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No significant cytologic atypia?
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No significant cytologic atypia?

› Forums › Cutaneous Melanoma Community › No significant cytologic atypia?

  • Post
    • December 20, 2018 at 8:04 am
    JamesKorte
    Participant
      Hi all, chanced upon this forum and found it very useful. Went to do a punch biopsy of a 3mm by 3mm mole and got the following report:

      “multiple step sections show skin with elongated rete ridges that horizontally fuse. The basal zone shows hyperpigmentation and small nests of nevus cells. Rare tiny nests of nevus cells are seen in the subjacent papillary dermis. The shoulder phenomenon is noted. The nevus cells do not show significant cytologic atypia. They do not reach the resection margins. There is no obvious malignancy. Dysplastic compound nevus.”

      What does “The nevus cells do not show significant cytologic atypia” mean? I know what is cytologic atypia, but does this mean there is no atypia or there is some but mild or moderate? I asked my derm and he said there is no atypia and the term “significant” is just medical lingo. Should i trust him?

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        • December 20, 2018 at 3:02 pm
        Janner
        Participant

          So if there wasn't a small amount of atypical features or atypical architecture, then the diagnosis would be benign normal mole.  The architecture is showing some atypical features hence the compound dysplastic diagnosis.  It is possibly that a few cells have some mild atypia but not enough to warrant a diagnosis including cellular atypia.  That's a bit of CYA lingo.  They won't guarantee every cell is perfect because that's not the real world.  I certainly would not be spending my time worrying about this.  Analyzing the word for word part of the path report description is rarely helpful.

            • December 21, 2018 at 11:03 am
            JamesKorte
            Participant
              Thanks for the reassurance Janner! This was making me paranoid.

              Should I read it as there is nothing significant observed amounting to cytologic atypia (not even mild), or should I read it as there is cytologic atypia (could be mild) but not significant (could be moderate or severe)? You seem to have interpreted it along the former.

              • December 22, 2018 at 2:33 am
              JamesKorte
              Participant
                Thanks Janner!

                So basically the pathologist could have said “no cytologic atypia” but to cover ass since realistically not all cells are guaranteed to be perfect, he prefixed it with “significant” to give himself some space?

                Separately, if this only has architecture atypia, does it qualify to be termed a dysplastic nevus? I was reading somewhere that it also needs to be cytologically atypical.

                Is the architecture atypia mentioned serious and increases my risk?

                • December 22, 2018 at 2:09 pm
                ed williams
                Participant

                  Seriously dude, how many people have to tell you that you don't have anything to worry about before you believe them????

                • December 21, 2018 at 1:37 pm
                MelMel
                Participant

                  Being that science is a game of numbers and significance, when the pathology report states the above, it means that although there may be some cells that show cytologic atypia there are far too few to be significant and there is no cause to worry and be concerned at this time 

                  Melanie 

                    • December 22, 2018 at 2:24 am
                    JamesKorte
                    Participant
                      Thanks for the explanation Melanie! =)
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