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Depression as first manifestation of a large intracerebral lymphoma

Published online by Cambridge University Press:  26 April 2013

Thorleif Etgen  and
Susanne Fleissner
Thorleif Etgen*
Affiliation:
Department of Neurology, Kliniken Südostbayern – Klinikum Traunstein, Traunstein, Germany Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
Susanne Fleissner
Affiliation:
Department of Neurology, Kliniken Südostbayern – Klinikum Traunstein, Traunstein, Germany
*
PD Dr Thorleif Etgen, Department of Neurology, Kliniken Südostbayern – Klinikum Traunstein, Cuno-Niggl-Strasse 3, D- 83278 Traunstein, Germany. Tel: +49 861 705 1771; Fax: +49 861 705 1515; E-mail: [email protected]
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Abstract

Objective

The differentiation between a ‘non-organic’ depressive episode and an organic depressive disorder on the basis of clinical grounds might be challenging.

Methods

We report a case with an initially typical severe depressive episode without any focal neurological deficits.

Results

Only medical history from a third party raised doubts about this provisional diagnosis. Brain magnetic resonance imaging revealed a highly malignant diffuse large intracerebral B-cell lymphoma in the right frontal lobe changing the diagnosis into an organic depressive disorder. The patient recovered after neurosurgical resection, chemotherapy and autologous stem cell transplantation.

Conclusion

This report helps to reduce possible errors in the differential diagnosis of depressive disorders by underlining the importance of a comprehensive medical history including anamnesis from a third party and neuroimaging, especially in first or atypical manifestation of depressive disorders.

Keywords

brain tumourdepressionlymphoma
Type
Case Report
Information
Acta Neuropsychiatrica , Volume 25 , Issue 4 , August 2013 , pp. 248 - 250
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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References

1.World Health Organization. The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. Geneva: World Health Organization, 1992.Google Scholar
2.Tyrer, P. Are general practitioners really unable to diagnose depression? Lancet 2009;374:589–590.CrossRefGoogle ScholarPubMed
3.Kessler, RC, Berglund, P, Demler, Oet al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003;289:3095–3105.CrossRefGoogle ScholarPubMed
4.Kupfer, DJ, Frank, E, Phillips, ML. Major depressive disorder: new clinical, neurobiological, and treatment perspectives. Lancet 2012;379:1045–1055.CrossRefGoogle ScholarPubMed
5.Masdeu, JC. Neuroimaging in psychiatric disorders. Neurotherapeutics 2011;8:93–102.CrossRefGoogle ScholarPubMed
6.Bunevicius, A, Deltuva, VP, Deltuviene, D, Tamasauskas, A, Bunevicius, R. Brain lesions manifesting as psychiatric disorders: eight cases. CNS Spectr 2008;13:950–958.CrossRefGoogle ScholarPubMed
7. DGPPN B, KBV, AWMF, AkdÄ, BPtK, BApK, DAGSHG, DEGAM, DGPM, DGPs, DGRW (Hrsg) für die Leitliniengruppe Unipolare Depression. S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression, 1. Auflage ed Berlin, Düsseldorf, DGPPN, ÄZQ, AWMF 2009.Google Scholar
8.Fisher, R, Harper, C. Depressive illness as a presentation of primary lymphoma of the central nervous system. Aust N Z J Psychiatry 1983;17:84–90.CrossRefGoogle ScholarPubMed
9.Gallop-Evans, E. Primary central nervous system lymphoma. Clin Oncol (R Coll Radiol) 2012;24:329–338.CrossRefGoogle ScholarPubMed
10.Fitzgerald, PB, Laird, AR, Maller, J, Daskalakis, ZJ. A meta-analytic study of changes in brain activation in depression. Hum Brain Mapp 2008;29:683–695.CrossRefGoogle ScholarPubMed