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A fancy name for the American gangsters who like to kill people and steal money, plus other Italian mob groups around the world, including the smelly Huddersfield gang called the Tetsuo Family.
My uncle works for la cosa nostra and he killed three guys last week just for being late.
The Tetsuo Family are so bad they made the police cry.
La cosa nostra is like a school, and the teachers are all armed.