› Forums › General Melanoma Community › Can anyone decipher my path report?
- This topic has 15 replies, 4 voices, and was last updated 12 years, 1 month ago by
blairashley.
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- March 9, 2012 at 1:59 am
2.4mm on abdomen > Had wide-excision (clear margins!) and SLNB on Friday 2/24. SLNB results are still not finalized. Doc went over the following report with me on Tuesday… said the results weren't clear enough to make a diagnoses and they're running more tests. But — I thought I'd put it out there and see if any of you had some insight? Thanks!
2.4mm on abdomen > Had wide-excision (clear margins!) and SLNB on Friday 2/24. SLNB results are still not finalized. Doc went over the following report with me on Tuesday… said the results weren't clear enough to make a diagnoses and they're running more tests. But — I thought I'd put it out there and see if any of you had some insight? Thanks!
Sentinel node right axilla, biopsy:
One lymph node with S100-positive cellular aggregate of uncertain significance. Immunohistochemical stains of S-100, Melan-A, and HMB45 were performed on specimen B per the sentinel lymph node protocol. A single focus of S100-positive cells is present within a sinus immediately subjacent to the capsule on the initial level of the right axillary sentinel lymph node. This aggregate is not present in subsequent sections stained for HMB45 and the histiocytic marker CD-163.
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- March 9, 2012 at 1:15 pm
I am not a pathologist, but I will give it a shot.
Melanoma has a diverse range of morphologic presentations, and can demonstrate features of tumors from other lineages, ranging from smooth muscle to epithelial origin. Immunohistochemistry has been long applied as an adjunct tool that can aid in the diagnosis of difficult cases. Useful markers include S100 protein, which is highly sensitive, as well as HMB-45, MART-1/Melan-A, tyrosinase, and MITF, which are generally more specific .
There is indication that there may be sign of Melanoma in the adjacent right axillary sentinel lymph node area. This was base on the S100 stainging. The pathologist did not see any stainging for HMB45 and Histiocytic CD-163. CD-163 has shown to have great specificity for tumors of monocyte/histiocyte linage (melanomas).
So the tests are sending a mixed message. It is not conclusive.
Best regards,
Jimmy B
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- March 9, 2012 at 6:23 pm
That's basically exactly what my doctor said — only you explained it much clearer. Thank you for taking the time!!
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- March 9, 2012 at 6:23 pm
That's basically exactly what my doctor said — only you explained it much clearer. Thank you for taking the time!!
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- March 9, 2012 at 6:23 pm
That's basically exactly what my doctor said — only you explained it much clearer. Thank you for taking the time!!
-
- March 9, 2012 at 1:15 pm
I am not a pathologist, but I will give it a shot.
Melanoma has a diverse range of morphologic presentations, and can demonstrate features of tumors from other lineages, ranging from smooth muscle to epithelial origin. Immunohistochemistry has been long applied as an adjunct tool that can aid in the diagnosis of difficult cases. Useful markers include S100 protein, which is highly sensitive, as well as HMB-45, MART-1/Melan-A, tyrosinase, and MITF, which are generally more specific .
There is indication that there may be sign of Melanoma in the adjacent right axillary sentinel lymph node area. This was base on the S100 stainging. The pathologist did not see any stainging for HMB45 and Histiocytic CD-163. CD-163 has shown to have great specificity for tumors of monocyte/histiocyte linage (melanomas).
So the tests are sending a mixed message. It is not conclusive.
Best regards,
Jimmy B
-
- March 9, 2012 at 1:15 pm
I am not a pathologist, but I will give it a shot.
Melanoma has a diverse range of morphologic presentations, and can demonstrate features of tumors from other lineages, ranging from smooth muscle to epithelial origin. Immunohistochemistry has been long applied as an adjunct tool that can aid in the diagnosis of difficult cases. Useful markers include S100 protein, which is highly sensitive, as well as HMB-45, MART-1/Melan-A, tyrosinase, and MITF, which are generally more specific .
There is indication that there may be sign of Melanoma in the adjacent right axillary sentinel lymph node area. This was base on the S100 stainging. The pathologist did not see any stainging for HMB45 and Histiocytic CD-163. CD-163 has shown to have great specificity for tumors of monocyte/histiocyte linage (melanomas).
So the tests are sending a mixed message. It is not conclusive.
Best regards,
Jimmy B
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- March 10, 2012 at 12:36 am
Hi – my husband also had a similar SNB pathology (2.5 years ago and he is still NED) – so we got a second opinion (at UCSF) – I would suggest you do the same at the best melanoma center you can find. It took them a long time to come to the conclusion but they did err on the side of caution and he is Stage 3a.
His path reports indicated one or two cells (sounds the same as yours) that looked like melanoma and stained as melanoma. Google "melanoma and micrometastases" and you will see that some cancer experts dont beleive this class of melanoma patients should be Stage 3. These patients have a better prognosis than late stage 2. But you just never know with these prognosis stats. Melanoma always keeps us guessing – that's how it rolls.
Here is one example:
Clinical relevance of melanoma micrometastases (<0.1 mm) in sentinel nodes: are these nodes to be considered negative?
http://annonc.oxfordjournals.org/content/17/10/1578.full
Take care!
Emily
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- March 10, 2012 at 12:36 am
Hi – my husband also had a similar SNB pathology (2.5 years ago and he is still NED) – so we got a second opinion (at UCSF) – I would suggest you do the same at the best melanoma center you can find. It took them a long time to come to the conclusion but they did err on the side of caution and he is Stage 3a.
His path reports indicated one or two cells (sounds the same as yours) that looked like melanoma and stained as melanoma. Google "melanoma and micrometastases" and you will see that some cancer experts dont beleive this class of melanoma patients should be Stage 3. These patients have a better prognosis than late stage 2. But you just never know with these prognosis stats. Melanoma always keeps us guessing – that's how it rolls.
Here is one example:
Clinical relevance of melanoma micrometastases (<0.1 mm) in sentinel nodes: are these nodes to be considered negative?
http://annonc.oxfordjournals.org/content/17/10/1578.full
Take care!
Emily
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- March 10, 2012 at 12:36 am
Hi – my husband also had a similar SNB pathology (2.5 years ago and he is still NED) – so we got a second opinion (at UCSF) – I would suggest you do the same at the best melanoma center you can find. It took them a long time to come to the conclusion but they did err on the side of caution and he is Stage 3a.
His path reports indicated one or two cells (sounds the same as yours) that looked like melanoma and stained as melanoma. Google "melanoma and micrometastases" and you will see that some cancer experts dont beleive this class of melanoma patients should be Stage 3. These patients have a better prognosis than late stage 2. But you just never know with these prognosis stats. Melanoma always keeps us guessing – that's how it rolls.
Here is one example:
Clinical relevance of melanoma micrometastases (<0.1 mm) in sentinel nodes: are these nodes to be considered negative?
http://annonc.oxfordjournals.org/content/17/10/1578.full
Take care!
Emily
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- March 11, 2012 at 3:09 am
I had the same thing happen. Mine ended up being just mole cells in my lymph node. They sent my path slides onto a top guy at the University of Penn. It is so hard being in the "maybe" area. More than happy to explain more if you want, and will give you the info of the guy at Penn. Too long to type at the moment I am much better at talking over the phone. Let me know if you want to chat.
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- March 11, 2012 at 3:09 am
I had the same thing happen. Mine ended up being just mole cells in my lymph node. They sent my path slides onto a top guy at the University of Penn. It is so hard being in the "maybe" area. More than happy to explain more if you want, and will give you the info of the guy at Penn. Too long to type at the moment I am much better at talking over the phone. Let me know if you want to chat.
-
- March 11, 2012 at 3:09 am
I had the same thing happen. Mine ended up being just mole cells in my lymph node. They sent my path slides onto a top guy at the University of Penn. It is so hard being in the "maybe" area. More than happy to explain more if you want, and will give you the info of the guy at Penn. Too long to type at the moment I am much better at talking over the phone. Let me know if you want to chat.
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- March 12, 2012 at 9:23 pm
Sorry for delay in responding — I think I forgot to check the "alert me by email to new replies" button!
Appreciate the advice. Yeah, I do wonder if I ought to get a second opinion. It took 3 different labs and 6-7 weeks to diagnose me in the first place… now I'm going through the waiting process again with the lymph node biopsy! However, my doctor is the best guy to see at OHSU in Portland… I do trust him. Sigh.
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- March 12, 2012 at 9:23 pm
Sorry for delay in responding — I think I forgot to check the "alert me by email to new replies" button!
Appreciate the advice. Yeah, I do wonder if I ought to get a second opinion. It took 3 different labs and 6-7 weeks to diagnose me in the first place… now I'm going through the waiting process again with the lymph node biopsy! However, my doctor is the best guy to see at OHSU in Portland… I do trust him. Sigh.
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- March 12, 2012 at 9:23 pm
Sorry for delay in responding — I think I forgot to check the "alert me by email to new replies" button!
Appreciate the advice. Yeah, I do wonder if I ought to get a second opinion. It took 3 different labs and 6-7 weeks to diagnose me in the first place… now I'm going through the waiting process again with the lymph node biopsy! However, my doctor is the best guy to see at OHSU in Portland… I do trust him. Sigh.
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