Can someone interpret my pathology report please?
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Can someone interpret my pathology report please?

› Forums › Cutaneous Melanoma Community › Can someone interpret my pathology report please?

  • Post
    • September 13, 2018 at 10:19 pm
    Amy Green
    Participant
    I’m a 29 year old female. Had a mole biopsied which came back positive for melanoma. I’m waiting on a call from the oncologist to know what comes next but hoping someone can look at this and tell me. Results below, thank you in advance!!

    Malignant melanoma, superficial spreading type

    Comment: Tumor Stage (pT) – T1bNxMx
    Clark Level: IV
    Below thickness: 1.0 mm
    Radial (non-tumorigenic) growth phase – Present
    Vertical (tumorigenic) growth phase – Not identified
    Mitotic figures: 1/MM2
    Ulceration: Not identified
    Regression: Not identified
    Vascular/lymphatic invasion: Not identified
    Perineural invasion: Not identified
    Microscopic satellitosis: Not identified
    Tumor-infiltrating lymphocytes: Non-brisk
    Associated melanocytic nevus: Not identified
    Predominant cytology: Nevoid
    Surgical margins: The margins are free of invasive of melanoma. The melanoma in-situ component extends to one lateral margin

    ICD: D48.5
    R/O: Neoplasm of Uncertain Behavior, Dysplastic Nevus
    Morphology: Plaque

    Present within the epidermis and dermis is a proliferation of atypical melanocytes. The dermal component displays small cell (nevoid) morphology. The epidermal atypical melanocytes are arranged in nests and single cells at the dermal-epidermal junction, and as solitary units above it. Obvious extension of the epidermal component beyond the dermal component is identified. Double immunohistochemical studies using Ki67/MART-1 reveal moderate proliferation index. Deeper sections have been examined.

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  • Replies
      • September 13, 2018 at 11:33 pm
      doragsda
      Participant

      It looks like you have melanoma in situ.   If you have melanoma, it is the type to have.   They will probably re-excise to get larger margins, but it appears no vertical invasion, which is great.   After margins are achieved you will likely just be on a diligent follow up schedule for skin checks with your dermatologist. 

      Your melanoma is isolated to the area they excised and has not spread anywhere else.

      • September 14, 2018 at 12:05 am
      Janner
      Participant

      Stage 1b at this point.  Your lesion was 1mm deep.  interestingly, it says it didin't have a vertical growth phase, only a radial.  Very unusual.  Typically you see radial only in stage 0 (in situ) lesions but it is acknowledged that it can happen in deeper lesions – maybe lesions that already existed in the dermis.  I'd say 1mm is the deepest I've ever seen with no mention of vertical growth and I'd still question that.  Most of the other characteristics are what you'd like to see.  Clark Level IV is an older classification but corresponds to the breslow depth/thickness.

      Next steps:  Sentinel Lymph Node biopsy (SLNB) and Wide Local Excision (WLE).  Staging may be updated depending on those results.

        • September 14, 2018 at 12:16 am
        Amy Green
        Participant
        Thank you very much! That is about what I was assuming based on the small amount of reading I’ve done based on my results. Would you recommend questioning my dermotologist about the vertical growth assessment or just wait and speak to the oncologist?
        • September 14, 2018 at 12:26 am
        Janner
        Participant

        I'd ask both but the derm may have a better knowledge of the pathologist who reads his slides and he could talk to the pathologist if clarification is needed.

        • September 14, 2018 at 12:43 am
        Amy Green
        Participant
        Okay great. Thank you for the input, I appreciate it!
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