EBV-POSITIVE NON-HODGKINS-LYMPHOMA DEVELOPING AFTER PHENYTOIN THERAPY

We report the first case of Epstein Barr virus (EBV) positive non-Hodg kin's lymphoma occurring 20 years after continuous phenytoin therapy f or idiopathic epilepsy. This malignant lymphoproliferative disease was preceded by an phenytoin-associated benign reactive lymphadenopathy. Serological findings suggested a chronic active EBV infection. Immunoh istochemistry showed that neoplastic cells expressed B antigens (CD20, lambda) and the bcl-2 protein. The presence of EBV-encoded latent mem brane protein 1 (LMP 1) was also expressed on neoplastic cells. Cytoto xic chemotherapy (CHOP) reversed the non-Hodgkin's lymphoma.