› Forums › Cutaneous Melanoma Community › Help with pathology report…ATTN: janner/regulars
- This topic has 4 replies, 2 voices, and was last updated 7 years, 9 months ago by
MK7.
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- September 4, 2017 at 9:25 pm
It was suggested I put ATTN Janner/regulars as you are all so full of knowledge 🙂 Anyways, was looking to see if anyone could help with "interpret" my pathology report. Long story short, I'm 30 now and had a mole biopsied when I was 20 when I casually asked at a derm appt if it looked ok, to which my derm said it was probably ok but would take it out anyway. At my follow-up he said I was good to go, so I assumed it wasn't bad (hey, I was 20 and didn't know to ask questions).
Fast forward to today, after having my kids I went for a skin check because I was concerned about one mole. Between my last two yearly checks my current derm biopsied 3 – two were mildly atypical and one was moderately atypical (which I had completely excised in July). So this all got me thinking about the one I had biopsied when I was 20 and if it had been moderately atypical I want it out. I got a copy of my path report (that derm who biopsied it is no longer in practice and it is too long ago to obtain the slide for my current derm to look at). I gave it to my current derm to look at and he said he wouldn't be able to tell if it was mild or moderate without the slide, but can pretty much "guarantee" if it had been severe my other derm would have removed it all. In the meantime he said we will keep an eye on the scar area (there is some pigment regrowth, but my derm is ok with that as long as it doesnt look "off" or go past the border of the scar).
I will also ask my derm at my appointment next year, but since my last appointment I've been wondering about the first path report, SPECIFICALLY the last sentence and if it means something else is going on/seems to be an immune response going on??? Here is the whole thing:
Dx: Melanocytic nevus, compound type, with focal architectural disorder
"There are melanocytes, singly and in nests, at the dermoepidermal junction, bridging between some nests, and concentric and lamellar fibroplasia in the papillary dermis. The epidermal component of the lesion extends laterally beyond the dermal component. Within the dermis there are nests of uniform melanocytic nevus cells. There is a superficial, perivascular, lymphohistiocytic inflammatory infiltrate with melanophages."
Not that I totally understand what it says, but the sounds of the last sentence makes me kinda just want to have my derm take the rest out anyway…Thanks everyone!! 🙂
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- September 4, 2017 at 10:11 pm
The last sentence, to me, is good. It means the white blood cells in your body are ingesting melanocytes – basically recognizing them as gone bad and doing what the immune system is supposed to do – destroy them. Melanophages are not melanocytes – they are eaters of melanocytes!
If you have had this for 10 years, I don't care what it was – I wouldn't worry about it at all. That's me. You have to do what works for you. Focal architectural disorder is only at the center of the lesion – not widespread.
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- September 4, 2017 at 11:59 pm
Thanks Janner, I appreciate you reading all that and answering! In my mind it seemed fine, but then I think about how well what if it actually means this or that or this or that and drive myself crazy thinking about it. I also wanted to say how nice it is of you to hang around answering questions for others…while this is my first time posting, when I had my first mildly atypical mole last year I totally freaked out (I wasn't as informed as I am now about this type of stuff, and even then obviously I'm no expert, but know enough not to freak out all the time over it :)), when I was googling things I would frequently see your answers to others questions and it helped "ease the fears." So thank you 🙂
Would you mind if I ask you another question? I will also discuss with my derm at my appt next year, but when I had my appt this year I had two biopsies done – one was a mild one and the other was the moderate one I had removed in July. When doing the excision I asked for a copy of all my path reports from this derm (for my records) and when I was looking at them at home, I noticed that the mild and moderate moles both had the same diagnosis and also the exact same microscopic description word for word….do you know if the dermatopathologists will use a "textbook" description that they "copy and paste" kinda thing if a biopsy fits in certain parameters? To me, I just don't see how two completely different moles could have the exact same microscopic description, especially with one being mildly atypical and the other moderate…
Also, the dermatopathologist put on there as a note – "NOTE: These changes correspond to those described in the dysplastic nevus syndrome, but they also occur sporadically. The significance depends on correlation with clinical findings." This was a note on both those moles, plus on the path report from my mild one I had biopsied last year…I guess he is not really saying I have DNS, but I might? Do you have any idea what that suggests? Thanks again!! 🙂
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- September 5, 2017 at 1:02 pm
I think you'd have to ask your derm or the dermpath – I've not had path reports that look similar. It may be that your moles do look very similar pathologically which is why he is suggesting DNS. That's a new one for me but it might make sense. I hadn't really heard that you could determine if someone has DNS from pathology. However, it may be that he puts that note on any atypical lesion. Again, these questions are a bit better answered by someone who knows YOUR situation better.
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