[Hodgkin's disease following treatment with hydantoins. Report of a case and review of the literature (author's transl)].

Diagnosis of Hodgkin's disease was made in a patient who had been treated with diphenylhydantoin sodium for 4 years. Three different neoplastic diseases of the lymphoid tissue following therapy with hydantoin derivatives have been reported. Pseudolymphoma is characterized by lymph node enlargement, fever, arthralgias, cutaneous rash, hepatosplenomegaly and eosinophilia. The lymph node biopsy reveals a non-malignant histopathologic pattern. Pseudolymphoma develops few weeks after administration of hydantoin and it completely disappears when medication is discontinued. Pseudo-pseudolymphoma has similar clinical and histologic characteristics than those of pseudolymphoma, but patients in this category develop a true lymphoma after an asymptomatic period. Lymphomas (Hodgkin's disease and non-Hodgkin's lymphomas) appear following prolonged treatments with hidantoin derivatives. Risk to develop lymphoma is two to four times higher for patients taking such medication. Carcinogenic mechanism of hydantoin is unknown, but it might be related to the immunosuppressive effect of this drug.