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Please decipher the pathology report for friend

Forums General Melanoma Community Please decipher the pathology report for friend

  • Post
    Noramott
    Participant

      My friend had his melanoma behind his ear and was cut quite a ways  down on his neck. 

       

      The report says:

      Pre Operative Diagonsis:  238.2: Preop Dx Atypical Melanocytic Proliferation/Melanoma Accession

      Diagnosis:

      Archival material and the pathology report have been reviewed.  Some sections exhibited residual proliferating melanocytes with atypia however these are adjacent to the previous biopsy sight and demonstrate no evidence of dermal involvement and the margins are widely clear.

      Gross examination:

      My friend had his melanoma behind his ear and was cut quite a ways  down on his neck. 

       

      The report says:

      Pre Operative Diagonsis:  238.2: Preop Dx Atypical Melanocytic Proliferation/Melanoma Accession

      Diagnosis:

      Archival material and the pathology report have been reviewed.  Some sections exhibited residual proliferating melanocytes with atypia however these are adjacent to the previous biopsy sight and demonstrate no evidence of dermal involvement and the margins are widely clear.

      Gross examination:

      The specimen is labeled "R neck lesion: one suture superior, two sutures inferior" and consists of a teardrop-shpaed tan skin, 5.5X3.7 cm, with attached subcutis tissue, up to .5 cm in thickness.  A single suture is present along one edge designating the superior margin with a double along with opposite margin marking the inferior margin.  The single suture will be assigned as the 12 o'clock position and the double suture the 6 o'clock position using clock face designation.  

       

      Then he had other places removed and this is what it says:

      1) Skin, Mid Superior Back:

      Pigmented Compound Lentiginous Nevus with Archituectureal Atypia, Cytologic Pielmorphism and focally involved margins.

        2) Skin, mid inferior back

      Pigmented compund nevus with focally involved margins.

       

      So if anyone can help tell him what this means, that would be wonderful.  There ought to be a section at the end that says, "all these big words means blah blah blah."  Thanks for any help.

       

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        Janner
        Participant

          #1

          Basically, the WLE says that they found no more melanoma.  They did find some atypical melanocytes close to the original biopsy site, but atypical melanocytes are not melanoma.  The margins are good / clear for the lesions and it doesn't appear that any more would need to be taken.

          #2

          This is an atypical lesion.  It doesn't state HOW atypical the cells are and he has involved margins.  I'd probably request a conservative WLE on this one to get at least clean margins.  If the degree of atypia is severe, then 5mm margins would be appropriate.  The doctor might have to talk to the pathologist for further clarification on the degree of atypia.

          #3

          Benign mole with margins involved.  However, the mole doesn't show any atypical features so it is just a normal mole.

           

          With all of these scars, the scar areas should be watched for any pigment regrowth.  This goes for even the normal mole although even if it grew back it would probably still be a normal mole.  But it's best not to take chances so any regrowth should be removed.  Any other moles that CHANGE should also be biopsied.  To me, change is the #1 criteria for removal.

          So as it stands, #2 appears to be the one that might require more cutting.  A frank discussion with his doctor is needed.

          Best wishes,

          Janner

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          Janner
          Participant

            #1

            Basically, the WLE says that they found no more melanoma.  They did find some atypical melanocytes close to the original biopsy site, but atypical melanocytes are not melanoma.  The margins are good / clear for the lesions and it doesn't appear that any more would need to be taken.

            #2

            This is an atypical lesion.  It doesn't state HOW atypical the cells are and he has involved margins.  I'd probably request a conservative WLE on this one to get at least clean margins.  If the degree of atypia is severe, then 5mm margins would be appropriate.  The doctor might have to talk to the pathologist for further clarification on the degree of atypia.

            #3

            Benign mole with margins involved.  However, the mole doesn't show any atypical features so it is just a normal mole.

             

            With all of these scars, the scar areas should be watched for any pigment regrowth.  This goes for even the normal mole although even if it grew back it would probably still be a normal mole.  But it's best not to take chances so any regrowth should be removed.  Any other moles that CHANGE should also be biopsied.  To me, change is the #1 criteria for removal.

            So as it stands, #2 appears to be the one that might require more cutting.  A frank discussion with his doctor is needed.

            Best wishes,

            Janner

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