[Neuropsychiatric disorders in Parkinson's disease]. / Trastornos neuropsiquiátricos en la enfermedad de Parkinson.

OBJECTIVE: This paper reviews the main neuropsychiatric disorders associated with Parkinson's disease (PD) and describes the neuropathological hypothesis proposed to explain these symptoms. DEVELOPMENT: This disease is usually associated with neuropsychiatric complications such as depression, anxiety and apathy. Besides, psychiatric symptoms are one of the most common side effects of antiparkinsonian drug-therapy. CONCLUSIONS: Depression is the most frequent emotional disorder reported in patients with PD. Up to 20% of parkinsonian patients meet DSM-IV criteria for major depressive episode and another 20% for dysthymia, while the prevalence of depression in normal aged population is about 2-8%. The relationship between PD and depression has not been fully established. Some investigators have suggested that depressive symptoms in PD are causally related to the underlying neuropathological process, affecting predominantly serotoninergic and dopaminergic pathways. Alternatively, depression in PD may represent a normal reaction to the progressive physical impairment induced by the disease. Otherwise, up to 20% of parkinsonian patients present levodopa-induced psychiatric complications. Visual hallucinations are the commonest, but delusions, confusional states, sexual disorders and sleep disorders have also been described. Serotonin and dopamine have been implicated in the neuropathological basis of these disorders.

[Diffuse T-cell lymphoma of the cervix uteri: an unusual localization of an infrequent tumor]. / Linfoma difuso de células T de cérvix uterino: una localización inusual de un tumor poco frecuente.

Non-Hodgkin lymphomas are frequent tumors. However, extraglandulary forms are very unusual, and the location in the uterine cervix is also extraordinary. A case of an elderly woman with symptoms not related with the tumor, in whom the diagnosis was made from the incidental finding of a distended obstructive bladder is presented. Pelvic mass is one of the forms of presentation of primary malignant lymphomas of the uterine cervix. Diagnosis was made in this case by transvaginal biopsy under general anesthesia. Biopsy showed a diffuse T-cell lymphoma, a very rare finding considering that most of published cases are B-cell type. The importance of distinguishing malignant lymphoma from undifferentiated carcinoma or sarcoma is emphasized since cervical malignant lymphoma can be successfully treated with irradiation.

Linfoma difuso de células T de cérvix uterino: una localización inusual de un tumor poco frecuente / Diffuse t-cEll lymphoma of the uterine cervix: an unusual location for a non-common disease

Los linfomas no hodgkinianos son tumores relativamente frecuentes. Sin embargo, las formas extraganglionares lo son menos, y la localización en cérvix uterino es excepcional. Se presenta el caso de una paciente anciana con sintomatología probablemente no relacionada con el tumor, en quien se llegó al diagnóstico a raíz del hallazgo casual de una gran distensión vesical producida por la compresión del tracto urinario inferior causada por el tumor. La masa pélvica es una de las formas de presentación de los linfomas de cérvix uterino. El diagnóstico se realizó en este caso mediante biopsia transvaginal bajo anestesia general. La biopsia mostró un linfoma difuso de células T, situación aún más excepcional, ya que la mayor parte de los casos publicados de linfomas de cérvix son linfomas de células B. Es de subrayar la importancia de distinguir los linfomas de carcinomas o sarcomas uterinos ya que los linfomas suelen tener una buena respuesta al tratamiento con radioterapia (AU)