Epstein-Barr-virus-positive large B-cell lymphoma associated with breast implants: an analysis of eight patients suggesting a possible pathogenetic relationship.

Breast implant anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm arising around textured breast implants that was recognized recently as a distinct entity by the World Health Organization. Rarely, other types of lymphoma have been reported in patients with breast implants, raising the possibility of a pathogenetic relationship between breast implants and other types of lymphoma. We report eight cases of Epstein-Barr virus (EBV)-positive large B-cell lymphoma associated with breast implants. One of these cases was invasive, and the other seven neoplasms were noninvasive and showed morphologic overlap with breast implant ALCL. All eight cases expressed B-cell markers, had a non-germinal center B-cell immunophenotype, and were EBV+ with a latency type III pattern of infection. We compared the noninvasive EBV+ large B-cell lymphoma cases with a cohort of breast implant ALCL cases matched for clinical and pathologic stage. The EBV+ large B-cell lymphoma cases more frequently showed a thicker capsule, and more often were associated with calcification and prominent lymphoid aggregates outside of the capsule. The EBV+ B-cell lymphoma cells were more often arranged within necrotic fibrinoid material in a layered pattern. We believe that this case series highlights many morphologic similarities between EBV+ large B-cell lymphoma and breast implant ALCL. The data presented suggest a pathogenetic role for breast implants (as well as EBV) in the pathogenesis of EBV+ large B-cell lymphoma. We also provide some histologic findings useful for distinguishing EBV+ large B-cell lymphoma from breast implant ALCL in this clinical setting

Learning Priorities of Staff, Residents, and Students for a Third-Year Psychiatric Clerkship.

Psychiatric clerkships combine classroom instruction with patient care. The different learning experiences in those two settings prompted the authors to survey 86 third-year medical student clerks, 44 staff psychiatrists, and 15 PGY-2 psychiatric residents about the importance of 31 skill and knowledge areas as learning goals for clerks. All groups of respondents included the following five items (16.2%) among the most important: performing a mental status examination, becoming comfortable with psychiatric patients, evaluating suicidally, developing interview skills, and suspecting drug and alcohol problems. The importance placed by staff on aspects of the doctor-patient relationship was not apparent to students, who perceived psychiatric diagnosis as receiving higher priority than staff intended. The implications of these findings for curriculum planning are discussed

Settler-Colonialism, Memoricide and Indigenous Toponymic Memory: The Appropriation of Palestinian Place Names by the Israeli State

Cartography, place-naming and state-sponsored explorations were central to the modern European conquest of the earth, empire building and settler-colonisation projects. Scholars often assume that place names provide clues to the historical and cultural heritage of places and regions. This article uses social memory theory to analyse the cultural politics of place-naming in Israel. Drawing on Maurice Halbwachs’ study of the construction of social memory by the Latin Crusaders and Christian medieval pilgrims, the article shows Zionists’ toponymic strategies in Palestine, their superimposition of Biblical and Talmudic toponyms was designed to erase the indigenous Palestinian and Arabo-Islamic heritage of the land. In the pre-Nakba period Zionist toponymic schemes utilised nineteenth century Western explorations of Biblical ‘names’ and ‘places’ and appropriated Palestinian toponyms. Following the ethnic cleansing of Palestine in 1948, the Israeli state, now in control of 78 percent of the land, accelerated its toponymic project and pursued methods whose main features were memoricide and erasure. Continuing into the post-1967 occupation, these colonial methods threaten the destruction of the diverse historical cultural heritage of the land