comment: lateral and deep edges are positive for neoplasm. The histologic diagnosis may include a compound dysplastic lanocytic nevus with severe atypia, however an early melanoma (0.4 mm in depth) cannot be excluded in these sections.
I had a wide excision done Tuesday and the more I think about it and read this the more scared I am. The doctor said that this was relatively good news but who knows. Is the fact that neoplasm goes to the edge of the biopsy bad news? Is this a good report? Could the biopsy from the excision come back with a deep melanoma because of the depth of the neoplasm?
I think you may need another opinion that could be more definitive than this. It sounds like worst case you have a very early melanoma. But it doesn’t sound like the pathologist knows for sure. Can you get the slides sent elsewhere? Where was this pathology done?
The dermatologist is here in Spartanburg, SC. Two pathologists looked at it. What is the worst case scenerio here? The doctor who did the excision said there was no pigmentation left when he looked at the biopsy area.
A compound type melanocytic proliferation is present demonstrating architectural disorder and severe cytologic atypia. Immunostain MART 1 stains atypical melanocytes at the dermo-epidermal junction as well as the dermis. Immunostain HMB 45 stains intraepidermal and superficial dermal melanocytes with decreased staining intensity in deeper melanocytes.
You need a second opinion on this pathology. They intersected the mole, so if it is cancerous an accurate depth may have been compromised. I’d have your slides from your WLE AND from the original biopsy sent to a center of excellence. Good luck and don’t worry….best case scenario it is jsut atypical.
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