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Pathology report
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Pathology report

› Forums › Cutaneous Melanoma Community › Pathology report

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    • November 14, 2017 at 4:02 pm
    lcg_595
    Participant

      Hi,

      I am a 30yo with a history of BCC at age 20.  Over the past six months, I noticed a mole changing (becoming raised and it was occasionally itchy).  It looked different than other lesions on my arm.  My doctor agreed that since I have a lot of freckles/moles that don't bother me, it made sense to get this one removed if it was bothering me.  I just received a preliminary pathology report and the findings are unclear.  Apparently the case is being reviewed by several consultant dermatopathologists to come up with a consensus.  I have to wait at least three weeks to review the final pathology and my surgeon isn't even sure it will be ready at that point.  I am driving myself crazy trying to figure out what features in the report are concerning and what features are reassuring.  Can anyone help provide some insight?  The report is as follows:

       

      Left Arm: ATYPICAL MELANOCYTIC PROLIFERATION – PRELIMINARY REPORT ONLT

      Sections show an ellipse of skin with an intradermal melanocytic proliferation composed of epithelioid melanocytes with vesicular nuclei and prominent nucleoid.  The melanocytes possess abundant pale slightly pigmented cytoplasm.  They are predominantly arranged as nests with occasional single cells in the dermis with a periadnexal growth pattern.  Maturation with descent is lacking.  A perivascular and interstitial lymphohistiocytic inflammatory infiltrate with melanophages is present.  The melanocytic proliferation appears completely excised within the planes of sections examined.  The histopathologic findings are unusual and although the lesion may represent an intradermal Spitz nevus, the case will be reviewed by other consultant dermatopathologists in order to obtain a consensus opinion.  An addendum report will follow.

       

      Is it pretty common to have a preliminary report issued and then have some consultation?  (i.e. am I worrying for nothing because this happens all the time).  Or is there a real chance there could be a bad outcome here?

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        • November 15, 2017 at 3:14 pm
        cancersnewnormal
        Participant

          I won't even attempt to google what they said and "figure out" what the heck they're talking about. If it confused the pathologist looking at the slides, I'm sure my brain is not even close to equipped enough to come to any conclusions. HOWEVER… there is one line that stands out.. "The melanocytic proliferation appears completely excised within the planes of sections examined." —- appears completely excised is good news. At least the portions that were reviewed have clear margins of healthy tissue surrounding them. Sounds like they don't know with certainty exactly what it is (or isn't)… but they do know that whatever was taken out appears to have been fully removed. The only catch here would be just how big those clear margins are….. soooooo… you may still be looking at a larger excision. Maybe. 

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