› Forums › General Melanoma Community › Skin biopsy showing characteristics of Melanoma, but no diagnosis given
- This topic has 15 replies, 3 voices, and was last updated 9 years, 11 months ago by
Starcar52.
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- March 11, 2016 at 8:43 pm
Hi everyone-
I went to the skin doc in early Feb to have a mole looked at. It actually looked nothing like a mole, more like a red blister, but it had been a little itchy for a few months, and I am fair-skinned with blue eyes (and have many, many blistering-sunburns in my past) so I thought I would get it looked at. The dermatologist that I saw did a biopsy and sent me away saying she would call within a week with results. Well, 2 weeks passed and no word so I called them. The office said that the sample had been sent to France and was "under consult" and they would call me within the next couple of days with some answers. So 2 days later they called and said that the biopsy did NOT show melanoma, but was so atypical that I need to be referred to a skin surgeon to perform the Mohs procedure. Well I waited and waited for they to contact me (as I was told they would) and finally about a week later my dermatologist called me and told me that the skin surgeon wanted me to go to an oncology surgeon instead and have a sentinel lymph node biopsy and skin excision at the site with 1cm margins–apparently he surgeon read my pathology report and decides that would be the best route for me. This was all (and still is) blowing my mind. So I go and see the surgeon 2 days ago and am yet to get an answer whether or not this thing is melanoma. They say they can't tell until they do the biopsy of the lymph nodes and if those are clear then "I'm all good." The report says that the sample had findings raising concern for melanoma, but also reassuring characteristics. Whatever that means. I am a worrier. I have spent countless hours crying and confused over this situation. I got a copy of the pathology report and it is like looking at a different language. The dermatopathologist says on the report that overall he favors "atypical dermal epithelioid cell nodular melanocytic proliferation with indeterminate biological potential, associated with dermal nevus remnant, extending to the margins." Can anyone tell me what that means? Or offer any advice when it comes to dealing with this? I want to be positive but I am terrified. And even if the lymph nodes are clear does that 100% exclude this from being melanoma? I am going for SLNB and surgery next Tuesday:(
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- March 11, 2016 at 9:12 pm
First let me say that from what I can determine (it IS confusing) it's probably NOT melanoma but the biopsy is "unusual" are being super cautious and are trying to check deeper just to be sure.
FYI the world of skin canser especially melanoma is highly analog with lots of room for interpretation in many cases such as yours.
I'll give you a rough explanation of the terms. FYI I am a formaer MM patient but NOT a pathologist.but have read many reports over the years so i can usually translate their terms.
My comments in ()
"atypical (unusual) dermal (in the dermal layer eg not deeper-good) epithelioid cell (a cell typical in the dermis that is hard to determine what it is but it is NOT considered to be a melanocyte good), nodular melanocytic proliferation (more dermal cells which ARE melanocytes but they do not show specific signs of melanoma pathology) with indeterminate biological potential ( pathologist cannot see enough abnormality to diagnose but it is "unusual looking"), associated with dermal nevus remnant (nevus = mole)"
Again probably NOT a melanoma but they are being super cautious especially with a sentinal lymph node biopsy.
Now you have to wait for the results.
Odds are in you favor IMO.
JD
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- March 11, 2016 at 9:12 pm
First let me say that from what I can determine (it IS confusing) it's probably NOT melanoma but the biopsy is "unusual" are being super cautious and are trying to check deeper just to be sure.
FYI the world of skin canser especially melanoma is highly analog with lots of room for interpretation in many cases such as yours.
I'll give you a rough explanation of the terms. FYI I am a formaer MM patient but NOT a pathologist.but have read many reports over the years so i can usually translate their terms.
My comments in ()
"atypical (unusual) dermal (in the dermal layer eg not deeper-good) epithelioid cell (a cell typical in the dermis that is hard to determine what it is but it is NOT considered to be a melanocyte good), nodular melanocytic proliferation (more dermal cells which ARE melanocytes but they do not show specific signs of melanoma pathology) with indeterminate biological potential ( pathologist cannot see enough abnormality to diagnose but it is "unusual looking"), associated with dermal nevus remnant (nevus = mole)"
Again probably NOT a melanoma but they are being super cautious especially with a sentinal lymph node biopsy.
Now you have to wait for the results.
Odds are in you favor IMO.
JD
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- March 11, 2016 at 9:26 pm
Thank you SO much for your response and for breaking that pathology impression down for me. Do you think they are going too far doing the SLNB and wide excision? I want to have it done anyway just to be certain it's nothing (the worrier in me)–but in your opinion, from your experience…do you think this is normal for them to do all this? The onc surgeon did admit that they are most likely "over treating" this, but also said this way we will be sure and from my report its "hard to tell what we are dealing with."
I'm just overwhelmed but your response does help me calm down a lot. Thank you for that:)
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- March 11, 2016 at 9:26 pm
Thank you SO much for your response and for breaking that pathology impression down for me. Do you think they are going too far doing the SLNB and wide excision? I want to have it done anyway just to be certain it's nothing (the worrier in me)–but in your opinion, from your experience…do you think this is normal for them to do all this? The onc surgeon did admit that they are most likely "over treating" this, but also said this way we will be sure and from my report its "hard to tell what we are dealing with."
I'm just overwhelmed but your response does help me calm down a lot. Thank you for that:)
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- March 11, 2016 at 9:26 pm
Thank you SO much for your response and for breaking that pathology impression down for me. Do you think they are going too far doing the SLNB and wide excision? I want to have it done anyway just to be certain it's nothing (the worrier in me)–but in your opinion, from your experience…do you think this is normal for them to do all this? The onc surgeon did admit that they are most likely "over treating" this, but also said this way we will be sure and from my report its "hard to tell what we are dealing with."
I'm just overwhelmed but your response does help me calm down a lot. Thank you for that:)
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- March 11, 2016 at 9:33 pm
Oh and also, since you have seen a lot of these reports–the dermatopathologist also said this–"The findings raising concern for melanoma include: the location on the posterior shoulder; the biphasic nature of the lesion; the nodular architecture of the dermal proliferation; cytological atypia; and dermal mitotic activity. Reassuring characteristics include: the small size of the lesion (6x5x2mm); the absence of junctional melanocytic proliferation/pagetoid melanocytosis; some spitzoid attributes; and evidence of some maturation." Does that make any sense to you? I understand the location and size but the rest is totally in a different language…thanks!
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- March 11, 2016 at 9:33 pm
Oh and also, since you have seen a lot of these reports–the dermatopathologist also said this–"The findings raising concern for melanoma include: the location on the posterior shoulder; the biphasic nature of the lesion; the nodular architecture of the dermal proliferation; cytological atypia; and dermal mitotic activity. Reassuring characteristics include: the small size of the lesion (6x5x2mm); the absence of junctional melanocytic proliferation/pagetoid melanocytosis; some spitzoid attributes; and evidence of some maturation." Does that make any sense to you? I understand the location and size but the rest is totally in a different language…thanks!
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- March 11, 2016 at 9:33 pm
Oh and also, since you have seen a lot of these reports–the dermatopathologist also said this–"The findings raising concern for melanoma include: the location on the posterior shoulder; the biphasic nature of the lesion; the nodular architecture of the dermal proliferation; cytological atypia; and dermal mitotic activity. Reassuring characteristics include: the small size of the lesion (6x5x2mm); the absence of junctional melanocytic proliferation/pagetoid melanocytosis; some spitzoid attributes; and evidence of some maturation." Does that make any sense to you? I understand the location and size but the rest is totally in a different language…thanks!
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- March 11, 2016 at 9:12 pm
First let me say that from what I can determine (it IS confusing) it's probably NOT melanoma but the biopsy is "unusual" are being super cautious and are trying to check deeper just to be sure.
FYI the world of skin canser especially melanoma is highly analog with lots of room for interpretation in many cases such as yours.
I'll give you a rough explanation of the terms. FYI I am a formaer MM patient but NOT a pathologist.but have read many reports over the years so i can usually translate their terms.
My comments in ()
"atypical (unusual) dermal (in the dermal layer eg not deeper-good) epithelioid cell (a cell typical in the dermis that is hard to determine what it is but it is NOT considered to be a melanocyte good), nodular melanocytic proliferation (more dermal cells which ARE melanocytes but they do not show specific signs of melanoma pathology) with indeterminate biological potential ( pathologist cannot see enough abnormality to diagnose but it is "unusual looking"), associated with dermal nevus remnant (nevus = mole)"
Again probably NOT a melanoma but they are being super cautious especially with a sentinal lymph node biopsy.
Now you have to wait for the results.
Odds are in you favor IMO.
JD
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- March 11, 2016 at 10:01 pm
IMHO – this pathologist's butt must be raw from stitting on the fence. Talk about major CYA! Not enough to call it MM, yet jumping to SNB? What is with that? An SNB is surgery afterall. No depth measurement? If this wasn't read by a dematopathologist (pathologist with extra training to interpret derm stuff), it should be. From what you say I bet it is.
The SNB without clear indication it is mel? I would feel funny about doing that. Regardless, it needs a wide excision.
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- March 11, 2016 at 10:01 pm
IMHO – this pathologist's butt must be raw from stitting on the fence. Talk about major CYA! Not enough to call it MM, yet jumping to SNB? What is with that? An SNB is surgery afterall. No depth measurement? If this wasn't read by a dematopathologist (pathologist with extra training to interpret derm stuff), it should be. From what you say I bet it is.
The SNB without clear indication it is mel? I would feel funny about doing that. Regardless, it needs a wide excision.
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- March 11, 2016 at 10:01 pm
IMHO – this pathologist's butt must be raw from stitting on the fence. Talk about major CYA! Not enough to call it MM, yet jumping to SNB? What is with that? An SNB is surgery afterall. No depth measurement? If this wasn't read by a dematopathologist (pathologist with extra training to interpret derm stuff), it should be. From what you say I bet it is.
The SNB without clear indication it is mel? I would feel funny about doing that. Regardless, it needs a wide excision.
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Tagged: cutaneous melanoma
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