title: Depression as first manifestation of a large intracerebral lymphoma.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Department of Neurology, Kliniken Südostbayern - Klinikum Traunstein, Traunstein, Germany.
authors.forename: Thorleif
authors.initials: T
authors.lastname: Etgen
authors.affiliation: 1 Department of Neurology, Kliniken Südostbayern - Klinikum Traunstein, Traunstein, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Fleissner