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Help with reading my pathatolgy report please

Forums General Melanoma Community Help with reading my pathatolgy report please

  • Post
    parkmk80
    Participant

      Hi, I'm a 32 year old female who has atleast 200 moles.  I have been diagnosed with Dyplastic Nevus Syndrome and have had atleast 20 moles removed.  All but 2 have came back mild while the other 2 were moderate.  I just received pathology report on 3 moles that were cut out by a new dermatologist.  My old derm who I still see as well never sent me a path report.  So they all three came back the same way.  Can someone please explain some of these things.  Like I said I have atleast 200 more of these things on my body and just found more on my scalp.&nbs

      Hi, I'm a 32 year old female who has atleast 200 moles.  I have been diagnosed with Dyplastic Nevus Syndrome and have had atleast 20 moles removed.  All but 2 have came back mild while the other 2 were moderate.  I just received pathology report on 3 moles that were cut out by a new dermatologist.  My old derm who I still see as well never sent me a path report.  So they all three came back the same way.  Can someone please explain some of these things.  Like I said I have atleast 200 more of these things on my body and just found more on my scalp.  I'm concerned since I was an avid sunbather until I was 30.  Anyway here is the path report. Any and all comments appreciated!

       

      DIAGNOSIS: Compound melanocytic nevus with  mild dysplasia, excised (surgical margins not involved)

      Histologic sections demonstrate skin with a melanocytic proliferation.  Melanocytes are present in nests, with scarttered single cells located predominantly along the dermal/peidermal junction, extending along elongated rete ridges.  There is occasional bridging of horizontally oriented nests of melanocytes between adjacent rete ridges.  The melanocytes display slight cytologic atypia.  Pagetoid cells are not prominent.  Papillary dermal fibrosis, a mild lymphocytic infiltrate, and melanophaes are noted.   Nests of melancytes are preent within the papillary dermis and appear to be relatively mature and lack significant cytologic atypia.  Surgical margins are free of mevomelanocytes on sections examined.

       

       

      Thanks so much,

      Mary

    Viewing 8 reply threads
    • Replies
        MichaelFL
        Participant

          This is what is called a mildly atypical mole. They can also be called a dysplastic nevus, which is the same thing. They are graded as mild, moderate, or severe. This is not melanoma.

          MichaelFL
          Participant

            This is what is called a mildly atypical mole. They can also be called a dysplastic nevus, which is the same thing. They are graded as mild, moderate, or severe. This is not melanoma.

            MichaelFL
            Participant

              This is what is called a mildly atypical mole. They can also be called a dysplastic nevus, which is the same thing. They are graded as mild, moderate, or severe. This is not melanoma.

              Janner
              Participant

                Mildly atypical nevi are about as close to "benign" as you can get.  They are generally not considered any threat and are extremely unlikely to change into anything more sinister. It may show some atypical features, but not anything of concern.

                Best wishes,

                Janner

                Janner
                Participant

                  Mildly atypical nevi are about as close to "benign" as you can get.  They are generally not considered any threat and are extremely unlikely to change into anything more sinister. It may show some atypical features, but not anything of concern.

                  Best wishes,

                  Janner

                  Janner
                  Participant

                    Mildly atypical nevi are about as close to "benign" as you can get.  They are generally not considered any threat and are extremely unlikely to change into anything more sinister. It may show some atypical features, but not anything of concern.

                    Best wishes,

                    Janner

                    parkmk80
                    Participant

                      Hey Janner!  I know you know your stuff so I want to ask you do you have a lot of moles?  I have read your story and know you've had melanoma and dysplastic nevus.  Are you more concerned with the moles themselves or the rest of your skin.  I have read you said 50% of melanoma come from moles but both dr's have said only 30% come from moles.  AFter research I def agree with your number.  I know you say change change c hange but what would be your advice for someone how has atleast 200 moles?  How do I keep an eye on all of these AND watch for new growth???  Have you ever checked your scalp?  I have recently found 6 places on my head.  Only 2 look like actual moles. The rest look like chunks of damaged scalp.  With the dysplastic nevus syndrome I'm in fear that that my derm's have, for the last 14 years, overlooked potiental problems on my scalp because I "my hair is too thick" to look over.  Regardless of my scalp I'm still freaked out about my skin since I have SO many moles.  it's like a breeding ground for cancer!  The line Pagetoid cells are not prominent.  Papillary dermal fibrosis, a mild lymphocytic infiltrate and melanophages are noted.  What does that mean????

                        Janner
                        Participant

                          I do not have dysplastic nevus syndrome.  I have about 20 atypical moles and tons of freckles.  I've had 3 primaries and am at high risk for more given the genetic defect I have (CDKN2A).  The institution I go to does a lot of genetic research on melanoma.  The numbers I quote are often from their statistics.  This institution does mole mapping for people like you.  That's what it was designed for!  They photograph all the atypical moles and compare them at each visit using hardware/software designed to detect changes.  Time consuming, but this is how they monitor for change.  I heard a report from them a couple of years ago about the study they were doing with atypical moles and mole mapping.  Essentially, they had mapped about 5000 moles at that time (over several years), and 97+% of them were stable.  Less than 3% were biopsied and not all of the biopsied ones were melanoma.  Anyway, mole mapping or baseline photos are a great tool for someone with DNS.  As for your scalp, look at it when your hair is wet.  Have your stylist check it or spouse, but the scalp is easier to see when the hair is wet.

                          I really don't worry much about melanoma.  For me, though, all my primaries came from exising moles.  So I tend to look toward existing more than new – but I really monitor anything I can for change. 

                          The lines from your pathology reports are really nothing to disect — they are justifying the final diagnosis.  Each characteristic itself doesn't mean much, it's the accumulation of many atypical features that make up a melanoma (or not) diagnosis.  The specific features that are significant in the report are the things called out in staging criteria.  Those are the factors that have proven themselves to have prognostic value – nothing else.  So analyzing line by line of a pathology report looking for negative or positive factors in the description is really pointless.

                          Best wishes,

                          Janner

                          parkmk80
                          Participant

                            were your three primaries in atypical moles?  Were they mildly atypical that just transgressed into melanoma or were they more moderate or or severe ones? 

                            parkmk80
                            Participant

                              were your three primaries in atypical moles?  Were they mildly atypical that just transgressed into melanoma or were they more moderate or or severe ones? 

                              Janner
                              Participant

                                There is no way to answer that question.  The moles were not biopsied prior to becoming melanoma.  Who knows what they were before, but it is extremely unlikely they were "mildly atypical".  My second primary was on a mole that just appeared one day.  The mole itself looked ok, but it was more "orange" than my other moles.  However, nothing about it really looked sinister.  (Knowing what I know now, I'd say it was an ugly duckling and should have been removed when I first noticed it.  But that didn't happen).  Two years later, I noticed some tiny black dots in the center.  Very small.  It was melanoma in situ.  It's impossible to know if it was always melanoma in situ from the start, or if it was some version of atypical.  The key for me with my three primaries is that all showed change.

                                Best wishes,

                                Janner

                                Janner
                                Participant

                                  There is no way to answer that question.  The moles were not biopsied prior to becoming melanoma.  Who knows what they were before, but it is extremely unlikely they were "mildly atypical".  My second primary was on a mole that just appeared one day.  The mole itself looked ok, but it was more "orange" than my other moles.  However, nothing about it really looked sinister.  (Knowing what I know now, I'd say it was an ugly duckling and should have been removed when I first noticed it.  But that didn't happen).  Two years later, I noticed some tiny black dots in the center.  Very small.  It was melanoma in situ.  It's impossible to know if it was always melanoma in situ from the start, or if it was some version of atypical.  The key for me with my three primaries is that all showed change.

                                  Best wishes,

                                  Janner

                                  Janner
                                  Participant

                                    There is no way to answer that question.  The moles were not biopsied prior to becoming melanoma.  Who knows what they were before, but it is extremely unlikely they were "mildly atypical".  My second primary was on a mole that just appeared one day.  The mole itself looked ok, but it was more "orange" than my other moles.  However, nothing about it really looked sinister.  (Knowing what I know now, I'd say it was an ugly duckling and should have been removed when I first noticed it.  But that didn't happen).  Two years later, I noticed some tiny black dots in the center.  Very small.  It was melanoma in situ.  It's impossible to know if it was always melanoma in situ from the start, or if it was some version of atypical.  The key for me with my three primaries is that all showed change.

                                    Best wishes,

                                    Janner

                                    parkmk80
                                    Participant

                                      were your three primaries in atypical moles?  Were they mildly atypical that just transgressed into melanoma or were they more moderate or or severe ones? 

                                      Janner
                                      Participant

                                        I do not have dysplastic nevus syndrome.  I have about 20 atypical moles and tons of freckles.  I've had 3 primaries and am at high risk for more given the genetic defect I have (CDKN2A).  The institution I go to does a lot of genetic research on melanoma.  The numbers I quote are often from their statistics.  This institution does mole mapping for people like you.  That's what it was designed for!  They photograph all the atypical moles and compare them at each visit using hardware/software designed to detect changes.  Time consuming, but this is how they monitor for change.  I heard a report from them a couple of years ago about the study they were doing with atypical moles and mole mapping.  Essentially, they had mapped about 5000 moles at that time (over several years), and 97+% of them were stable.  Less than 3% were biopsied and not all of the biopsied ones were melanoma.  Anyway, mole mapping or baseline photos are a great tool for someone with DNS.  As for your scalp, look at it when your hair is wet.  Have your stylist check it or spouse, but the scalp is easier to see when the hair is wet.

                                        I really don't worry much about melanoma.  For me, though, all my primaries came from exising moles.  So I tend to look toward existing more than new – but I really monitor anything I can for change. 

                                        The lines from your pathology reports are really nothing to disect — they are justifying the final diagnosis.  Each characteristic itself doesn't mean much, it's the accumulation of many atypical features that make up a melanoma (or not) diagnosis.  The specific features that are significant in the report are the things called out in staging criteria.  Those are the factors that have proven themselves to have prognostic value – nothing else.  So analyzing line by line of a pathology report looking for negative or positive factors in the description is really pointless.

                                        Best wishes,

                                        Janner

                                        Janner
                                        Participant

                                          I do not have dysplastic nevus syndrome.  I have about 20 atypical moles and tons of freckles.  I've had 3 primaries and am at high risk for more given the genetic defect I have (CDKN2A).  The institution I go to does a lot of genetic research on melanoma.  The numbers I quote are often from their statistics.  This institution does mole mapping for people like you.  That's what it was designed for!  They photograph all the atypical moles and compare them at each visit using hardware/software designed to detect changes.  Time consuming, but this is how they monitor for change.  I heard a report from them a couple of years ago about the study they were doing with atypical moles and mole mapping.  Essentially, they had mapped about 5000 moles at that time (over several years), and 97+% of them were stable.  Less than 3% were biopsied and not all of the biopsied ones were melanoma.  Anyway, mole mapping or baseline photos are a great tool for someone with DNS.  As for your scalp, look at it when your hair is wet.  Have your stylist check it or spouse, but the scalp is easier to see when the hair is wet.

                                          I really don't worry much about melanoma.  For me, though, all my primaries came from exising moles.  So I tend to look toward existing more than new – but I really monitor anything I can for change. 

                                          The lines from your pathology reports are really nothing to disect — they are justifying the final diagnosis.  Each characteristic itself doesn't mean much, it's the accumulation of many atypical features that make up a melanoma (or not) diagnosis.  The specific features that are significant in the report are the things called out in staging criteria.  Those are the factors that have proven themselves to have prognostic value – nothing else.  So analyzing line by line of a pathology report looking for negative or positive factors in the description is really pointless.

                                          Best wishes,

                                          Janner

                                        parkmk80
                                        Participant

                                          Hey Janner!  I know you know your stuff so I want to ask you do you have a lot of moles?  I have read your story and know you've had melanoma and dysplastic nevus.  Are you more concerned with the moles themselves or the rest of your skin.  I have read you said 50% of melanoma come from moles but both dr's have said only 30% come from moles.  AFter research I def agree with your number.  I know you say change change c hange but what would be your advice for someone how has atleast 200 moles?  How do I keep an eye on all of these AND watch for new growth???  Have you ever checked your scalp?  I have recently found 6 places on my head.  Only 2 look like actual moles. The rest look like chunks of damaged scalp.  With the dysplastic nevus syndrome I'm in fear that that my derm's have, for the last 14 years, overlooked potiental problems on my scalp because I "my hair is too thick" to look over.  Regardless of my scalp I'm still freaked out about my skin since I have SO many moles.  it's like a breeding ground for cancer!  The line Pagetoid cells are not prominent.  Papillary dermal fibrosis, a mild lymphocytic infiltrate and melanophages are noted.  What does that mean????

                                          parkmk80
                                          Participant

                                            Hey Janner!  I know you know your stuff so I want to ask you do you have a lot of moles?  I have read your story and know you've had melanoma and dysplastic nevus.  Are you more concerned with the moles themselves or the rest of your skin.  I have read you said 50% of melanoma come from moles but both dr's have said only 30% come from moles.  AFter research I def agree with your number.  I know you say change change c hange but what would be your advice for someone how has atleast 200 moles?  How do I keep an eye on all of these AND watch for new growth???  Have you ever checked your scalp?  I have recently found 6 places on my head.  Only 2 look like actual moles. The rest look like chunks of damaged scalp.  With the dysplastic nevus syndrome I'm in fear that that my derm's have, for the last 14 years, overlooked potiental problems on my scalp because I "my hair is too thick" to look over.  Regardless of my scalp I'm still freaked out about my skin since I have SO many moles.  it's like a breeding ground for cancer!  The line Pagetoid cells are not prominent.  Papillary dermal fibrosis, a mild lymphocytic infiltrate and melanophages are noted.  What does that mean????

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