help with pathology report

The stains are designed to make melanocytes show up in a tissue sample, that's all.  Sometimes multiple stains are used to make sure that all cells are "illuminated".  Without staining, it is much harder to read a pathology slide and look for melanocytes. 

It sounds like with the diagnosis that this may have mild atypia.  Focal means in the central part of the lesion.  This also means that outside the center, the cells show no atypia.  In general, many doctors wouldn't even remove  the lesion to get clear margins.  I do believe that the tiny sample size is the reason they are asking for removal – the pathologist can't be certain there isn't something else there.  However, pathologists often cover their tracks by asking for more removal – just in case.  I, personally, would not be worried about the next removal in the least given the previous diagnosis.  And I also agree that shave biopsies – while easy for the doctor – are the best choice for the patient.

"And I also agree that shave biopsies – while easy for the doctor – are the best choice for the patient."

should read

"And I also agree that shave biopsies – while easy for the doctor – are NOT always the best choice for the patient". 

The lesion is basically benign.  Do I think looking at the rest of the lesion will change this?  Extremely unlikely.  This is a cover your A$$ situation — the pathologist is saying that there is more left behind and complete removal is needed to make sure there isn't anything sinister there.  They've already made a diagnosis which is benign.  They know what it is, they just haven't seen all of it.  I'd say the likelihood of the remainder of the lesion being anything other than what was removed before is EXTREMELY unlikely.  DO NOT WORRY ABOUT THIS – there is nothing to worry about with this lesion.  This is just doctor's being careful in a society that likes to sue.  Remove everything "to be sure", but I wouldn't spend another minute on this site as it is totally unnecessary!  This lesion is not melanoma, and the remaining portion is not melanoma.  There's not much more that can be said.

The lesion is basically benign.  Do I think looking at the rest of the lesion will change this?  Extremely unlikely.  This is a cover your A$$ situation — the pathologist is saying that there is more left behind and complete removal is needed to make sure there isn't anything sinister there.  They've already made a diagnosis which is benign.  They know what it is, they just haven't seen all of it.  I'd say the likelihood of the remainder of the lesion being anything other than what was removed before is EXTREMELY unlikely.  DO NOT WORRY ABOUT THIS – there is nothing to worry about with this lesion.  This is just doctor's being careful in a society that likes to sue.  Remove everything "to be sure", but I wouldn't spend another minute on this site as it is totally unnecessary!  This lesion is not melanoma, and the remaining portion is not melanoma.  There's not much more that can be said.

The lesion is basically benign.  Do I think looking at the rest of the lesion will change this?  Extremely unlikely.  This is a cover your A$$ situation — the pathologist is saying that there is more left behind and complete removal is needed to make sure there isn't anything sinister there.  They've already made a diagnosis which is benign.  They know what it is, they just haven't seen all of it.  I'd say the likelihood of the remainder of the lesion being anything other than what was removed before is EXTREMELY unlikely.  DO NOT WORRY ABOUT THIS – there is nothing to worry about with this lesion.  This is just doctor's being careful in a society that likes to sue.  Remove everything "to be sure", but I wouldn't spend another minute on this site as it is totally unnecessary!  This lesion is not melanoma, and the remaining portion is not melanoma.  There's not much more that can be said.

"And I also agree that shave biopsies – while easy for the doctor – are the best choice for the patient."

should read

"And I also agree that shave biopsies – while easy for the doctor – are NOT always the best choice for the patient". 

"And I also agree that shave biopsies – while easy for the doctor – are the best choice for the patient."

should read

"And I also agree that shave biopsies – while easy for the doctor – are NOT always the best choice for the patient". 

The stains are designed to make melanocytes show up in a tissue sample, that's all.  Sometimes multiple stains are used to make sure that all cells are "illuminated".  Without staining, it is much harder to read a pathology slide and look for melanocytes. 

It sounds like with the diagnosis that this may have mild atypia.  Focal means in the central part of the lesion.  This also means that outside the center, the cells show no atypia.  In general, many doctors wouldn't even remove  the lesion to get clear margins.  I do believe that the tiny sample size is the reason they are asking for removal – the pathologist can't be certain there isn't something else there.  However, pathologists often cover their tracks by asking for more removal – just in case.  I, personally, would not be worried about the next removal in the least given the previous diagnosis.  And I also agree that shave biopsies – while easy for the doctor – are the best choice for the patient.

The stains are designed to make melanocytes show up in a tissue sample, that's all.  Sometimes multiple stains are used to make sure that all cells are "illuminated".  Without staining, it is much harder to read a pathology slide and look for melanocytes. 

It sounds like with the diagnosis that this may have mild atypia.  Focal means in the central part of the lesion.  This also means that outside the center, the cells show no atypia.  In general, many doctors wouldn't even remove  the lesion to get clear margins.  I do believe that the tiny sample size is the reason they are asking for removal – the pathologist can't be certain there isn't something else there.  However, pathologists often cover their tracks by asking for more removal – just in case.  I, personally, would not be worried about the next removal in the least given the previous diagnosis.  And I also agree that shave biopsies – while easy for the doctor – are the best choice for the patient.

When you say "second report", do you mean that the same set of microscope slides was read a second time? Or do you mean that this mole was biopsied before and now, on another biopsy, the results are different?

When you say "second report", do you mean that the same set of microscope slides was read a second time? Or do you mean that this mole was biopsied before and now, on another biopsy, the results are different?

When you say "second report", do you mean that the same set of microscope slides was read a second time? Or do you mean that this mole was biopsied before and now, on another biopsy, the results are different?

Oh. I see. Well, it seems to me that you're on the right track (remember, I'm not a doctor). The pathologist said that if they had not removed all of the mole, they should go back and get the rest of it. So that's what your doctor is going to do. They will probably send this specimen to the pathologist, too, to make sure (under the microscope) that the whole thing has been removed (i.e., the margins are clear). That all sounds good.

And you are correct. Since you have not been diagonosed with malignant melanoma you don't need to see an oncologist.

Oh. I see. Well, it seems to me that you're on the right track (remember, I'm not a doctor). The pathologist said that if they had not removed all of the mole, they should go back and get the rest of it. So that's what your doctor is going to do. They will probably send this specimen to the pathologist, too, to make sure (under the microscope) that the whole thing has been removed (i.e., the margins are clear). That all sounds good.

And you are correct. Since you have not been diagonosed with malignant melanoma you don't need to see an oncologist.

Oh. I see. Well, it seems to me that you're on the right track (remember, I'm not a doctor). The pathologist said that if they had not removed all of the mole, they should go back and get the rest of it. So that's what your doctor is going to do. They will probably send this specimen to the pathologist, too, to make sure (under the microscope) that the whole thing has been removed (i.e., the margins are clear). That all sounds good.

And you are correct. Since you have not been diagonosed with malignant melanoma you don't need to see an oncologist.

My husband is an anxiety freak, too, and especially phobic about cancer. A wouldn't you know, a funny-looking freckle that suddenly turned black. It was on his forearm and he noticed the change at once, went immediately to the dermatologist and had it removed. It was a very, very small melanoma in situ. 

That was 15 years ago, and he is fine now. But from that day to this, I scan every inch of his skin every month and he goes to the dermatologist for a scan every 6 months.  The has learned to trust this "team" and that eases his anxiety.

My brother, on the other hand, kept refusing to have a funny-looking "freckle" on his leg removed for 2 years. "Oh, that's always been there." he said. Well, now he's got Stage IV melanoma with brain mets.

I think the lesson is: malignant melanoma is very rare. Basal cell and squamous cell carcinomas are much more common, but they are much less aggressive and easily treatable. Respect your own level of concern– don't pooh-pooh things like my brother did. Know the warning signs of malignant melanoma (what they call "ABCD"). Look at lots of pictures of different melanomas on the Internet. Then teach someone close to you what to look for. Scan yourself once a month. Have a friend or your spouse scan you once every couple of months. And visit a good dermatologist (with melanoma experience, not acne experience) twice a year. Then knowing that you have taken all reasonable precautions, forget about it!

My husband is an anxiety freak, too, and especially phobic about cancer. A wouldn't you know, a funny-looking freckle that suddenly turned black. It was on his forearm and he noticed the change at once, went immediately to the dermatologist and had it removed. It was a very, very small melanoma in situ. 

That was 15 years ago, and he is fine now. But from that day to this, I scan every inch of his skin every month and he goes to the dermatologist for a scan every 6 months.  The has learned to trust this "team" and that eases his anxiety.

My brother, on the other hand, kept refusing to have a funny-looking "freckle" on his leg removed for 2 years. "Oh, that's always been there." he said. Well, now he's got Stage IV melanoma with brain mets.

I think the lesson is: malignant melanoma is very rare. Basal cell and squamous cell carcinomas are much more common, but they are much less aggressive and easily treatable. Respect your own level of concern– don't pooh-pooh things like my brother did. Know the warning signs of malignant melanoma (what they call "ABCD"). Look at lots of pictures of different melanomas on the Internet. Then teach someone close to you what to look for. Scan yourself once a month. Have a friend or your spouse scan you once every couple of months. And visit a good dermatologist (with melanoma experience, not acne experience) twice a year. Then knowing that you have taken all reasonable precautions, forget about it!

My husband is an anxiety freak, too, and especially phobic about cancer. A wouldn't you know, a funny-looking freckle that suddenly turned black. It was on his forearm and he noticed the change at once, went immediately to the dermatologist and had it removed. It was a very, very small melanoma in situ. 

That was 15 years ago, and he is fine now. But from that day to this, I scan every inch of his skin every month and he goes to the dermatologist for a scan every 6 months.  The has learned to trust this "team" and that eases his anxiety.

My brother, on the other hand, kept refusing to have a funny-looking "freckle" on his leg removed for 2 years. "Oh, that's always been there." he said. Well, now he's got Stage IV melanoma with brain mets.

I think the lesson is: malignant melanoma is very rare. Basal cell and squamous cell carcinomas are much more common, but they are much less aggressive and easily treatable. Respect your own level of concern– don't pooh-pooh things like my brother did. Know the warning signs of malignant melanoma (what they call "ABCD"). Look at lots of pictures of different melanomas on the Internet. Then teach someone close to you what to look for. Scan yourself once a month. Have a friend or your spouse scan you once every couple of months. And visit a good dermatologist (with melanoma experience, not acne experience) twice a year. Then knowing that you have taken all reasonable precautions, forget about it!