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Help Understanding Pathology Report

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  • Post
    • September 17, 2019 at 5:59 pm
    Emerald18
    Participant
      Hi there. I was diagnosed with melanoma 2 weeks ago. It took 4 weeks to get my first results and I am still waiting to hear about an appointment for a WLE and SNB. I don’t know how you all deal with the waiting. It’s excruciating! My doctor told me my tumor was T2b. The lesion was on my upper left arm. I saw the doctor again yesterday to ask for a copy of my pathology report. I cannot see any reference to T2b on it just pT2.

      Here’s the specifics in the report:

      Superficial spreading melanoma with spindle cell features
      Breslow Thickness 1.1 mm
      Macroscopic Satellite Nodule(s) – not identified
      Ulceration – not identified
      Clark Level III

      Accessory findings:
      Microsatellite(s) – not identified
      Lymphovascular Invasion – not identified
      Neurotropism – not identified
      Tumour-Infiltrating Lymphocytes – Present, nonbrisk
      Tumour regression – not identified
      Mitotic Rate – 2

      Margins:
      Peripheral margins – uninvolved by invasive melanoma
      Distance of Invasive melanoma from closest peripheral margin: 3.5 mm
      Status of melanoma in situ at peripheral margins: uninvolved
      Distance of melanoma in situ in peripheral margin: 2.5 mm
      Deep margin – uninvolved by invasive melanoma
      Distance of melanoma from deep margin: 4.5 mm

      Pathologic Stage Classification: pT2: Melanoma 1.0 to 2.0 mm in thickness, ulceration status unknown or unspecified

      My questions are when it says ulceration status unknown or unspecified what does that mean? No ulceration or they couldn’t tell for sure?
      What are spindle cell features and how do they affect my diagnosis?

      I’ve been reading lots of posts in this forum and you are all so amazing and supportive to each other! Any insight anyone can provide would be much appreciated!

      Thank you.

    Viewing 2 reply threads
    • Replies
        • September 18, 2019 at 11:55 am
        ohernan
        Participant
          • September 18, 2019 at 11:57 am
          LRS88
          Participant
            Hello, I am sorry that you have found yourself on this board, but as you indicated, the people here are very encouraging and knowledgeable! Based on what you have posted I would definitely ask for clarification because your pathology report and differs from what your doctor has told you.
            Your pathology report states that the Breslow Thickness is 1.1 and ulceration has not been identified. This would make your lesion T2a. I do believe there is a difference between ulceration not present vs. ulceration unknown. If it is unknown, perhaps that is why your doctor said the lesion was T2b. A lesion between 1-2 mm with ulceration is T2b.
            Does this doctor have experience with melanoma? At this point it sounds like the next step would be a WLE and SLNB regardless of if this lesion was T2a or T2b but I think working with a doctor who has experience in melanoma is a good way to go. Hang in there and sending you good vibes!
              • September 18, 2019 at 1:32 pm
              Emerald18
              Participant
                Thank you! I am not sure of this doctor’s experience with melanoma but I have been referred to a different surgeon in a nearby city for the next step as I live in a small town and they don’t have the ability to do a SNB. I already have a list of questions ready for her/him when I see them! I was referred on Sept 5th but have not heard from them yet regarding a surgery date. Tomorrow will be 2 weeks of waiting. It took 4 weeks to get the original diagnosis. I am concerned that when I finally do get the appointment it won’t be for a couple of weeks after that and then how long to wait for SNB results? I have a “Best Doctors” service with my work insurance so I have contacted them this morning for some assistance in finding a melanoma specialist as well as a dermatologist as I have not been referred to one yet either. I saw the original surgeon again two days ago and asked him about a referral to a dermatologist and he said that would be coordinated through the city’s cancer centre but I haven’t heard from them either. The stress of waiting is horrible but I am trying different stress relieving techniques this week that seem to be helping some. I figure this is going to be a long road and I need to learn to take it one day/procedure at a time and not fret about what might be until it actually is!
              • September 18, 2019 at 2:53 pm
              MMH
              Participant
                Hi! I am sorry you are here but it really is a good place to find others who can relate to your questions and anxiety. I wanted to comment on the spindle cell portion of your question. I am clearly no expert, but my biopsy also showed spindle cells. My lesion was a spitzoid melanoma. Was yours a spitzoid? If so, we should chat.
                  • September 18, 2019 at 4:39 pm
                  Emerald18
                  Participant
                    Thank you. My lesion was superficial spreading melanoma with spindle cell features. Trying to figure of that is common for superficial spreading melanoma or do the spindle cell features mean something else.
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