Can someone interpret my pathology report please?
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Can someone interpret my pathology report please?

› Forums › Cutaneous Melanoma Community › Can someone interpret my pathology report please?

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    • September 13, 2018 at 10:19 pm
    Amy Green
    Participant
      I’m a 29 year old female. Had a mole biopsied which came back positive for melanoma. I’m waiting on a call from the oncologist to know what comes next but hoping someone can look at this and tell me. Results below, thank you in advance!!

      Malignant melanoma, superficial spreading type

      Comment: Tumor Stage (pT) – T1bNxMx
      Clark Level: IV
      Below thickness: 1.0 mm
      Radial (non-tumorigenic) growth phase – Present
      Vertical (tumorigenic) growth phase – Not identified
      Mitotic figures: 1/MM2
      Ulceration: Not identified
      Regression: Not identified
      Vascular/lymphatic invasion: Not identified
      Perineural invasion: Not identified
      Microscopic satellitosis: Not identified
      Tumor-infiltrating lymphocytes: Non-brisk
      Associated melanocytic nevus: Not identified
      Predominant cytology: Nevoid
      Surgical margins: The margins are free of invasive of melanoma. The melanoma in-situ component extends to one lateral margin

      ICD: D48.5
      R/O: Neoplasm of Uncertain Behavior, Dysplastic Nevus
      Morphology: Plaque

      Present within the epidermis and dermis is a proliferation of atypical melanocytes. The dermal component displays small cell (nevoid) morphology. The epidermal atypical melanocytes are arranged in nests and single cells at the dermal-epidermal junction, and as solitary units above it. Obvious extension of the epidermal component beyond the dermal component is identified. Double immunohistochemical studies using Ki67/MART-1 reveal moderate proliferation index. Deeper sections have been examined.

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        • September 13, 2018 at 11:33 pm
        doragsda
        Participant

          It looks like you have melanoma in situ.   If you have melanoma, it is the type to have.   They will probably re-excise to get larger margins, but it appears no vertical invasion, which is great.   After margins are achieved you will likely just be on a diligent follow up schedule for skin checks with your dermatologist. 

          Your melanoma is isolated to the area they excised and has not spread anywhere else.

          • September 14, 2018 at 12:05 am
          Janner
          Participant

            Stage 1b at this point.  Your lesion was 1mm deep.  interestingly, it says it didin't have a vertical growth phase, only a radial.  Very unusual.  Typically you see radial only in stage 0 (in situ) lesions but it is acknowledged that it can happen in deeper lesions – maybe lesions that already existed in the dermis.  I'd say 1mm is the deepest I've ever seen with no mention of vertical growth and I'd still question that.  Most of the other characteristics are what you'd like to see.  Clark Level IV is an older classification but corresponds to the breslow depth/thickness.

            Next steps:  Sentinel Lymph Node biopsy (SLNB) and Wide Local Excision (WLE).  Staging may be updated depending on those results.

              • September 14, 2018 at 12:16 am
              Amy Green
              Participant
                Thank you very much! That is about what I was assuming based on the small amount of reading I’ve done based on my results. Would you recommend questioning my dermotologist about the vertical growth assessment or just wait and speak to the oncologist?
                • September 14, 2018 at 12:26 am
                Janner
                Participant

                  I'd ask both but the derm may have a better knowledge of the pathologist who reads his slides and he could talk to the pathologist if clarification is needed.

                  • September 14, 2018 at 12:43 am
                  Amy Green
                  Participant
                    Okay great. Thank you for the input, I appreciate it!
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