PATHOLOGY REPORT-LENTIGO ATYPIA

Posted By
1Cbras
11/28/2017 5:24pm
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Replies: 6

So,after two weeks I received my biopsy report. It determined a lesion on my foot to be LENTIGO ATYPIA. The doctor said because the margins are clear no further treatment is required. What exactly is LENTIGO atypia?

Janner - (11/29/2017 - 10:43am)

Without more info from the path report, all we can say is "lentigo = freckle" and atypia = some degree of atypical cells, but not enough atypia to be melanoma.  Weird freckle.

Here is the entire report...thanks...

Final PATH
AP results

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FINAL PATHOLOGY REPORT

Final PATH
AP results

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FINAL PATHOLOGY REPORT
DIAGNOSIS
LEFT FOOT BIOPSY:
LENTIGO WITH ATYPIA, COMPLETELY EXCISED

COMMENTS: MULTIPLE LEVELS HAVE BEEN OBTAINED. THIS CASE HAS ALSO BEEN REVIEWED BY 2 DERMATOPATHOLOGISTS.

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Surgical Site: Other(specify below); left foot plantar aspect
Operative Procedure: Other(specify below); excision
Clinical Information: skin lesion
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GROSS EXAMINATION
the specimen is received in 10% neutral buffered formalin labeled "left foot" and consists of one piece of tan-gray ellipse of skin with a suture marking at the 12:00 margin. the specimen measures 2.2 x 1.3 x 0.5 cm. The specimen has a light brown flat lesion in the center measuring 0.5 x 0.4 cm. The 3:00 margin is inked blue. the 9:00 margin is inked yellow. the specimen is serially sectioned from the 12:00 margin to the 6:00 margin. the specimen is entirely submitted in cassettes 1A through 1H. PD

Summary of sections:
1A= 2 tips (12:00 margin)
1B thorugh 1G= 1 piece each (center sections)
1H= 2 tips (6:00 margin)

Electronically Signed 11/28/2017 1:16 PM
Geraldine Mercer,MD
Pathologist

CPT Codes: 88305

RESULT NOTE Surg02: Op Procedure? : Other(specify below) excision
Surg04: Clinical information? : skin lesion

The full report isn't any more illuminating.  It describes the sample but not the atypia.  I was looking to see if there were any description of the type of atypia (cellular or architectural) or any degree (mild, moderate, severe).  Often found in reports but not yours.  You just get to go with the final diagnosis and what I said before doesn't change.

Thanks. So, now I'm torn. I have at least two other weird lesions on the same foot...not as weird as the one removed but weird...and smaller...should I get at least a punch biopsy (to avoid recovery time for removal) or should I just photograph and watch? Thoughts? Thanks...

Having multiple that are similar actually makes things less likely they are concerning.  You are really looking for the ugly duckling - the lesion that stands out because it is different.  Me?  I'd photograph and watch for change.  That's what I've always done and I'm still stage I 25 years later (with 3 primaries).  I really don't biopsy without reason.  You have to do what makes sense to you.