Mesantoin Lymphadenopathy Morphologically Simulating Hodgkin's Disease

Abstract

A patient is described whose intractable epilepsy prompted the administration of 3-methyl-5, 5-phenylethyl hydantoin (Mesantoin) on three separate occasions between 1951 and 1956. Each time, he developed tender lymphadenopathy, fever, rash, and splenomegaly within a few days after administration of the drug, and on the third exposure a severe Coombs''-positive hemolytic anemia. On the latter occasion, lymph node biopsy revealed an atypical reticulum cell hyperplasia with the presence of giant cells meeting the criteria for Reed-Sternberg cells. A diagnosis of Hodgkin''s granuloma was rendered and the patient received nitrogen mustard and radiation. Since that time (1956) he has remained well except for his epilepsy. It is considered that the Reed-Sternberg-like cells in this instance were reactive and morphologic extensions of the atypical reticulum cell hyperplasia incident to Mesantoin hypersensitivity and did not represent Hodgkin''s disease.