mizmena
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mizmena

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      • March 23, 2015 at 9:33 pm
      mizmena
      Participant
      Final Dermatopathology Report
         
         
      Final Pathologic Diagnosis
         
      SKIN, RIGHT CLAVICLE (BIOPSY): INTRADERMAL MELANOMA. THE TUMOR IS TRANSECTED AT THE DEEP SECTION EDGE. (SEE COMMENT).
         
      Comment
         
      Multiple levels of recut sections have been examined. The sections show a shave biopsy of skin to the level of the mid reticular dermis. The epidermis exhibits atrophy. Intraepidermal tumor is not identified. Within the dermis are large, discrete nodules of tumor displaying prominent epithelioid morphologic features with moderate to marked nuclear pleomorphism and focally prominent nucleoli. The tumor measures at least 2.8 mm from the granular layer of the epidermis. Numerous mitotic figures are present in the neoplastic cells (14 per millimeter squared). A moderate to focally dense lymphoplasmacytic inflammatory infiltrate is admixed within and surrounding the tumor nodules. Immunohistochemistry for S-100 protein and Melan-A is diffusely positive in the tumor cells and staining for cytokeratin (AE1/AE3) is negative in the neoplastic cells. The tumor is transected at the deep section edge.
         
      The histopathologic findings show nodules of melanoma diffusely involving the dermis. The differential diagnosis includes primary nodular melanoma, primary dermal melanoma and metastatic melanoma requiring close correlation with the clinical history, clinical presentation and results of imaging studies for distinction. If the tumor is determined to represent a primary melanoma, the following histopathologic parameters apply:
      Breslow thickness = at least 2.8 mm
      Clark level = at least IV
      Ulceration: absent
      Regression: Present
      Mitoses: 14 per millimeter squared
      Angiolymphatic invasion: absent
      Perineural invasion: absent
      Microscopic satellites: absent
      Pathologic stage: at least pT3a
         
      In view of transection of the tumor at the deep section edge, the Breslow thickness and Clark level may require revision pending examination of the excision specimen.
         
      Close correlation is essential to determine rather this represents a primary or metastatic melanoma.
         
      In addition, given the clinical history of recent onset vitiligo and prominent inflammatory response to the tumor, the depigmented areas may represent melanoma-associated vitiligo.
         
      The case was discussed with Dr. Rice on 3/17/15.
         
         
      mplclx
      Electronically Signed by Douglas C. Parker, M.D.
         
      3/18/2015 15:49
         
         
         
         
         
      Clinical History
      Right clavicle. BCC. Biopsy shave. No personal/family history of NMSC/MM.
         
      Specimen(s) Received
      A: Right clavicle
         
      Gross Description
      The specimen is received in formalin and is labeled “right clavicle .” The specimen consists of an ovoid pink-tan skin shave excision measuring 1.6 x 1.3 x 0.5cm. The specimen is trisected and submitted entirely in cassette A1.
         
         
      mplsmp/3/13/2015
         
         
      Microscopic Description
         
      Microscopic examination performed.
         
         
      • March 23, 2015 at 9:33 pm
      mizmena
      Participant
      Final Dermatopathology Report
         
         
      Final Pathologic Diagnosis
         
      SKIN, RIGHT CLAVICLE (BIOPSY): INTRADERMAL MELANOMA. THE TUMOR IS TRANSECTED AT THE DEEP SECTION EDGE. (SEE COMMENT).
         
      Comment
         
      Multiple levels of recut sections have been examined. The sections show a shave biopsy of skin to the level of the mid reticular dermis. The epidermis exhibits atrophy. Intraepidermal tumor is not identified. Within the dermis are large, discrete nodules of tumor displaying prominent epithelioid morphologic features with moderate to marked nuclear pleomorphism and focally prominent nucleoli. The tumor measures at least 2.8 mm from the granular layer of the epidermis. Numerous mitotic figures are present in the neoplastic cells (14 per millimeter squared). A moderate to focally dense lymphoplasmacytic inflammatory infiltrate is admixed within and surrounding the tumor nodules. Immunohistochemistry for S-100 protein and Melan-A is diffusely positive in the tumor cells and staining for cytokeratin (AE1/AE3) is negative in the neoplastic cells. The tumor is transected at the deep section edge.
         
      The histopathologic findings show nodules of melanoma diffusely involving the dermis. The differential diagnosis includes primary nodular melanoma, primary dermal melanoma and metastatic melanoma requiring close correlation with the clinical history, clinical presentation and results of imaging studies for distinction. If the tumor is determined to represent a primary melanoma, the following histopathologic parameters apply:
      Breslow thickness = at least 2.8 mm
      Clark level = at least IV
      Ulceration: absent
      Regression: Present
      Mitoses: 14 per millimeter squared
      Angiolymphatic invasion: absent
      Perineural invasion: absent
      Microscopic satellites: absent
      Pathologic stage: at least pT3a
         
      In view of transection of the tumor at the deep section edge, the Breslow thickness and Clark level may require revision pending examination of the excision specimen.
         
      Close correlation is essential to determine rather this represents a primary or metastatic melanoma.
         
      In addition, given the clinical history of recent onset vitiligo and prominent inflammatory response to the tumor, the depigmented areas may represent melanoma-associated vitiligo.
         
      The case was discussed with Dr. Rice on 3/17/15.
         
         
      mplclx
      Electronically Signed by Douglas C. Parker, M.D.
         
      3/18/2015 15:49
         
         
         
         
         
      Clinical History
      Right clavicle. BCC. Biopsy shave. No personal/family history of NMSC/MM.
         
      Specimen(s) Received
      A: Right clavicle
         
      Gross Description
      The specimen is received in formalin and is labeled “right clavicle .” The specimen consists of an ovoid pink-tan skin shave excision measuring 1.6 x 1.3 x 0.5cm. The specimen is trisected and submitted entirely in cassette A1.
         
         
      mplsmp/3/13/2015
         
         
      Microscopic Description
         
      Microscopic examination performed.
         
         
      • March 23, 2015 at 9:33 pm
      mizmena
      Participant
      Final Dermatopathology Report
         
         
      Final Pathologic Diagnosis
         
      SKIN, RIGHT CLAVICLE (BIOPSY): INTRADERMAL MELANOMA. THE TUMOR IS TRANSECTED AT THE DEEP SECTION EDGE. (SEE COMMENT).
         
      Comment
         
      Multiple levels of recut sections have been examined. The sections show a shave biopsy of skin to the level of the mid reticular dermis. The epidermis exhibits atrophy. Intraepidermal tumor is not identified. Within the dermis are large, discrete nodules of tumor displaying prominent epithelioid morphologic features with moderate to marked nuclear pleomorphism and focally prominent nucleoli. The tumor measures at least 2.8 mm from the granular layer of the epidermis. Numerous mitotic figures are present in the neoplastic cells (14 per millimeter squared). A moderate to focally dense lymphoplasmacytic inflammatory infiltrate is admixed within and surrounding the tumor nodules. Immunohistochemistry for S-100 protein and Melan-A is diffusely positive in the tumor cells and staining for cytokeratin (AE1/AE3) is negative in the neoplastic cells. The tumor is transected at the deep section edge.
         
      The histopathologic findings show nodules of melanoma diffusely involving the dermis. The differential diagnosis includes primary nodular melanoma, primary dermal melanoma and metastatic melanoma requiring close correlation with the clinical history, clinical presentation and results of imaging studies for distinction. If the tumor is determined to represent a primary melanoma, the following histopathologic parameters apply:
      Breslow thickness = at least 2.8 mm
      Clark level = at least IV
      Ulceration: absent
      Regression: Present
      Mitoses: 14 per millimeter squared
      Angiolymphatic invasion: absent
      Perineural invasion: absent
      Microscopic satellites: absent
      Pathologic stage: at least pT3a
         
      In view of transection of the tumor at the deep section edge, the Breslow thickness and Clark level may require revision pending examination of the excision specimen.
         
      Close correlation is essential to determine rather this represents a primary or metastatic melanoma.
         
      In addition, given the clinical history of recent onset vitiligo and prominent inflammatory response to the tumor, the depigmented areas may represent melanoma-associated vitiligo.
         
      The case was discussed with Dr. Rice on 3/17/15.
         
         
      mplclx
      Electronically Signed by Douglas C. Parker, M.D.
         
      3/18/2015 15:49
         
         
         
         
         
      Clinical History
      Right clavicle. BCC. Biopsy shave. No personal/family history of NMSC/MM.
         
      Specimen(s) Received
      A: Right clavicle
         
      Gross Description
      The specimen is received in formalin and is labeled “right clavicle .” The specimen consists of an ovoid pink-tan skin shave excision measuring 1.6 x 1.3 x 0.5cm. The specimen is trisected and submitted entirely in cassette A1.
         
         
      mplsmp/3/13/2015
         
         
      Microscopic Description
         
      Microscopic examination performed.
         
         
      • March 25, 2015 at 1:38 pm
      mizmena
      Participant

      Thank you so much. I am scheduled for my Scans on April 6 and my first consultation w/ the doctors the following day..these next 12 days are gonna be horrendous for me. I am already showing an abnormal lymph node so yes its very much possible its metastatic which makes me even more nervous. Praying it hasnt traveled farther. I am def preparing my mind for the worse as with any situation. I am def glad that i found this forum it will come as much needed relief with all the questions that are soon to follow. I am also confident in Emory's team. I have already researched the two oncologist i will be meeting with. They seem to be okay. I believe i will be satisfied w/ the level of care they are going to provide me. 

      🙂 thanks again.

      • March 25, 2015 at 1:38 pm
      mizmena
      Participant

      Thank you so much. I am scheduled for my Scans on April 6 and my first consultation w/ the doctors the following day..these next 12 days are gonna be horrendous for me. I am already showing an abnormal lymph node so yes its very much possible its metastatic which makes me even more nervous. Praying it hasnt traveled farther. I am def preparing my mind for the worse as with any situation. I am def glad that i found this forum it will come as much needed relief with all the questions that are soon to follow. I am also confident in Emory's team. I have already researched the two oncologist i will be meeting with. They seem to be okay. I believe i will be satisfied w/ the level of care they are going to provide me. 

      🙂 thanks again.

      • March 25, 2015 at 1:38 pm
      mizmena
      Participant

      Thank you so much. I am scheduled for my Scans on April 6 and my first consultation w/ the doctors the following day..these next 12 days are gonna be horrendous for me. I am already showing an abnormal lymph node so yes its very much possible its metastatic which makes me even more nervous. Praying it hasnt traveled farther. I am def preparing my mind for the worse as with any situation. I am def glad that i found this forum it will come as much needed relief with all the questions that are soon to follow. I am also confident in Emory's team. I have already researched the two oncologist i will be meeting with. They seem to be okay. I believe i will be satisfied w/ the level of care they are going to provide me. 

      🙂 thanks again.

      • March 24, 2015 at 4:52 pm
      mizmena
      Participant

      Thank you so much!! I have Pet Scan and MRI scheduled for April 6, I am assuming this is to make sure if it has spread to other areas or not. Patiently awaiting the biopsy of the lymph node results. It was scheudled before the actual lesion biopsy came back because i was complaining of a painful swollen node to my primary care doc and when they did the ultrasound they noticed and abnormality, then two days later the biopsy came back of the lesion positive for melanoma. So rather than me canceling the biopsy since it was scheduled for the next day we moved forward with it.

      I have been speaking w/ the melanoma coordinator at WINSHIP Emory and she has been nice, but not very informative. So my emotions are all over the place. Then getting the path report is like an alien language. 

      Thank you so much for taking the time to help me understand. I am sure as the time passes i will have tons of questions.

       

      • March 24, 2015 at 4:52 pm
      mizmena
      Participant

      Thank you so much!! I have Pet Scan and MRI scheduled for April 6, I am assuming this is to make sure if it has spread to other areas or not. Patiently awaiting the biopsy of the lymph node results. It was scheudled before the actual lesion biopsy came back because i was complaining of a painful swollen node to my primary care doc and when they did the ultrasound they noticed and abnormality, then two days later the biopsy came back of the lesion positive for melanoma. So rather than me canceling the biopsy since it was scheduled for the next day we moved forward with it.

      I have been speaking w/ the melanoma coordinator at WINSHIP Emory and she has been nice, but not very informative. So my emotions are all over the place. Then getting the path report is like an alien language. 

      Thank you so much for taking the time to help me understand. I am sure as the time passes i will have tons of questions.

       

      • March 24, 2015 at 4:52 pm
      mizmena
      Participant

      Thank you so much!! I have Pet Scan and MRI scheduled for April 6, I am assuming this is to make sure if it has spread to other areas or not. Patiently awaiting the biopsy of the lymph node results. It was scheudled before the actual lesion biopsy came back because i was complaining of a painful swollen node to my primary care doc and when they did the ultrasound they noticed and abnormality, then two days later the biopsy came back of the lesion positive for melanoma. So rather than me canceling the biopsy since it was scheduled for the next day we moved forward with it.

      I have been speaking w/ the melanoma coordinator at WINSHIP Emory and she has been nice, but not very informative. So my emotions are all over the place. Then getting the path report is like an alien language. 

      Thank you so much for taking the time to help me understand. I am sure as the time passes i will have tons of questions.

       

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