complete path report

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5/16/2014 6:01pm
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Replies: 6

The more I read my path report the most questions I have, so here is the complete report:

 

Cooment:Lateral and deep edges are positive for neoplasm.  The histologicdifferetial diagnosis may include a compound dysplastic melanocytic nevus with severe atypia, however, an early melanoma (0.4 mm in depth) cannot be excluded in these sections.  Re excision is suggested in order to perform additional histologic analysis and ensure the prolifieration has been removed moved from the patient.

 

I had the wide excision Tuesday and been reading this over and over and l\lateral and deep edges being positive for neoplasm is freaking me out.  The doctor said this was a "soft call" of no melanoma but they they wanted to treat it like an early melanoma?

 

Thoughts??

Kim K - (5/16/2014 - 8:42pm)

Basically it is a nasty benign atypical mole or very very early melanoma.  Regardless, it appears not all of the lesion was removed as it extended to some of the margins of the original biopsy.  The wide excision should get the rest if any.

The Breslow is 0.4 so even if they were to err on the side of melanoma, it is a very early one.  There should be other information regarding ulceration, regression, any lymphatic or vascular invasion and mitotic index.  If not, make sure it was read by a dermatopathologist with special training on reading these slides.

There are ceartain markers / stains that help differentiate between the two as well.  It should be noted in your path report.

Regardless, treatment would consist of the WLE and frequent skin checks to monitor for any new lesions.  You caught this very early and while scary, is probably one of the better diagnosis to have when considering the range of severity of disease.

Typically no oncologist follow up or SNB, scans, bloodwork is required with your lesion.  Hope that makes you feel better.  At worst you are stage IA with a very high survivability.  Just use it as a wake up call to continue frequent skin checks and to practice sun safety.

Aloha,

Kim

Cancer Sucks Shit Happens Nothing is ever 100% bad, there is a reason and silver lining in everything. Sometimes I need a good light and my glasses to find it though. You can't fix stupid.

ray39 - (5/16/2014 - 8:59pm)

No ulceration or mitotic activity

ray39 - (5/17/2014 - 8:54am)

Does "lateral and deep edges positive for neoplasm" mean the edges of the mole or the edges of the entire biopsy ?

ray39 - (5/17/2014 - 12:11pm)

Microsscopic description

 

A compound type melanocytic proliferation is present demonstrating architectural disorder and severe cytologic atypia.  Immunostain MART 1 stains atypical melanocytes at the dermo-epidermal junction as well as the dermis.  Immunostain HMB 45 stains intraepidermal and superficial dermal melanocytes with decreased staining intensity in deeper melanocytes.

Anonymous - (5/19/2014 - 8:48am)

Does it say that in the report, or does it not mention either one at all? It would be better to post the ENTIRE path report, not just bits and pieces

ray39 - (5/19/2014 - 10:12am)

That is the entire report