Malignant Lymphoma Associated With Hydantoin Drugs

Abstract

LYMPHADENOPATHY has been recognized as one of the less common side effects of the hydantoin drugs^1-3 for more than a quarter of a century. These drugs have been available for the treatment of epilepsy since 1938. Lymphadenopathy in these patients had been considered a hypersensitivity reaction because of the frequent occurrence of eosinophilia, and benign since it disappeared with discontinuation of the hydantoin. There is a dearth of knowledge about the mechanism of hydantoin lymphadenopathy. The benignancy of this lymphadenopathy has been questioned.^4-6 Great difficulty has been encountered in the differentiation between "benign" and malignant lymphoid reactions in general.⁴ Hyman and Sommers⁷ reported six cases of lymphoma in association with hydantoin therapy. A study was undertaken with the hope of clarifying the relationship between hydantoin therapy and malignant lymphoma. A review of the literature was processed, and then a retrospective study of necropsies undertaken to