[Changes in the incidence and mortality rates of malignant melanoma in the Seine-Maritime region over a 20-year period]. / Évolution de l'incidence et de la mortalité du mélanome en Seine-Maritime sur une période de 20ans.

BACKGROUND: The aim of this study was to assess changes in the incidence and mortality rates of malignant melanoma (MM) over a 20-year period in a region without a cancer registry. METHODS: All cases of MM studied were collected retrospectively from the databases of six private and three hospital-based histopathology laboratories in the Seine-Maritime region covering three 24-month periods each 10years apart: 1988-1989, 1998-1999 and 2008-2009, The incidence and mortality rates were estimated based on data provided by French National Institute for Statistics and Economic Studies (Insee) and French National Institute of Health and Medical Research (Inserm). RESULTS: Over the 20-year period, the incidence of MM increased from 8.6 to 21.2/100,000inhabitants per year (+147%, P<0.0001) while the mortality rate rose from 1.3 to 2.8/100,000inhabitants per year (+115%, P=0.0003). The incidence of invasive MM increased by +110%, while the incidence of MM in situ increased by +456%. The incidence and overall mortality rate of invasive MM increased particularly during the first 10-year period: +62% (P<0.0001) and +77% (P=0.01) respectively, and to a much lesser extent during the last 10-year period: +30% (P=0.0007) and +22% (P=0.22) respectively. This slowdown in the incidence of invasive MM and in overall mortality rates was even more pronounced in women over the last 10years (+17 and +9%), whereas these rates continued to increase in men (+49% and +35%, respectively). In contrast, the incidence of MM in situ increased above all during this same period (+257%). CONCLUSION: This study shows that while the incidence and mortality rate of invasive MM has increased little over the last 10years in the Seine-Maritime region, the incidence of MM in situ continues to rise sharply.

Histopathological lesions of the liver in hairy cell leukemia: a report of 14 cases.

Pathological lesions of the liver were studied in 14 cases of hairy cell leukemia, a rare hematologic neoplasm involving numerous organs. Tumor infiltration of hepatic parenchyma was observed in all cases. Tumor cells were easily recognized by their cytological features, namely their "halo" appearance consisting of a clear rim of abundant cytoplasm surrounding uniform round or slightly indented nuclei. Portal infiltration was observed in all cases, associated with sinusoidal infiltration in 12 cases. A peculiar change of the sinusoids, i.e., the angiomatous lesions, was noted in 9 of 14 patients. Angiomatous lesions consisted of intralobular cavities without zonal predominance which were lined by tumor cells which replaced the normal sinusoidal wall and were filled with red blood cells and tumor cells. This pattern of involvement is different from hepatic localization of other blood malignancies and is highly suggestive of hairy, cell leukemia. It might reflect the unique phenotype of the tumor cells, which express lymphocytic and monocytic features. The angiomatous lesion strongly mimics peliosis hepatis and could be, as well as in peliosis, the consequence of modification of the sinusoidal barrier. In hairy cell leukemia, sinusoidal wall abnormalities might be secondary to infiltration of the sinusoids by tumor cells.