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Need some opinion with path report… For Janner)
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Need some opinion with path report… For Janner)

› Forums › General Melanoma Community › Need some opinion with path report… For Janner)

  • Post
    • July 11, 2015 at 3:10 pm
    LisaName
    Participant

      Hey, I have mentioned that you guys here have many God answers, so I hope to hear your opinion on my dx)

      i am a girl who leaves in Czech Republic, Europe, but originally I am from Ukraine, so when I decided to remove my mole, I did it in Ukraine. 

      My childhood friend there is having the whole family of professors, so her brother(surgeon) removed my mole with radio wave method(surgitron) and they sent it to the pathologist who is my friend's grandfather) 

      So the diagnosis from pathologist is following:compound dysplastic nevi, with proliferation of tha pagetoid cells. 1 cm in diameter, removed with healthy tissues.

      but also it was sent to immunegistochemical examination which said: tyrosinasa,HMB 45 – bright positive cytoplasmic reaction in the epithel with cells up to basic layer. Negative reaction in the dermal layer.

      Ki67 – positive reaction up to basal area in the epithelial layer.

      conclusion: morphology and immunefenotype are similar to melanoma evolving from nevi.

       

      interesting fact, when path report was read by General oncologists in Ukraine they all said it was melanoma in situ.

      but as I live in other country in Europe, I took my report to the DERMATOONCOLOGISTS here in the main hospital, where they also deal with melanoma and my dialog with doctor there was following

      – darling, where did u see melanoma in situ dx here?

      -in the end.

      -as I can see here, it is just dysplastic nevi that tried to evolve, but didn't as it was removed.

       

      so for my safety, she went to consultate with doctor who specializes in melanoma, as far as I understood she didn't see anything critical there too.

      but of course they did a regular check up for me and sent for WLE(as it is the same thing they do for dysplastic nevi).

      my WLE histology was : no atypical,malignant etc cells were found in the sample.

       

      Still I was not sure and went to other dermatologist who has experience in dermatooncolgy and now works for private clinic and he said absolutely the same thing

      – It is not in situ yet, he sees it as evolving nevi and it was just a call for me to check my skin from time to time.

       

      Still it was not enough reassurance for me, so I called professor who did my hystology who said following:

      "I didn't mention any formed tumor, what I saw is the spreading of atypical cells. Melanoma is atypical cells, but not all atypical cells are melanoma. If you were not like a grand daughter for me, I would just write dysplastic nevi, but I decided to send for check. Yes, this type of cells could have formed tumor if not removed, or they just would have continue move, without forming a tumor. But instead of guessing we just removed the mole"

       

      so so he doesn't seem very worried too.

      and I spoke to many doctors here and they say that immune tests are not informative in differing melanoma from severely dysplastic nevi. Melanoma from regular nevi – maybe yes, but not dysplastic.

       

      and what is your opinion on that? Many doctors here seem to be sure, that it is not even in situ yet.

      i understand that in Central Europe in melanoma center doctors are more experienced that regular oncologists in my small city(who did resection of both breasts to my 17yo friend, when she just had bening fibroma as the biopsy showed), but still I am worried and now checking all my body((.

      now I cannot sleep because I think that my lymph node in the neck are enlargdd(the doctor said that they are normal for a person who was often sick in childhood and who had very bad otitis just this winter) and I think this is due to mole(even though it was in my right armpit and I am worried for my lymph nodes next to the left ear).

       

    Viewing 2 reply threads
    • Replies
        • July 11, 2015 at 3:47 pm
        Janner
        Participant

          Many people (including myself) have had dysplastic nevi.  They are not melanoma.  In fact, the vast majority will NEVER become melanoma.  The cell structure may be somewhat atypical, but it doesn't mean it is cancerous.  It sounds like you have had multiple opinions that all say the same thing.  Having extra margins taken is usually the treatment taken.  You should watch the scar area for any pigment regrowth.  Otherwise, I wouldn't give it a second thought.  As for enlarged lymph nodes in the neck, that's very common.  Reactive nodes become enlarged from infection but they don't return to their normal size.  I have some in my neck as well.  You need to understand that the neck nodes really wouldn't be involved in a lesion near the armpit.  If the lesion was on your head, then neck nodes might be involved.  

          I think all opinions say this is nothing to worry about, and again, you had the surgery to remove extra margins.  That's all they do for any early melanoma so you are in good shape.  I see absolutely no reason to worry.  Time to move on.  Watch any other moles for CHANGE.  Changing moles don't have to be melanoma but those are the ones that should be checked.

          best wishes!

           

            • July 11, 2015 at 8:36 pm
            LisaName
            Participant

              Thank you so much Janner for this amazing advices that you are giving here.

              so as I understand you see it more as evolving dis plastic nevi too than melanoma?

              as the doc mention here that it is evolving:not enough cells to be in situ, but too many cells reaction to be regular mole.

              and what is your opinion about this immune test with markers(ki-67 etc)?because I saw this for the first time and as I understood from the reaction of the European doctors they don't pay much attention to it, for them histology is the important part, not immune chemical. Histology.

               

              I have read many articles and books and doctors write that this test is helpful for other cancers, not melanoma. That in melanoma this test showes only how deep cells are found, but doesn't differ cancerous cells from just atypical(like in dysplastic nevi).

               

              it is not like I am going to ask for something extra, just I am curious now and want prevent people from laying in the beach,etc. want to write some articles, because tanning beds are extremely popular in the country where I live. Even though never in my life I used them.

              Thank you again, you gave me piece of my mind back)

              i wish a lot of health to you and your family.:)

              • July 12, 2015 at 2:28 am
              Janner
              Participant

                I am not a pathologist nor have I looked at your slides.  All I can do is make assumptions on the info you have given me.  You've had multiple opinions that all say the same thing.  I'd trust the dermatopahologist over all the others as skin pathology is their specialty.  I've had many dysplastic nevi as well as three primary melanomas and everything you state seems reasonable indicating a dysplastic nevus.  More than that, I can't say.  Oh, the immune markers are not regularly used in the U.S., just histology here too.  Regardless of the diagnosis, though, you've had the correct treatment.  The WLE has done its job to make sure all cells are gone.  That's all you can reasonably do.

                • July 12, 2015 at 9:32 am
                LisaName
                Participant

                  Thank you so much:)

                  • July 12, 2015 at 9:32 am
                  LisaName
                  Participant

                    Thank you so much:)

                    • July 12, 2015 at 9:32 am
                    LisaName
                    Participant

                      Thank you so much:)

                      • July 12, 2015 at 2:28 am
                      Janner
                      Participant

                        I am not a pathologist nor have I looked at your slides.  All I can do is make assumptions on the info you have given me.  You've had multiple opinions that all say the same thing.  I'd trust the dermatopahologist over all the others as skin pathology is their specialty.  I've had many dysplastic nevi as well as three primary melanomas and everything you state seems reasonable indicating a dysplastic nevus.  More than that, I can't say.  Oh, the immune markers are not regularly used in the U.S., just histology here too.  Regardless of the diagnosis, though, you've had the correct treatment.  The WLE has done its job to make sure all cells are gone.  That's all you can reasonably do.

                        • July 12, 2015 at 2:28 am
                        Janner
                        Participant

                          I am not a pathologist nor have I looked at your slides.  All I can do is make assumptions on the info you have given me.  You've had multiple opinions that all say the same thing.  I'd trust the dermatopahologist over all the others as skin pathology is their specialty.  I've had many dysplastic nevi as well as three primary melanomas and everything you state seems reasonable indicating a dysplastic nevus.  More than that, I can't say.  Oh, the immune markers are not regularly used in the U.S., just histology here too.  Regardless of the diagnosis, though, you've had the correct treatment.  The WLE has done its job to make sure all cells are gone.  That's all you can reasonably do.

                          • July 11, 2015 at 8:36 pm
                          LisaName
                          Participant

                            Thank you so much Janner for this amazing advices that you are giving here.

                            so as I understand you see it more as evolving dis plastic nevi too than melanoma?

                            as the doc mention here that it is evolving:not enough cells to be in situ, but too many cells reaction to be regular mole.

                            and what is your opinion about this immune test with markers(ki-67 etc)?because I saw this for the first time and as I understood from the reaction of the European doctors they don't pay much attention to it, for them histology is the important part, not immune chemical. Histology.

                             

                            I have read many articles and books and doctors write that this test is helpful for other cancers, not melanoma. That in melanoma this test showes only how deep cells are found, but doesn't differ cancerous cells from just atypical(like in dysplastic nevi).

                             

                            it is not like I am going to ask for something extra, just I am curious now and want prevent people from laying in the beach,etc. want to write some articles, because tanning beds are extremely popular in the country where I live. Even though never in my life I used them.

                            Thank you again, you gave me piece of my mind back)

                            i wish a lot of health to you and your family.:)

                            • July 11, 2015 at 8:36 pm
                            LisaName
                            Participant

                              Thank you so much Janner for this amazing advices that you are giving here.

                              so as I understand you see it more as evolving dis plastic nevi too than melanoma?

                              as the doc mention here that it is evolving:not enough cells to be in situ, but too many cells reaction to be regular mole.

                              and what is your opinion about this immune test with markers(ki-67 etc)?because I saw this for the first time and as I understood from the reaction of the European doctors they don't pay much attention to it, for them histology is the important part, not immune chemical. Histology.

                               

                              I have read many articles and books and doctors write that this test is helpful for other cancers, not melanoma. That in melanoma this test showes only how deep cells are found, but doesn't differ cancerous cells from just atypical(like in dysplastic nevi).

                               

                              it is not like I am going to ask for something extra, just I am curious now and want prevent people from laying in the beach,etc. want to write some articles, because tanning beds are extremely popular in the country where I live. Even though never in my life I used them.

                              Thank you again, you gave me piece of my mind back)

                              i wish a lot of health to you and your family.:)

                            • July 11, 2015 at 3:47 pm
                            Janner
                            Participant

                              Many people (including myself) have had dysplastic nevi.  They are not melanoma.  In fact, the vast majority will NEVER become melanoma.  The cell structure may be somewhat atypical, but it doesn't mean it is cancerous.  It sounds like you have had multiple opinions that all say the same thing.  Having extra margins taken is usually the treatment taken.  You should watch the scar area for any pigment regrowth.  Otherwise, I wouldn't give it a second thought.  As for enlarged lymph nodes in the neck, that's very common.  Reactive nodes become enlarged from infection but they don't return to their normal size.  I have some in my neck as well.  You need to understand that the neck nodes really wouldn't be involved in a lesion near the armpit.  If the lesion was on your head, then neck nodes might be involved.  

                              I think all opinions say this is nothing to worry about, and again, you had the surgery to remove extra margins.  That's all they do for any early melanoma so you are in good shape.  I see absolutely no reason to worry.  Time to move on.  Watch any other moles for CHANGE.  Changing moles don't have to be melanoma but those are the ones that should be checked.

                              best wishes!

                               

                              • July 11, 2015 at 3:47 pm
                              Janner
                              Participant

                                Many people (including myself) have had dysplastic nevi.  They are not melanoma.  In fact, the vast majority will NEVER become melanoma.  The cell structure may be somewhat atypical, but it doesn't mean it is cancerous.  It sounds like you have had multiple opinions that all say the same thing.  Having extra margins taken is usually the treatment taken.  You should watch the scar area for any pigment regrowth.  Otherwise, I wouldn't give it a second thought.  As for enlarged lymph nodes in the neck, that's very common.  Reactive nodes become enlarged from infection but they don't return to their normal size.  I have some in my neck as well.  You need to understand that the neck nodes really wouldn't be involved in a lesion near the armpit.  If the lesion was on your head, then neck nodes might be involved.  

                                I think all opinions say this is nothing to worry about, and again, you had the surgery to remove extra margins.  That's all they do for any early melanoma so you are in good shape.  I see absolutely no reason to worry.  Time to move on.  Watch any other moles for CHANGE.  Changing moles don't have to be melanoma but those are the ones that should be checked.

                                best wishes!

                                 

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