PHENYTOIN-ASSOCIATED LYMPHOADENOPATHY MIMICKING A PERIPHERAL T-CELL LYMPHOMA

Abstract

<span style="font-size: 12.0pt; font-family: " lang="EN-US">We report a case of phenytoin-induced pseudolymphoma in a 28-year-old male with a history of autism and seizure disorder.<span style="mso-spacerun: yes;"> </span>The patient presented with bilateral cervical lymphadenopathy that was shown to be moderately to markedly FDG-avid on a whole body PET/CT scan.<span style="mso-spacerun: yes;"> </span>Flow cytometry analysis of peripheral blood and bone marrow mononuclear cells detected identical T cell population with aberrant immunophenotype.<span style="mso-spacerun: yes;"> </span>Additionally,<span style="background: white;"> a TCR beta gene was found to be clonally rearranged in both peripheral blood and bone marrow supporting a clonal origin of atypical T cells. However, </span>no such clonal population of T-cells could be detected in a pathologic specimen obtained from an excisional biopsy of one of the patient’s cervical lymph nodes. After discontinuing the patient’s phenytoin, his lymphadenopathy has nearly completely resolved and circulation clonal T cell population disappeared with 12 months of follow-up.<br style="mso-special-character: line-break; page-break-before: always;" /></span>

Keywords

• Lymphoma, psedolymphoma, Phenitoine