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Pathology report, someone please help soon

Forums Cutaneous Melanoma Community Pathology report, someone please help soon

  • Post
    Chrissingh
    Participant

      Hello so i received this initial report and was wondering if someone could please explain it to me.

      From acral skin, there is a compct orthokeratoic scale that overlies the spinous zone and is approximately the same thickness as the prickle cell layer. There is a hint of increased melanin pigment among epithelial cells at the junction, but no distinct proliferation of melanocytes on these initial sections.

      Diagnosis: Most consistent with acral lentigo right foot

      Note: because of the suspicion for nevus i am going to cut deeper into this block and provide an addendum note.

      Is this saying their suspicion it might be cancerous or are they suspicious it might be a mole (nevus). I tried to speak to my dermatologist but she was busy and the front office manager freaked me out by saying theyre probably doing it because it looks cancerous

       

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    • Replies
        Janner
        Participant

          Acral tissue is different than cutaneous so I'm winging this a bit.  An acral lentigo would essentially be a freckle.  So the diagnosis is freckle with the caviat that there may be a dermal nevus.  A nevus by itself is no big deal – it's a normal mole.  So the pathologist will analyze the tissue to distinguish between lentigo and nevus.  My initial impression is not that they are suspecting cancer, but they are covering all bases and making sure any deeper tissue is analyzed to make sure nothing untoward shows up. 

          Janner
          Participant

            Acral tissue is different than cutaneous so I'm winging this a bit.  An acral lentigo would essentially be a freckle.  So the diagnosis is freckle with the caviat that there may be a dermal nevus.  A nevus by itself is no big deal – it's a normal mole.  So the pathologist will analyze the tissue to distinguish between lentigo and nevus.  My initial impression is not that they are suspecting cancer, but they are covering all bases and making sure any deeper tissue is analyzed to make sure nothing untoward shows up. 

              kdhill
              Participant

                So I talked to the dermatologist finally and she basically said the same thing. I don't get what it means by deeper cut, like what exactly does that mean or entail?

                 

                Janner or anyone else who has knowledge, I'm sure there are case where a few where something suspicous showed up, but typically from reports you've seen this is basically a report saying don't worry it's benign, we're just trying to figure out if its a mole or freckle?

                Please correct me if I'm wrong, but I would assume they would mention if they saw something suspicous in terms of cancer they would say it?

                Janner
                Participant

                  Honestly, most path reports these days take a cya attitude.  If they see something concerning, they mention it.  Err on the side of worst case.  Your extra excision seems to be the case of "we don't think there is a problem but we will take more tissue to analyze it -just in case".  Typically an excision removes all skin down to the muscle fascia, but on the foot, I'm not sure if they will do that or not.   You will have to ask your doc what type of biopsy/excision they intend to do.

                  kdhill
                  Participant

                    They aren't doing anymore excisions on me. They're just doing it on the sample that was sent already.

                     

                    So my main question is the report saying they think it might be a benign mole instead of a freckle? Or we think there is a mole that is cancerous is my wondering

                    kdhill
                    Participant

                      Also to add on to that, i'm guessing even though probablity it's benign they just have to cut deeper to see if its a mole or not and just determine if its okay if it is a mole even though every thing looks fine right now, but they're just making sure?

                      kdhill
                      Participant

                        Also to add on to that, i'm guessing even though probablity it's benign they just have to cut deeper to see if its a mole or not and just determine if its okay if it is a mole even though every thing looks fine right now, but they're just making sure?

                        kdhill
                        Participant

                          Also to add on to that, i'm guessing even though probablity it's benign they just have to cut deeper to see if its a mole or not and just determine if its okay if it is a mole even though every thing looks fine right now, but they're just making sure?

                          Janner
                          Participant

                            I do not understand 'cut deeper' because typically, all biopsy tissue is analyzed.  So that makes no sense to me.  Is this a dermatopathologist who is reading the slides?  A general pathologist is not the right person.  I can't answer your other questions better than I have especially given the fact they aren't taking more tissue.  You will have to ask your doc.

                            Janner
                            Participant

                              I do not understand 'cut deeper' because typically, all biopsy tissue is analyzed.  So that makes no sense to me.  Is this a dermatopathologist who is reading the slides?  A general pathologist is not the right person.  I can't answer your other questions better than I have especially given the fact they aren't taking more tissue.  You will have to ask your doc.

                              kdhill
                              Participant

                                It is a dermatopathologist, yeah I'm confused as well unless they cut part of the tissue and viewed it, trust me I'm just as confused and dermatologist is closed until monday, which is probably when the finally results will be done. The biopsy was 7x5x1mm no idea if that size plays a factor and they cut it to look at smaller sections or what

                                kdhill
                                Participant

                                  It is a dermatopathologist, yeah I'm confused as well unless they cut part of the tissue and viewed it, trust me I'm just as confused and dermatologist is closed until monday, which is probably when the finally results will be done. The biopsy was 7x5x1mm no idea if that size plays a factor and they cut it to look at smaller sections or what

                                  kdhill
                                  Participant

                                    I'll just call the lab monday morning and hope they have finished since I need to know immediately because I just learned last night my grandmother passed away outside of the united states and I need to leave as soon as possible

                                    kdhill
                                    Participant

                                      I'll just call the lab monday morning and hope they have finished since I need to know immediately because I just learned last night my grandmother passed away outside of the united states and I need to leave as soon as possible

                                      kdhill
                                      Participant

                                        I'll just call the lab monday morning and hope they have finished since I need to know immediately because I just learned last night my grandmother passed away outside of the united states and I need to leave as soon as possible

                                        kdhill
                                        Participant

                                          It is a dermatopathologist, yeah I'm confused as well unless they cut part of the tissue and viewed it, trust me I'm just as confused and dermatologist is closed until monday, which is probably when the finally results will be done. The biopsy was 7x5x1mm no idea if that size plays a factor and they cut it to look at smaller sections or what

                                          Janner
                                          Participant

                                            I do not understand 'cut deeper' because typically, all biopsy tissue is analyzed.  So that makes no sense to me.  Is this a dermatopathologist who is reading the slides?  A general pathologist is not the right person.  I can't answer your other questions better than I have especially given the fact they aren't taking more tissue.  You will have to ask your doc.

                                            kdhill
                                            Participant

                                              They aren't doing anymore excisions on me. They're just doing it on the sample that was sent already.

                                               

                                              So my main question is the report saying they think it might be a benign mole instead of a freckle? Or we think there is a mole that is cancerous is my wondering

                                              kdhill
                                              Participant

                                                They aren't doing anymore excisions on me. They're just doing it on the sample that was sent already.

                                                 

                                                So my main question is the report saying they think it might be a benign mole instead of a freckle? Or we think there is a mole that is cancerous is my wondering

                                                Janner
                                                Participant

                                                  Honestly, most path reports these days take a cya attitude.  If they see something concerning, they mention it.  Err on the side of worst case.  Your extra excision seems to be the case of "we don't think there is a problem but we will take more tissue to analyze it -just in case".  Typically an excision removes all skin down to the muscle fascia, but on the foot, I'm not sure if they will do that or not.   You will have to ask your doc what type of biopsy/excision they intend to do.

                                                  Janner
                                                  Participant

                                                    Honestly, most path reports these days take a cya attitude.  If they see something concerning, they mention it.  Err on the side of worst case.  Your extra excision seems to be the case of "we don't think there is a problem but we will take more tissue to analyze it -just in case".  Typically an excision removes all skin down to the muscle fascia, but on the foot, I'm not sure if they will do that or not.   You will have to ask your doc what type of biopsy/excision they intend to do.

                                                    kdhill
                                                    Participant

                                                      So I talked to the dermatologist finally and she basically said the same thing. I don't get what it means by deeper cut, like what exactly does that mean or entail?

                                                       

                                                      Janner or anyone else who has knowledge, I'm sure there are case where a few where something suspicous showed up, but typically from reports you've seen this is basically a report saying don't worry it's benign, we're just trying to figure out if its a mole or freckle?

                                                      Please correct me if I'm wrong, but I would assume they would mention if they saw something suspicous in terms of cancer they would say it?

                                                      kdhill
                                                      Participant

                                                        So I talked to the dermatologist finally and she basically said the same thing. I don't get what it means by deeper cut, like what exactly does that mean or entail?

                                                         

                                                        Janner or anyone else who has knowledge, I'm sure there are case where a few where something suspicous showed up, but typically from reports you've seen this is basically a report saying don't worry it's benign, we're just trying to figure out if its a mole or freckle?

                                                        Please correct me if I'm wrong, but I would assume they would mention if they saw something suspicous in terms of cancer they would say it?

                                                      Janner
                                                      Participant

                                                        Acral tissue is different than cutaneous so I'm winging this a bit.  An acral lentigo would essentially be a freckle.  So the diagnosis is freckle with the caviat that there may be a dermal nevus.  A nevus by itself is no big deal – it's a normal mole.  So the pathologist will analyze the tissue to distinguish between lentigo and nevus.  My initial impression is not that they are suspecting cancer, but they are covering all bases and making sure any deeper tissue is analyzed to make sure nothing untoward shows up. 

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