Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma (MEITL) Presenting As An Obstructive Pancreaticoduodenal Mass: A Case Report

Casestudy: A 74-year-old woman of Scottish descent presented with obstructive jaundice and weight loss. Imaging revealed a head of pancreas mass with extrahepatic bile duct dilation. Fine needle aspiration cytology of the mass was non-diagnostic, therefore the patient underwent a pancreaticoduodenectomy. Gross examination revealed a circumferential, necrotic lesion involving the periampullary duodenum with invasion into the pancreas and peri-pancreatic soft tissue. Microscopically, the lesion was composed of diffuse sheets of monomorphic medium-sized cells with fine chromatin, inconspicuous nucleoli, and scant pale cytoplasm. The duodenal mucosa overlying the lesion was ulcerated. Epitheliotropism was noted in the duodenal villi, crypt epithelium and pancreatic duct epithelium. The tumor showed extensive areas of necrosis and conspicuous perineural invasion. The duodenal mucosa uninvolved by the tumor showed no evidence of an underlying enteropathy, such as Celiac disease. By immunohistochemistry, the neoplastic cells were positive for CD45, CD3, CD8, CD56, TIA-1, granzyme B, TCR-BF1, and TCR-gamma, and were negative pan B-cell markers, CD4, CD5, CD25, CD30, EBER, HHV-8, and TCL-1. Molecular studies for T cell clonality revealed clonal TCR-alpha-beta and gamma-delta gene rearrangements. Given the morphologic and immunophenotypic findings, the diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) was rendered. This case is unique with features not typical of MEITL, namely mass-like pancreaticoduodenal presentation resulting in a Whipple resection, extensive necrosis, and perineural invasion.

Catharine Trotter Cockburn (1679?–1749)

This chapter contains selected letters from the correspondence of Catharine Trotter Cockburn, an English moral philosopher of Scottish descent. It includes a large selection of Cockburn’s letters to and from her niece Ann Hepburn Arbuthnot, spanning the period from 1731 to 1748, as well as letters from Cockburn’s exchanges with the philosophers John Locke and Edmund Law. The topics of the letters concern ethical and moral-theological issues such as the metaphysical foundations of moral obligation and the role of reason in discerning the will of God. The chapter begins with an introductory essay by the editor, arguing that the letters provide insight into how Cockburn developed her mature ethical position in relation to her philosophical contemporaries, especially the freethinkers, deists, mystics, and advocates of self-interest in her time. The text includes editorial annotations to assist the reader’s understanding of early modern words and ideas.

The narrative self in rural dementia: a case study from eastern Nova Scotia

ABSTRACTThis analysis examines how the narrative self of a person with dementia is maintained by family members in a small rural Nova Scotian community. In the literature, the expectation is often that rurality is a condition of isolation, distance from family and limited health resources. However, drawing on three years of ethnographic and interviewing research with a large extended family whose patriarch, Alexander, is a person with dementia, we demonstrate how a community's rurality influences interpretations of dementia. In Alexander's rurality, of particular import are local definitions of belonging, which privilege intimate knowledge of local history, working as a farmer to shape the land, and being of Scottish descent and male. As family members find Alexander's belonging to come into question in their community, we show them to employ narratives in which he is valorised for continuing to uphold local values – of ‘usefulness’ and of ‘being the land’. We show how the family members must also revisit and revise these narratives when Alexander's belonging is further called into question outside the family setting and, specifically, at the local farmer's market, where Alexander is often no longer greeted by other marketgoers. The men and women of the family arrive at different interpretations of this development, with the women considering marketgoers to demean and dehumanise Alexander, while the men feel that the marketgoers are avoiding interactions that would embarrass him. Such disagreements reveal the ongoing emotional labour of creating narratives that lack closure, certainty and consensus, as well as ways in which gender and rurality operate intersectionally in the process of meaning-making.

Australia and the Scottish Independence Referendum

The chapter analyzes data from print and online media, including online broadcaster sites, and includes an overview of the Australian media landscape. It also notes the significant percentage of Australians (8.9%) who are Scottish or of Scottish descent. There was considerable Australian interest in the referendum. While there was focus on the Scottish referendum in its own context, the other chief tendency was for the Australian media to use the Scottish referendum as a hook for tackling Australian issues. This especially applies to the republican/monarchist debate there. Until close to polling day coverage tended to rely on agencies or UK partner titles, reflecting a general lack of foreign news in the Australian press. The chapter notes the predominance of one newspaper, The Australian, which along with the news services of ABC and SBS was the only source of detailed reporting. Notwithstanding hostile comment on the Yes campaign by Australian Prime Minister Tony Abbott, the Australian media generally did not take sides in the debate. After the poll, the story rapidly faded from the media.

Alexander Robertus Todd, O.M., Baron Todd of Trumpington. 2 October 1907 — 10 January 1997

Alexander Robertus Todd (Alex to his friends), was born in October 1907 in Cathcart, to the south of Glasgow. His father, Alexander Todd, of southern Scottish descent, was at first a clerk in the Glasgow Subway Railway Company and later its Secretary; subsequently he was the Managing Director of the Drapery and Furnishing Co–operative Society Ltd in Glasgow. He was ambitious to better himself and his family and although his formal teaching had ended at thirteen he held a strong regard for education and was determined, as was his wife Jane (née Lowry) that it should not be denied to their children. As their affluence increased they moved to the village of Clarkston, whence Alex had to trudge one and a half miles each day to the public school in Cathcart. One should recall that this was during wartime: life was hard and boots were of poor quality. At the age of eleven he passed the entrance examination to Allan Glen's school, the Glasgow High School of Science in the centre of the city. Among the teachers was Robert Gillespie, who taught chemistry and fostered Alex's growing interest in that subject. This gave him the impetus, after passing the Higher Leaving Certificate examination in 1924, to enter the University of Glasgow to read for an honours degree in chemistry. Once there, he was recognized by his teachers as a highly talented student, taking the James Black Medal and the Roger Muirhead Prize in his first year, which also gave him a scholarship for the rest of his course. Alex graduated BSc with first class honours in 1928 and was awarded a Carnegie Research Scholarship of €100 a year to work with Professor T.S. Patterson. He and his predecessor, G.G. Henderson, F.R.S., had strong interests in alchemy and the history of chemistry. The latter subject was even compulsory in the final year. Alex was interested in this and, much later in life, spoke and wrote knowledgeably on several aspects of the history of organic chemistry. Patterson's research interest was optical rotatory dispersion and, although Todd's first two papers were published jointly with Patterson in 1929 (1, 2)*, it was clear that a subject in which theory and practice made little contact was not for him. With encouragement from Patterson, Alex transferred to the University of Frankfurt to work in the laboratory of W. Borsche.

Alexander Edgar Douglas, 12 April 1916 - 26 July 1981

Alexander Edgar Douglas was born on a farm near Melfort, Saskatchewan, on 12 April 1916, of Scottish descent. His paternal grandfather, Kenneth Douglas, as a young man was a shepherd in Scotland and Alex ’s father, Donald Douglas, was born in Inverness in October 1879. A few years later the family moved to Watton at Stone in Hertfordshire (England) where they rented a substantial farm .The farm residence was Broome Hall which is still standing and has been named a heritage building. Donald Douglas attended school at Watton. After leaving school he worked for a while as a wheelwright but in 1904 emigrated to Canada. In 1905 he took up a homestead at Thaxted, near Melfort, Saskatchewan, in an area that was largely unpopulated at the time. Through the years he played a considerable role in founding and operating the local school, the local telephone company and the farmers ’ cooperative society. In 1909 he married Jessie Florence Carwardine. They had four children of whom Alex was the third . Donald Douglas and his wife remained on the same farm until 1945. Alex Douglas said of his father: ‘He was a quiet modest man who fitted the model of a Scottish Highlander (with absolute honesty and deep convictions). In spite of the harsh conditions of the time he loved the farm and country .’