› Forums › General Melanoma Community › Biopsy result need help interpreting
- This topic has 24 replies, 3 voices, and was last updated 12 years, 7 months ago by
Janner.
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- July 23, 2013 at 3:52 pm
I found a weird mole 2 wks ago. I had the doc biopsy it and here are the results. I spoke with the nurse and she sd it wasnt cancer but a changing mole and if I hadnt removed it it wouldve turned to melanoma. i had then fax me the report and it didnt say anything about severe or moderate dysplasia. It was confusing. I go see the doc in a week for another full body ck and I will ask but was hoping that some ppl more knowledgeable than I could shed some light to this. BTW i am 34 with freckles and reddish brown hair and I grew up in Florida out in the sun!
I found a weird mole 2 wks ago. I had the doc biopsy it and here are the results. I spoke with the nurse and she sd it wasnt cancer but a changing mole and if I hadnt removed it it wouldve turned to melanoma. i had then fax me the report and it didnt say anything about severe or moderate dysplasia. It was confusing. I go see the doc in a week for another full body ck and I will ask but was hoping that some ppl more knowledgeable than I could shed some light to this. BTW i am 34 with freckles and reddish brown hair and I grew up in Florida out in the sun!
Here is what the lab results said:
Diagnosis: Compound Nevus with features of dysplastic (clarks) nevus
Note: This lesion has features of a so-called dysplastic (Clark's) nevus. The significance of this can only be assessed in the clinical and historical context of the patient.
CLINICAL DATA:
R/O DN
GROSS DESCRIPTION: The specimin recieved labeled with patient name was tan and measured 4.0 x3.0 x 2.0mm
MICROSCOPIC DESCRIPTION: There is a proliferation of melanocytes arranged mostly in the nests at the dermoepidermal junction which focally tend to coalesce. Nests and solitary melanocytes extend past the intradermal component in the epidermis. The epidermis is hyperplastic and focally, there is fibroplasia surrounding the rete ridges. Nevus cells are present in the dermis centrally.
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So that is it. it seems a little scary tho. what is scary is the nevus cells in the dermis centrally and so other things. maybe I shouldnt be concerned about that. i dont know. ive never had anything biopsied.
help!
- Replies
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- July 23, 2013 at 4:38 pm
This is an atypical mole. It most likely NEVER would have turned into melanoma. Most atypical nevi never do. Trying to interpret the microscopic description is of little value. Basically, it's an atypical mole that has been removed and that should be it. Nothing more. Watch for CHANGING moles. Watch the scar area for any pigment regrowth. Continue to see your derm and practice sun safety!
Best wishes,
Janner
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- July 23, 2013 at 4:38 pm
This is an atypical mole. It most likely NEVER would have turned into melanoma. Most atypical nevi never do. Trying to interpret the microscopic description is of little value. Basically, it's an atypical mole that has been removed and that should be it. Nothing more. Watch for CHANGING moles. Watch the scar area for any pigment regrowth. Continue to see your derm and practice sun safety!
Best wishes,
Janner
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- July 23, 2013 at 4:38 pm
This is an atypical mole. It most likely NEVER would have turned into melanoma. Most atypical nevi never do. Trying to interpret the microscopic description is of little value. Basically, it's an atypical mole that has been removed and that should be it. Nothing more. Watch for CHANGING moles. Watch the scar area for any pigment regrowth. Continue to see your derm and practice sun safety!
Best wishes,
Janner
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- July 23, 2013 at 4:56 pm
Thank you Janner so much! I had it removed because i wasnt sure if it was changing. the borders were fuzzy and it seemed suspicious. I asked the nurse (can you ever trust the nurse???) if it was benign because I had read that dysplastic nevi can be benign and she sd no that it was changing. I dont know if she really knew what she was talking about. that is why i am going into the doc's office next week. You would think that the doc wouldve let me speak with him or he wouldve given me the results instead of sloughing it off to the nurse but maybe he didnt think it was important enough to speak to me.
QUESTION- since it doesnt say that they need to take out more does that mean that they got clear normal cells all around it??? Ive read some ppl';s report on suspicious moles say they need to remove more of the lesion. I am assuming that they got it all since it doenst say they need to take more. (can u tell Im totally neurotic?? lol)
Thank you again! 🙂
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- July 24, 2013 at 1:17 pm
Hi Janner!
I contacted the lab yesterday and asked them about the margins and the severity of the dysplasia- mild, moderate or severe. they are going to pull it and measure the margins and grade it and send the amendment to the docs office so I will get more answers! You really have to take your health care into your own hands!!!
I know you are not a doc but maybe you could shed some light on a few questions. One is I noticed my doc did a shave biopsy and went 2 MM deep. is 2 mm still the epidermis or is that dermis? Also the report said that there were nevus cells in the dermis. would it be advisable to get all those removed or are those just normal cells because its a compound nevus? I want clear margins so I guess if the pathologist says they got clear margins going 2 mm down then i guess that should be good? I read some of your other posts that said that if any abnomal cells are left that that could speed up metastisis and that was a little scary and i definitely dont want that to happen so I want to take control of things now.
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- July 24, 2013 at 1:34 pm
If most atypical nevi would never become melanoma, why would a biopsy "cause" the atypical cells left behind to more quickly turn malignant?
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- July 23, 2013 at 4:56 pm
Thank you Janner so much! I had it removed because i wasnt sure if it was changing. the borders were fuzzy and it seemed suspicious. I asked the nurse (can you ever trust the nurse???) if it was benign because I had read that dysplastic nevi can be benign and she sd no that it was changing. I dont know if she really knew what she was talking about. that is why i am going into the doc's office next week. You would think that the doc wouldve let me speak with him or he wouldve given me the results instead of sloughing it off to the nurse but maybe he didnt think it was important enough to speak to me.
QUESTION- since it doesnt say that they need to take out more does that mean that they got clear normal cells all around it??? Ive read some ppl';s report on suspicious moles say they need to remove more of the lesion. I am assuming that they got it all since it doenst say they need to take more. (can u tell Im totally neurotic?? lol)
Thank you again! 🙂
-
- July 23, 2013 at 4:56 pm
Thank you Janner so much! I had it removed because i wasnt sure if it was changing. the borders were fuzzy and it seemed suspicious. I asked the nurse (can you ever trust the nurse???) if it was benign because I had read that dysplastic nevi can be benign and she sd no that it was changing. I dont know if she really knew what she was talking about. that is why i am going into the doc's office next week. You would think that the doc wouldve let me speak with him or he wouldve given me the results instead of sloughing it off to the nurse but maybe he didnt think it was important enough to speak to me.
QUESTION- since it doesnt say that they need to take out more does that mean that they got clear normal cells all around it??? Ive read some ppl';s report on suspicious moles say they need to remove more of the lesion. I am assuming that they got it all since it doenst say they need to take more. (can u tell Im totally neurotic?? lol)
Thank you again! 🙂
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- July 24, 2013 at 4:58 pm
The size of the epidermis is totally dependent upon anatomy. Some areas have thicker/thinner skin. So there is no way to answer your question. However, the report says there are cells in the dermis, that means you had some tissue deeper than the epidermis removed. A compound nevus has cells in the dermis. If they are normal, then they are not an issue.
I need to clarify your interpretation of my other posts. My cutaneous oncologist does not like to leave any atypical cells around because HE BELIEVES the trauma of the biopsy COULD induce further changes rare as that might be. That doesn't mean those cells will turn into melanoma and doesn't mean that those cells would metastasize. However, this view is far from universal. Since I've had 3 primaries, I think it is prudent the be on the aggressive side. Many doctors do not have the same opinion as my doc – especially for lesions that are only mildly or moderately atypical. Truthfully, I personally wouldn't be worrying much about leaving a mildly atypical lesion that didn't have clean margins. All I would do is watch the scar area for any pigment regrowth. Anything that starts to grow back should be removed. A severely atypical lesion is another beast, however, and I would insist on at least 5mm as is recommended by most docs. There are no universal guidelines for atypical nevi and you will find opinions all over the spectrum.
I truthfully wouldn't be worrying too much about this lesion or yours or insisting on further removal against your doctor's advice. This is all a bit of a balancing act. Just continue to watch your lesions for CHANGE and watch and biopsy sites for pigment regrowth. You're ahead of the game by knowing that you should even watch your skin!
Best wishes,
Janner
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- July 29, 2013 at 2:21 pm
Thank you Janner! Before your reply I had called the lab and asked them to grade the lesion and to let me know if all the margins were clear. I know what you are saying but the whole thing was making me still fell nervous.
The report I got from the lab said that the lesion was mildly atypical and get this, it said, and I quote, "The lesion seems to have been completely removed in this section."
How's that for ambiguity?!?!? I was really hoping for a yes or a no. I know what you said but I dont like to leave room for error. Plus I am pregnant so i know that pregnancy lowers your immune system too. Im trying to not worry but it really is bothering me. I just need to figure out how to not think about it.
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- July 29, 2013 at 2:21 pm
Thank you Janner! Before your reply I had called the lab and asked them to grade the lesion and to let me know if all the margins were clear. I know what you are saying but the whole thing was making me still fell nervous.
The report I got from the lab said that the lesion was mildly atypical and get this, it said, and I quote, "The lesion seems to have been completely removed in this section."
How's that for ambiguity?!?!? I was really hoping for a yes or a no. I know what you said but I dont like to leave room for error. Plus I am pregnant so i know that pregnancy lowers your immune system too. Im trying to not worry but it really is bothering me. I just need to figure out how to not think about it.
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- July 29, 2013 at 2:21 pm
Thank you Janner! Before your reply I had called the lab and asked them to grade the lesion and to let me know if all the margins were clear. I know what you are saying but the whole thing was making me still fell nervous.
The report I got from the lab said that the lesion was mildly atypical and get this, it said, and I quote, "The lesion seems to have been completely removed in this section."
How's that for ambiguity?!?!? I was really hoping for a yes or a no. I know what you said but I dont like to leave room for error. Plus I am pregnant so i know that pregnancy lowers your immune system too. Im trying to not worry but it really is bothering me. I just need to figure out how to not think about it.
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- July 30, 2013 at 4:27 am
That's not really ambiguous. Any time they do a biopsy, the pathologist will not GUARANTEE that they got every cell. They will always hedge because they don't have all the extra tissue from a wider excision to evaluate. I've seen that hedging on some of my own reports saying something along the lines about guaranteeing margins because it is a punch biopsy with minimal margins.
The bottom line, if I were in your shoes, I would not worry about this lesion in the least. I would check, periodically, for pigment regrowth. As you said, pregnancy lowers the immune system and often causes moles to change color. So it pays to be more vigilant. But I know if I had a mildly atypical lesion, I wouldn't lose a minute's sleep over it. The likelihood that it would ever change enough to become melanoma is too remote for me to even consider. As I said before, I'd feel differently about a severely atypical lesion.
Stop reading anything about it – stop visiting here too. Consciously avoid doing anything that reminds you of it. Schedule a date on your calendar MONTHLY to evaluate your skin and move on. You can worry about it that one day a month when you check your skin. Until then, it doesn't deserve the attention you are giving it.
Just my take,
Janner
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- July 24, 2013 at 1:17 pm
Hi Janner!
I contacted the lab yesterday and asked them about the margins and the severity of the dysplasia- mild, moderate or severe. they are going to pull it and measure the margins and grade it and send the amendment to the docs office so I will get more answers! You really have to take your health care into your own hands!!!
I know you are not a doc but maybe you could shed some light on a few questions. One is I noticed my doc did a shave biopsy and went 2 MM deep. is 2 mm still the epidermis or is that dermis? Also the report said that there were nevus cells in the dermis. would it be advisable to get all those removed or are those just normal cells because its a compound nevus? I want clear margins so I guess if the pathologist says they got clear margins going 2 mm down then i guess that should be good? I read some of your other posts that said that if any abnomal cells are left that that could speed up metastisis and that was a little scary and i definitely dont want that to happen so I want to take control of things now.
-
- July 24, 2013 at 1:17 pm
Hi Janner!
I contacted the lab yesterday and asked them about the margins and the severity of the dysplasia- mild, moderate or severe. they are going to pull it and measure the margins and grade it and send the amendment to the docs office so I will get more answers! You really have to take your health care into your own hands!!!
I know you are not a doc but maybe you could shed some light on a few questions. One is I noticed my doc did a shave biopsy and went 2 MM deep. is 2 mm still the epidermis or is that dermis? Also the report said that there were nevus cells in the dermis. would it be advisable to get all those removed or are those just normal cells because its a compound nevus? I want clear margins so I guess if the pathologist says they got clear margins going 2 mm down then i guess that should be good? I read some of your other posts that said that if any abnomal cells are left that that could speed up metastisis and that was a little scary and i definitely dont want that to happen so I want to take control of things now.
-
- July 24, 2013 at 4:58 pm
The size of the epidermis is totally dependent upon anatomy. Some areas have thicker/thinner skin. So there is no way to answer your question. However, the report says there are cells in the dermis, that means you had some tissue deeper than the epidermis removed. A compound nevus has cells in the dermis. If they are normal, then they are not an issue.
I need to clarify your interpretation of my other posts. My cutaneous oncologist does not like to leave any atypical cells around because HE BELIEVES the trauma of the biopsy COULD induce further changes rare as that might be. That doesn't mean those cells will turn into melanoma and doesn't mean that those cells would metastasize. However, this view is far from universal. Since I've had 3 primaries, I think it is prudent the be on the aggressive side. Many doctors do not have the same opinion as my doc – especially for lesions that are only mildly or moderately atypical. Truthfully, I personally wouldn't be worrying much about leaving a mildly atypical lesion that didn't have clean margins. All I would do is watch the scar area for any pigment regrowth. Anything that starts to grow back should be removed. A severely atypical lesion is another beast, however, and I would insist on at least 5mm as is recommended by most docs. There are no universal guidelines for atypical nevi and you will find opinions all over the spectrum.
I truthfully wouldn't be worrying too much about this lesion or yours or insisting on further removal against your doctor's advice. This is all a bit of a balancing act. Just continue to watch your lesions for CHANGE and watch and biopsy sites for pigment regrowth. You're ahead of the game by knowing that you should even watch your skin!
Best wishes,
Janner
-
- July 24, 2013 at 4:58 pm
The size of the epidermis is totally dependent upon anatomy. Some areas have thicker/thinner skin. So there is no way to answer your question. However, the report says there are cells in the dermis, that means you had some tissue deeper than the epidermis removed. A compound nevus has cells in the dermis. If they are normal, then they are not an issue.
I need to clarify your interpretation of my other posts. My cutaneous oncologist does not like to leave any atypical cells around because HE BELIEVES the trauma of the biopsy COULD induce further changes rare as that might be. That doesn't mean those cells will turn into melanoma and doesn't mean that those cells would metastasize. However, this view is far from universal. Since I've had 3 primaries, I think it is prudent the be on the aggressive side. Many doctors do not have the same opinion as my doc – especially for lesions that are only mildly or moderately atypical. Truthfully, I personally wouldn't be worrying much about leaving a mildly atypical lesion that didn't have clean margins. All I would do is watch the scar area for any pigment regrowth. Anything that starts to grow back should be removed. A severely atypical lesion is another beast, however, and I would insist on at least 5mm as is recommended by most docs. There are no universal guidelines for atypical nevi and you will find opinions all over the spectrum.
I truthfully wouldn't be worrying too much about this lesion or yours or insisting on further removal against your doctor's advice. This is all a bit of a balancing act. Just continue to watch your lesions for CHANGE and watch and biopsy sites for pigment regrowth. You're ahead of the game by knowing that you should even watch your skin!
Best wishes,
Janner
-
- July 30, 2013 at 4:27 am
That's not really ambiguous. Any time they do a biopsy, the pathologist will not GUARANTEE that they got every cell. They will always hedge because they don't have all the extra tissue from a wider excision to evaluate. I've seen that hedging on some of my own reports saying something along the lines about guaranteeing margins because it is a punch biopsy with minimal margins.
The bottom line, if I were in your shoes, I would not worry about this lesion in the least. I would check, periodically, for pigment regrowth. As you said, pregnancy lowers the immune system and often causes moles to change color. So it pays to be more vigilant. But I know if I had a mildly atypical lesion, I wouldn't lose a minute's sleep over it. The likelihood that it would ever change enough to become melanoma is too remote for me to even consider. As I said before, I'd feel differently about a severely atypical lesion.
Stop reading anything about it – stop visiting here too. Consciously avoid doing anything that reminds you of it. Schedule a date on your calendar MONTHLY to evaluate your skin and move on. You can worry about it that one day a month when you check your skin. Until then, it doesn't deserve the attention you are giving it.
Just my take,
Janner
-
- July 30, 2013 at 4:27 am
That's not really ambiguous. Any time they do a biopsy, the pathologist will not GUARANTEE that they got every cell. They will always hedge because they don't have all the extra tissue from a wider excision to evaluate. I've seen that hedging on some of my own reports saying something along the lines about guaranteeing margins because it is a punch biopsy with minimal margins.
The bottom line, if I were in your shoes, I would not worry about this lesion in the least. I would check, periodically, for pigment regrowth. As you said, pregnancy lowers the immune system and often causes moles to change color. So it pays to be more vigilant. But I know if I had a mildly atypical lesion, I wouldn't lose a minute's sleep over it. The likelihood that it would ever change enough to become melanoma is too remote for me to even consider. As I said before, I'd feel differently about a severely atypical lesion.
Stop reading anything about it – stop visiting here too. Consciously avoid doing anything that reminds you of it. Schedule a date on your calendar MONTHLY to evaluate your skin and move on. You can worry about it that one day a month when you check your skin. Until then, it doesn't deserve the attention you are giving it.
Just my take,
Janner
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Tagged: cutaneous melanoma
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