Conversion of a benign lymphoepithelial salivary gland lesion to lymphocytic lymphoma during dilantin therapy.Correlation with dilantin-induced lymphocyte transformation in vitro

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Abstract
A patient with a classical salivary gland benign lymphoepithelial lesion (BLL) that converted to a lymphoblastic lymphoma (LSA) localized to the salivary glands is described. The malignant transformation of the BLL was preceded by Dilantin anticonvulsant therapy, and in vitro tests subsequent to the development of LSA demonstrated positive Dilantin-induced lymphocyte transformation. The lymphoma was treated successfully by local irradiation, chemotherapy, and discontinuation of Dilantin. The case illustrates the “prelymphomatous” nature of BLL in certain patients, as well as the possible potential danger of Drlantin and other lymphoid-stimulating drugs in such patients. The etiologic role of Dilantin in converting BLL to LSA is discussed. Further study of drugs capable of inducing lymphocyte transformation in patients with prelymphomatous disorders is warranted.