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Finally Received My Pathology Results from Biopsy
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Finally Received My Pathology Results from Biopsy

› Forums › General Melanoma Community › Finally Received My Pathology Results from Biopsy

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    • April 30, 2019 at 1:43 pm
    unicornsnow
    Participant

      So I finally received my pathology report from the shave biopsy.  Maybe someone on here can translate it for me.  smiley

      There is a proliferation of atypical melanocytes in the epidermis and upper epidermis.  The epidermal portion consists of variable nests and solitary cells which are most densely distributed in the basal layer.  In some areas the melanocytes replace the basal keratinocytes.  Some upward migration of individual melanocytes is present.  SOX-10 and Melan-A were reviewed.

      Type: Superficial spreading melanoma

      Growth Phase: vertical

      Clark's Level: IV

      Breslow's Depth: at least 0.7mm

      Ulceration: not identified

      Mitotic rate: 1-2mm/2

      Host Response: focally present, non-brisk

      Vascular Invasion: not identified

      Perineural Involvement: not identified

      Regression: not identified

      T-Stage: at least T1a

      Margins: The lateral margins of the shave specimin are involved.  The deep margin of the shave specimin is focally involved.

      NOTE: The melanoma focally extends to the base of the specimen.  Therefore, the depth measurement and histopathological staging as measured here may not represent the deepest portion of the melanoma.

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        • April 30, 2019 at 9:46 pm
        Bubbles
        Participant

          I think this pretty much states what you were already told.  The lesion is melanoma.  The margins on the side of the lesion and at the base are NOT clear.  That is why the depth is not currently entirely known.  There is no ulceration of the lesion – which is good.  There is no vascular or nerve involvement  – which is good.  The rest doesn't mean that much one way or another.  You most certainly need a WLE (wide local excision – I posted a glossary of terms on your last post) to attain clear margins…tissue that is free of melanoma. 

          An update of the guidelines regarding SLNB in 2017 reads:  "Routine SLN biopsy is not recommended for patients with thin melanomas that are T1a (non-ulcerated lesions less than 0.8 mm in Breslow thickness). SLN biopsy may be considered for thin melanomas that are T1b (0.8 to 1.0 mm Breslow thickness or less than 0.8 mm Breslow thickness with ulceration)…"   However, since your doc doesn't really know how deep your lesion is currently and already made plans to do the SLNB with your WLE, (and they SHOULD be done together like that if one is doing them) I think that is appropriate.

          Here is a recent post I put up with articles on the topic and additional links within:  https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2018/08/slnb-and-clndin-melanoma-patients-again.html

          You will probably have a negative node and this will be all you have to do with melanoma, beyond vigilence and skin checks in the future.  I hope this helps.  I wish you my best.  Celeste

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