Please help in interpreting pathology report!!

Posted By
kilz
8/6/2018 9:54am
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Replies: 10

It was described as ‘4.5mm symmetrical dark brown macule with central gray speckling’ with the dermoscopy. I was given a punch biopsy of part of the mole. 

A. Left cheek punch biopsy 

Compound Melanocytic Nevus

A. Sections demonstrate a punch of skin. There are both single and nested melancyotes in the superficial dermis. There are melanocytes present. I do not identify areas of confluence or upward migration. Melanocytes are located predominantly at the sides and bases of rete. There are melanocytes present above the dermal-epidermal junction, though I do not identify areas of confluence or diffuse pagetoid upward migration. It highlights nests of melanocytes in a reassuring pattern. Numerous deeper level sections have been evaluated and the findings are similar. 

There are rare melanocytes present above the dermal-epidermal junction. Given the overlying pigmented parakeratosis, this may be a result of irritation or trauma at the site. If this is a partial sample of a larger more clinically worrisome proliferation, or if there is a clinical progression, additional sampling may be helpful. 

Hi Kilz, a copy of full report is always the best, but what you have written above doesn't say " positive for melanoma" any where, and the rest of the description doesn't have anything that makes me nervous. Then again I am not a doctor, hopefully Janner will chime in if she sees this post, but from what you have written I don't see anything to worry about. When do you see your derm for follow up? Do you have any history with melanoma?

Thank you sooo much for writing back! That Was the full report provided to me from the lab directly.

 No personal and no family history of melanoma. Some tanning as a teenager but nothing major. I’m a 30 year old Russian.

I follow up with him in 3 weeks.  

I'm not particularly skilled in this, either.  However, I do know that melanocytes are what gives our skin pigment, so melanocytes does not equal melanoma!  I don't think this is anything to worry about at all.

Strength and Courage,

Susan

Anonymous - (8/6/2018 - 2:19pm)

The pathology report indicates benign compound nevus; however, because only a part of this nevus was removed, I would see a plastic surgeon, remove the whole thing, and forget about it.

Thanks so much for responding. I’m so relieved it’s benign!! Why do you recommend removing it? To be safe? Anywhere else on my body I probably wouldn’t think twice- being it on my face- gives me a quick pause. 

Anonymous - (8/6/2018 - 4:38pm)

Because you want to be sure that the rest of the lesion has the same pathology and you also want to be sure that that it will not grow back from the "left over". Plastic surgeon can make the scar almost not visible (and much less visible that your scar from the biopsy). This is what I would do, but the choice is yours.

Thanks!!! Will the insurance company pay for a full excision when the pathology came back as benign? 

Anonymous - (8/7/2018 - 10:40am)

I believe yes (mine would).

Anonymous - (8/7/2018 - 2:24pm)

What I read is short hand from pathology to doctor saying wtf this is not a full sample this bit is ok but cut the whole thing out to be sure. I have had lesions which were incompletely excised (like yours), similar pathology language (sample not complete) and on full excision melanoma in very innocent looking parts of the mole. If I were you I'd go for a proper excisional biopsy of the full lesion, the face is very vascularised so heals amazingly well, it's likely clear and then you have peace of mind.

Thanks for the responses everyone. Wanted to let y’all know that my dermatologist along with two other dermatologist opinions’ confirmed that no further excision at this time was needed due to the pathology report. The pathologist ended up clarifying that if there was high suspicion or significant clinical progression, he would need more sample. I have my piece of mind! Thanks again!