Shawna1972

Thank you for your view on this, it does help to have someone at least say something other than dr's who say nothing except 'we're referring you to oncology'.  It gives me a little more explanation to what the 'greek' says.  Thanks again…my appt can't get here fast enough!

Thank you for your view on this, it does help to have someone at least say something other than dr's who say nothing except 'we're referring you to oncology'.  It gives me a little more explanation to what the 'greek' says.  Thanks again…my appt can't get here fast enough!

Thank you for your view on this, it does help to have someone at least say something other than dr's who say nothing except 'we're referring you to oncology'.  It gives me a little more explanation to what the 'greek' says.  Thanks again…my appt can't get here fast enough!

Sorry, not able to scan path report but I will type in here:

CLINICAL IMPRESSION/HISTORY

5mm pink papule.  DDx: Neoplasm of uncertain behavior vs. dysplastic nevus vs. basal cell carcinoma.  Possible BCC vs. nevus. 238.2

FINAL MICROSCOPIC DIAGNOSIS

Right central mylar cheek, Punch biopsy:  ATYPICAL DERMOEPIDERMAL MELANOCYTIC PROLIFERATION; THE LESION EXTENDS TO BOTH LATERAL MARGICS AND TO THE DEEP MARGIN OF THE SPECIMEN.

Comment:  Multiple additional levels are performed in our laboratory.  Sections show an atypical compound melanocytic proliferation with pleomorphic spindle and epithelioid cell with large irregular nuclei and prominent nucleoli without maturation.  Spindle and epithelioid cell melanocytic neoplasms are notoriously difficult to classify in postpubertal populations.  Although special stains (Ki67/MART-1) reveals a low dermal mitotic index (<1%) and in areas the dermal melanocytes has a fascicular growth pattern reminiscent of deep penetrating nevus, two dermal mitoses are identified in the mid dermis and the degree of cytological atypia is very worrisome for malignant melanoma.  Overall, perhaps such a lesion in best considered to have uncertain malignant potential.  A complete excision is recommended.  Given the unusual features, this case was forwarded to Dr. Scott Granter at the Brigham and Women's Hospital for an expert consultation.  This case was also reviewed by Dr. Elsa Velazquez who is in concurrence with the above interpretation.

***Let me know what you get out of this report.  Thanks so much!  If melanoma, stage would be advanced due to it being at least 5mm???

Sorry, not able to scan path report but I will type in here:

CLINICAL IMPRESSION/HISTORY

5mm pink papule.  DDx: Neoplasm of uncertain behavior vs. dysplastic nevus vs. basal cell carcinoma.  Possible BCC vs. nevus. 238.2

FINAL MICROSCOPIC DIAGNOSIS

Right central mylar cheek, Punch biopsy:  ATYPICAL DERMOEPIDERMAL MELANOCYTIC PROLIFERATION; THE LESION EXTENDS TO BOTH LATERAL MARGICS AND TO THE DEEP MARGIN OF THE SPECIMEN.

Comment:  Multiple additional levels are performed in our laboratory.  Sections show an atypical compound melanocytic proliferation with pleomorphic spindle and epithelioid cell with large irregular nuclei and prominent nucleoli without maturation.  Spindle and epithelioid cell melanocytic neoplasms are notoriously difficult to classify in postpubertal populations.  Although special stains (Ki67/MART-1) reveals a low dermal mitotic index (<1%) and in areas the dermal melanocytes has a fascicular growth pattern reminiscent of deep penetrating nevus, two dermal mitoses are identified in the mid dermis and the degree of cytological atypia is very worrisome for malignant melanoma.  Overall, perhaps such a lesion in best considered to have uncertain malignant potential.  A complete excision is recommended.  Given the unusual features, this case was forwarded to Dr. Scott Granter at the Brigham and Women's Hospital for an expert consultation.  This case was also reviewed by Dr. Elsa Velazquez who is in concurrence with the above interpretation.

***Let me know what you get out of this report.  Thanks so much!  If melanoma, stage would be advanced due to it being at least 5mm???

Sorry, not able to scan path report but I will type in here:

CLINICAL IMPRESSION/HISTORY

5mm pink papule.  DDx: Neoplasm of uncertain behavior vs. dysplastic nevus vs. basal cell carcinoma.  Possible BCC vs. nevus. 238.2

FINAL MICROSCOPIC DIAGNOSIS

Right central mylar cheek, Punch biopsy:  ATYPICAL DERMOEPIDERMAL MELANOCYTIC PROLIFERATION; THE LESION EXTENDS TO BOTH LATERAL MARGICS AND TO THE DEEP MARGIN OF THE SPECIMEN.

Comment:  Multiple additional levels are performed in our laboratory.  Sections show an atypical compound melanocytic proliferation with pleomorphic spindle and epithelioid cell with large irregular nuclei and prominent nucleoli without maturation.  Spindle and epithelioid cell melanocytic neoplasms are notoriously difficult to classify in postpubertal populations.  Although special stains (Ki67/MART-1) reveals a low dermal mitotic index (<1%) and in areas the dermal melanocytes has a fascicular growth pattern reminiscent of deep penetrating nevus, two dermal mitoses are identified in the mid dermis and the degree of cytological atypia is very worrisome for malignant melanoma.  Overall, perhaps such a lesion in best considered to have uncertain malignant potential.  A complete excision is recommended.  Given the unusual features, this case was forwarded to Dr. Scott Granter at the Brigham and Women's Hospital for an expert consultation.  This case was also reviewed by Dr. Elsa Velazquez who is in concurrence with the above interpretation.

***Let me know what you get out of this report.  Thanks so much!  If melanoma, stage would be advanced due to it being at least 5mm???

I will post the pathology report tomorrow if it will help get anymore information to the surface here.  The Dr. I am scheduled to see is an associate professor at the University of Iowa Hospital & Clinics – specializing in melanoma and sarcoma, so hopefully he will be the appropriate Dr. to tackle this.

Thanks for all your help!  I hope you will be on tomorrow to take a look at the path report, you have been a great deal of help and some relief to me in trying to figure out this puzzle…

I will post the pathology report tomorrow if it will help get anymore information to the surface here.  The Dr. I am scheduled to see is an associate professor at the University of Iowa Hospital & Clinics – specializing in melanoma and sarcoma, so hopefully he will be the appropriate Dr. to tackle this.

Thanks for all your help!  I hope you will be on tomorrow to take a look at the path report, you have been a great deal of help and some relief to me in trying to figure out this puzzle…

I will post the pathology report tomorrow if it will help get anymore information to the surface here.  The Dr. I am scheduled to see is an associate professor at the University of Iowa Hospital & Clinics – specializing in melanoma and sarcoma, so hopefully he will be the appropriate Dr. to tackle this.

Thanks for all your help!  I hope you will be on tomorrow to take a look at the path report, you have been a great deal of help and some relief to me in trying to figure out this puzzle…

Janner,

I do have a copy of the lab report, though not with me at the moment.  I do not recall any wording saying 'dysplatic' or 'atypical', but I will review again tonight.

Thank you for all your input and information!

Shawna

Janner,

I do have a copy of the lab report, though not with me at the moment.  I do not recall any wording saying 'dysplatic' or 'atypical', but I will review again tonight.

Thank you for all your input and information!

Shawna

Janner,

I do have a copy of the lab report, though not with me at the moment.  I do not recall any wording saying 'dysplatic' or 'atypical', but I will review again tonight.

Thank you for all your input and information!

Shawna

As far as I am aware, this Dr that I am scheduled with is a specialist in melanoma and sarcoma at the University of Iowa Hospitals & Clinics and is an associate professor, so hopefully he will be the right Dr. for me!

Thanks so much!

As far as I am aware, this Dr that I am scheduled with is a specialist in melanoma and sarcoma at the University of Iowa Hospitals & Clinics and is an associate professor, so hopefully he will be the right Dr. for me!

Thanks so much!

As far as I am aware, this Dr that I am scheduled with is a specialist in melanoma and sarcoma at the University of Iowa Hospitals & Clinics and is an associate professor, so hopefully he will be the right Dr. for me!

Thanks so much!