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Biopsy Pathology Report

Forums Cutaneous Melanoma Community Biopsy Pathology Report

  • Post

      Hello all,


      I’m hoping someone can help me de-code and understand this pathology report I received regarding my biopsy on 3/5/19. I’m going back in on 3/19/19 for full recision of the mole that was biopsied. Here’s the report:


      “Microscopic Description:

      Submitted is one slide of shave biopsy material. The lesion submitted contains skin with a pigmented cellular tumor with junction and intradermal elements. Junction melanocytes are in nests and singly and interconnect along rete ridges and demonstrate focally severe cytologic atypia. Larger type A upper dermal nevus cells are seen with maturation to smaller cells. The areas of greater atypia are seen focally scattered through the lesion.

      Microscopic Diagnosis:
      (Compound Nevus) associated architectural disorder and focally severe cytologic atypia

      COMMENT: This nevus exhibits an architectural disorder (formerly called dysplastic nevus) with focally severe cytologic atypia, one of several histologic counterparts of a clinically atypical nevus. Diagnostic invasive melanoma or pagetoid pre-cancerous precursor is not seen in the present material. Familial Atypical Mole-Melanoma Syndrome cannot be excluded without clinical or familial correlation. Due to the severity of the cytologic atypia at the edge of the biopsy, it is recommended that conservative recision be done.”


      For reference, I have no history of melanoma in my family, although my mother (60 years old) has had about 5 pre-cancerous lesions removed over her lifetime. I am a 23 year old male, fair skin/blue eyes, history of many sunburns across the body with a moderate amount of moles on my body.


      Any help in understanding this report is much appreciated, thank you in advance!

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          Not a medical professional, but some quick google fu makes it sound like what this says is you have a really weird mole that doesn't look cancerous from what they've got, but they want to go back and get the rest of it off of you just to be sure. You might be at a higher risk for melanoma, but it sounds like the sample they got wasn't positive. 

          Most dermatologists and dermatopathologists use a system devised by the NIH for classifying melanocytic lesions. In this classification, a nevus can be defined as benign, having atypia, or being a melanoma. A benign nevus is read as (or understood as) having no cytologic or architectural atypia. An atypical mole is read as having architectural atypia, and having (mild, moderate, or severe) cytologic (melanocytic) atypia.[10] Usually, cytologic atypia is of more important clinical concern than architectural atypia. Usually, moderate to severe cytologic atypia will require further excision to make sure that the surgical margin is completely clear of the lesion.

          So basically the options are "it's fine," "it's weird," or "it's cancer." And you're in the "weird" category. That's how I'm reading it anyway, and again, I'm far, far, faaaaaar from an expert. Hopefully someone with more background on this will weigh in.


            Get a full depth punch biopsy next time


              I concur with the above.  You have an atpical mole that is at higher risk for becoming melanoma.  This does NOT mean it will…just a higher risk and the pathologist is recommending a conservative removal to avoid any future issue.  Even though I have had melanoma…I have also had 4 atypical moles fully excised and my 23 year old daughter has had 1 atypical excised.  I am fair, strawberry blonde with a history of burns.  She is brunette, olive complected who tans easily as my husband has indian in his ancestry.  All that does not matter…she still has 50% of her momma's genetics as do you.

              The derm may advise you come in for skin checks every 6 months for a while as they did my daughter.  I am still on an every 3 month watch for now.  Find peace that it is not cancer and just be aware that you need to watch yourself for new lesions and changes in existing spots.  Protect yourself from the sun as we  all should anyway.  My daughter's skin is nowhere near as dark as it used to be as she is avoiding too much sun exposure and nixed the tanning bed…but she is still beautiful and most importantly healthy.

              Best wishes!


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