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.     

Implementing Privatization Policies in ‘Next Steps’ Agencies

This article examines the implementation of privatization policies in two ‘Next Steps’ agencies. This is discussed with reference to the broader theoretical and empirical questions of how do institutions change and when are political actors constrained in implementing their policy choices. Cortell and Peterson’s framework for explaining institutional change, and the concept of intra-state policy networks are used to analyse the cases. The differential outcomes identified illustrate how constraints operate and how these may be overcome by strategic actors to produce change. Constraints in these cases arose from fragmentation and dependence in central government, from differing institutionalized beliefs and from the development of intra-state networks between the departments and agencies. The paper concludes by suggesting that the type of intra-state networks created through agencification can be seen to have an effect on policy outcomes and are worthy of more detailed research.     

Y chromosome J2 subtyping in an Italian sample: Population and forensic implications

In the recent years the Y chromosome genealogy has been refined by a number of newly discovered SNPs. The non-random distribution of the Y chromosome lineages worldwide makes fundamental the dissection and characterisation of haplogroups associated with specific geographic areas. In Southern Europe the haplogroup J2, as defined by the M172 marker, can reach frequencies up to 35%, making the dissection of such lineage critical for population studies. Here we present a study on J2 chromosomes from the Italian peninsula. Populations and forensic implications are discussed. A total of 900 individuals were previously genotyped for a number of SNPs, including M172. More than 200 of these have been now genotyped for 7 SNPs within the J2 lineage using a multiplex SNaPshot approach. The different distribution of the various lineages in different geographic areas probably reflects different historical demographic events and points to differential Y chromosome haplotype distribution, with implication for forensic application of this genetic marker.     

The narrative structure of psychiatric reports

The present contribution illustrates the findings of a research about the narrative structure of psychiatric expertise. We have analysed a sample of nine expertises, using the methodology proposed by Roland Barthes in his book S/Z, in which he applies it to Honoré de Balzac's "Sarrasine". Barthes suggests that every narrative is characterized by the presence of five codes (hermeneutical, proairetic, semantic, symbolic and referential): we have searched for them in the expertises, but we have also observed the presence of many lapsus calami. As for our results, we have interpreted the massive presence of symbolic code in an expertise as a proof of the elaboration of the horror elicited by crime in the expert's narrative and, on the other side, the presence of referential code as the proof of the incapacity to treat such feeling and the necessity to defend himself from it. In this vision, lapsuses arise when the expert is astonished by the horror of the crime, and does not succeed in elaborating it either by using symbolic code or through his cultural resources (referential code). Finally, some reflections are made upon the difficulty for the voice of the defendant to be heard in the texts written about him.