy.
We report the first case of Epstein Barr virus (EBV) positive non-Hodgkin's lymphoma occurring 20 years after continuous phenytoin therapy for idiopathic epilepsy. This malignant lymphoproliferative disease was preceded by an phenytoin-associated benign reactive lymphadenopathy. Serological findings suggested a chronic active EBV infection. Immunohistochemistry showed that neoplastic cells expressed B antigens (CD20, lambda) and the bcl-2 protein. The presence of EBV-encoded latent membrane protein 1 (LMP 1) was also expressed on neoplastic cells. Cytotoxic chemotherapy (CHOP) reversed the non-Hodgkin's lymphoma.
Garcia-Suarez
J
J
Department of Haematology, Principe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain.
Dominguez-Franjo
P
P
Del Campo
F
F
Herrero
B
B
Munoz
M A
MA
Piris
M A
MA
Pardo
A
A
D000927:Anticonvulsants / Q000009:adverse effects*; D018951:Antigens, CD20 / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D007150:Immunohistochemistry; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects*; D011241:Prednisone / Q000627:therapeutic use; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D014412:Tumor Virus Infections / Q000150:complications*; D014750:Vincristine / Q000627:therapeutic use
D000927:Anticonvulsants; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D019253:Proto-Oncogene Proteins c-bcl-2; D014750:Vincristine; D010672:Phenytoin; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone