Unusual and Fatal Case of an Undiagnosed Intravascular Large B-cell Lymphoma: The Oncologist’s Great Imitator†

Intravascular lymphoma (IVL) is a rare subtype of extranodal lymphomas that is characterized by the selective growth of neoplastic cells within the lumen of small vessels. Authors document the case of an unexpected death caused by an undiagnosed intravascular large B-cell lymphoma with multi-organ involvement, which had initially manifested as an infection and then as an unclarified central nervous system pathology. Histological examination showed a diffuse intravascular large B-cell brain lymphoma with prominent cerebral involvement. The relevance of the case report reveals the importance of an autopsy of an extremely rare and threatening pathology that in most cases is diagnosed only postmortem. As a result, the role of the forensic pathologist becomes particularly important. When specifically performing an in-depth autopsy evaluation with a specific histologic analysis, it is possible to identify the intravascular lymphoma and declare a more accurate cause of death.     

Ethyl Glucuronide Concentration in Hair of Detainees: A Preliminary Study

Through the measurement of ethyl glucuronide in hair (hETG), it is possible to assess chronic alcohol abuse over time. In this paper, we present a study on hETG in Italian prison inmates. Analyses were performed by LC-MS according to a previously published method. Results were evaluated using the cut-offs established by the Society of Hair Testing. Positives samples (ETG > 30 pg/mg) accounted for 6% of all subjects, with concentrations ranging from 42 pg/mg up to 270 pg/mg, abstinent subjects (ETG < 7 pg/mg) accounted for 88%, and moderate alcohol consumption (7 < ETG < 30 pg/mg) for 6% of the subjects. No females displayed ETG values above 30 pg/mg. Among positive samples, only two subjects did not declare heavy alcohol consumption and were found strongly positive at 210 and 270 pg/mg. To the best of our knowledge, this represents the first study on ETG hair concentration on prison inmates.     

Pitfalls of Computed Tomography 3D Reconstruction Models in Cranial Nonmetric Analysis*

Many studies in the literature have highlighted the utility of virtual 3D databanks as a substitute for real skeletal collections and the important application of radiological records in personal identification. However, none have investigated the accuracy of virtual material compared to skeletal remains in nonmetric variant analysis using 3D models. The present study investigates the accuracy of 20 computed tomography (CT) 3D reconstruction models compared to the real crania, focusing on the quality of the reproduction of the real crania and the possibility to detect 29 dental/cranial morphological variations in 3D images. An interobserver analysis was performed to evaluate trait identification, number, position, and shape. Results demonstrate a false bone loss in 3D models in some cranial regions, specifically the maxillary and occipital bones in 85% and 20% of the samples. Additional analyses revealed several difficulties in the detection of cranial nonmetric traits in 3D models, resulting in incorrect identification in circa 70% of the traits. In particular, pitfalls included the detection of erroneous position, error in presence/absence rates, in number, and in shape. The lowest percentages of correct evaluations were found in traits localized in the lateral side of the cranium and for the infraorbital suture, mastoid foramen, and crenulation. The present study highlights important pitfalls in CT scan when compared with the real crania for nonmetric analysis. This may have crucial consequences in cases where 3D databanks are used as a source of reference population data for nonmetric traits and pathologies and during bone-CT comparisons for identification purposes.     

Organizational and Human Factors Affecting Forensic Decision-Making: Workplace Stress and Feedback

Although forensic examiners operate in a stressful environment, there is a lack of understanding about workplace stress and feedback. These organizational and human factors can potentially impact forensic science judgments. In this study, 150 practicing forensic examiners from one laboratory were surveyed about their experiences of workplace stress, and the explicit and implicit feedback they receive. Forensic examiners reported that their high stress levels originated more from workplace-related factors (management and/or supervision, backlogs, and the pressure to do many cases) than from personal related factors (family, medical, and/or financial). The findings showed that a few (8%) of the forensic examiners sometimes felt strong implicit feedback about what conclusions were expected from them and that some (14%) also strongly felt that they were more appreciated when they helped to solve a case (e.g., by reaching a “match” as opposed to an “inconclusive” conclusion). Differences were found when comparing workplace stress and feedback levels across three core forensic science fields (forensic biology, chemistry, and latent prints) and across career stages (early, mid, and late). Gaining insights into the stress factors within a workplace and explicit and implicit feedback has implications for developing policies to improve the well-being, motivation, and performance of forensic examiners.     

Civilian Forensic Technician and Sworn Police Officer Job-Related Stress

Forensic Technicians provide crime scene investigation services and are exposed to stressful violent crimes, motor vehicle accidents, biological or chemical hazards, and other appalling imagery. Forensic Technicians would likely experience physical and psychological stress after exposure to trauma, and security vulnerabilities similar to Sworn Police Officers. The perceived availability of mental health resources, job-related physical, psychological stress, and traumatic experiences of both Forensic Technicians and Sworn Police Officers from California law enforcement agencies were investigated using a self-reported survey. Responses were evaluated for any significant differences in the perceived stress, job-related physical stress, and resulting psychological impact affecting the participants. The survey contained a mix of True/False, Circle/Check the Appropriate Box, or Likert Scale (1–5) responses. The results were evaluated statistically and discussed. Results indicated Sworn Police Officers and Forensic Technicians have different on-duty stress levels, but similar off-duty stress levels. Nearly two-thirds of 54 job-related stressors were not significantly different between the two occupations. However, Forensic Technicians reported more adverse effects in 17 physical and psychological job-related activities compared with Sworn Police Officers. Forensic Technicians reported lower awareness levels and availability of agency mental health support services than were reported by Sworn Police Officers. This study reports for the first time an unexpected outcome that perceived and job-related psychological stress is greater for Forensic Technicians than Sworn Police Officers. Possible reasons for this disparity will be discussed as well as stress management tools that should be implemented to reduce health risk factors for both career professionals as well as increase public safety.     

The Effect of Temperature and Exposure Time on Stability of Cholesterol and Squalene in Latent Fingermarks Deposited on PVDF Membrane

Cholesterol and squalene are fatty materials of latent fingermarks that can be utilized for dating methodologies and visualization techniques. Previous studies have suggested these compounds undergo degradation in fingermarks as a function of time (days) and light at ambient temperature. However, studies assessing how their composition changes at low and high temperatures over short periods of time (hours) have not been published previously. Here, we performed quantitative analysis of cholesterol and squalene in natural fingermark residue using PVDF membrane, after exposure to a range of temperatures (−20 to 100°C) for 4 and 8 h. We found that levels of both fatty materials remained constant at −20 to 60°C, but both showed significant reduction at 100°C, over short exposure times. These results indicate that cholesterol and squalene are detectable at −20 to 60°C, whereas at 100°C or higher, both are lost due to rapid thermal degradation.     

Evaluating Bioinformatic Pipeline Performance for Forensic Microbiome Analysis*,†,‡

Microbial communities have potential evidential utility for forensic applications. However, bioinformatic analysis of high-throughput sequencing data varies widely among laboratories. These differences can potentially affect microbial community composition and downstream analyses. To illustrate the importance of standardizing methodology, we compared analyses of postmortem microbiome samples using several bioinformatic pipelines, varying minimum library size or minimum number of sequences per sample, and sample size. Using the same input sequence data, we found that three open-source bioinformatic pipelines, MG-RAST, mothur, and QIIME2, had significant differences in relative abundance, alpha-diversity, and beta-diversity, despite the same input data. Increasing minimum library size and sample size increased the number of low-abundant and infrequent taxa detected. Our results show that bioinformatic pipeline and parameter choice affect results in important ways. Given the growing potential application of forensic microbiology to the criminal justice system, continued research on standardizing computational methodology will be important for downstream applications.     

DNA Recovery From Tape-Lifting Kits: Methodology and Practice

In the case of suspicious deaths, the technique of 1:1 taping is often used in Belgium. It consists of affixing a large number of adhesive tapes to the body of the victim. It is conventionally aimed at obtaining microtraces (e.g., fibers, hair) and is usually not used for DNA analysis. However, in some cases, DNA analysis of certain areas of interest identified on the 1:1 taping material can offer a last resort solution. The four-step method that is described in this article involves the selection of areas of interest on the body (Step 1), the selection of the corresponding tapes (Step 2), the decontamination of the tapes (Step 3), the selection of areas of interest on the tapes, for DNA sampling (Step 4). The method is illustrated by its successful application in four murder cases. In each case, DNA profiles of good quality could be identified, including profiles of persons different from the victim.