› Forums › General Melanoma Community › Questions about my path report
- This topic has 12 replies, 3 voices, and was last updated 9 years, 10 months ago by
Mamapegela.
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- April 16, 2016 at 9:50 pm
Hi- I am newly diagnosed with melanoma in a cervical lymph node after having a small melanoma removed from my neck 4 months ago. Scans are done, lymph node sent off to Mayo clinic for Braf & other further testing as I understand it and I have an appointment at the Melanoma Clinic at the University of Michigan coming up.
My question is about the path report on the WLE done in the original spot. First, I noticed that it was a shave biopsy. There is nothing on it about Clark's level. It does state breslow depth .35.mm which I know is very thin, but hey! Here I am with a positive lymph node 4 months later.
the pathology report is as follows:
Subtype: superficial spreading malignant melanoma
Cell type: epithelial
Ulceration, regression, satellitosis, vascular extension,lymphatic extension, perineural etension : all not identified
Mitotic activity: 2/mm2
Host response: lymphocytes 3+, melanophages 1+, fibrosis is present
Margins: The tumor extends to the peripheral margins and focally to the deep margin
What concerns me is the part about margins. It sounds as if the "tumor" goes thru the whole depth of the specimen so how can a depth be determined? I guess this is really water under the bridge now, but I would appreciate any thought.
PEGGY
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- April 16, 2016 at 9:52 pm
Correction: the path report is from the shave biopst- NOT the WLE- SORRY!
Peggy
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- April 16, 2016 at 9:52 pm
Correction: the path report is from the shave biopst- NOT the WLE- SORRY!
Peggy
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- April 16, 2016 at 9:52 pm
Correction: the path report is from the shave biopst- NOT the WLE- SORRY!
Peggy
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- April 17, 2016 at 3:44 am
That's the way I understand it. The biopsy bisected the melanoma, so there is no way to determine actual depth. I will insist on punch biopsies for anything suspicious from now on.
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- April 17, 2016 at 3:44 am
That's the way I understand it. The biopsy bisected the melanoma, so there is no way to determine actual depth. I will insist on punch biopsies for anything suspicious from now on.
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- April 17, 2016 at 3:44 am
That's the way I understand it. The biopsy bisected the melanoma, so there is no way to determine actual depth. I will insist on punch biopsies for anything suspicious from now on.
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- April 18, 2016 at 12:28 am
So you've been saying your lesion was .35mm deep, but that isn't the case. With a transected lesion, all you can say is that your lesion was AT LEAST .35mm deep. The exact depth can never be determined. Even if they were to see melanoma in the wide excision path report, it could not be "added" to the original biopsy depth. You can't match up the samples. The WLE will have scar tissue and inflammation and may not reflect what was there prior to the biopsy. And if you think about how they slice up the biopsy into multiple slices (same with the WLE), you can understand how it's impossible to match a slice from the biopsy to a slice from the WLE. This is the reason that shave biopsies aren't the best type of biopsy type with suspected melanomas. Docs swear by them because they are easy to do and require no stitches or followups. But if they don't go deep (and this one is VERY shallow), if it is melanoma, you lose staging information. You're right that it matters little now, but understanding can avoid this type of issue in the future.
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- April 18, 2016 at 12:28 am
So you've been saying your lesion was .35mm deep, but that isn't the case. With a transected lesion, all you can say is that your lesion was AT LEAST .35mm deep. The exact depth can never be determined. Even if they were to see melanoma in the wide excision path report, it could not be "added" to the original biopsy depth. You can't match up the samples. The WLE will have scar tissue and inflammation and may not reflect what was there prior to the biopsy. And if you think about how they slice up the biopsy into multiple slices (same with the WLE), you can understand how it's impossible to match a slice from the biopsy to a slice from the WLE. This is the reason that shave biopsies aren't the best type of biopsy type with suspected melanomas. Docs swear by them because they are easy to do and require no stitches or followups. But if they don't go deep (and this one is VERY shallow), if it is melanoma, you lose staging information. You're right that it matters little now, but understanding can avoid this type of issue in the future.
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- April 18, 2016 at 12:28 am
So you've been saying your lesion was .35mm deep, but that isn't the case. With a transected lesion, all you can say is that your lesion was AT LEAST .35mm deep. The exact depth can never be determined. Even if they were to see melanoma in the wide excision path report, it could not be "added" to the original biopsy depth. You can't match up the samples. The WLE will have scar tissue and inflammation and may not reflect what was there prior to the biopsy. And if you think about how they slice up the biopsy into multiple slices (same with the WLE), you can understand how it's impossible to match a slice from the biopsy to a slice from the WLE. This is the reason that shave biopsies aren't the best type of biopsy type with suspected melanomas. Docs swear by them because they are easy to do and require no stitches or followups. But if they don't go deep (and this one is VERY shallow), if it is melanoma, you lose staging information. You're right that it matters little now, but understanding can avoid this type of issue in the future.
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- April 18, 2016 at 5:20 pm
Thanks to you both, I guess I just wanted to see if my thinkin g on this made sense. My derm was shocked when the lesion came back as melanoma- I don't think she even considered it which is probably why she didn't do a punch biopsy.
However, I don't think she should've told me it was very shallow so not to worry much after the WLE based on truly not knowing the depth. In fact, she told me I didn't need to see her for another 6 months after my first three month skin check because it has ten so small. I found the enlarged node two weeks after that appointment. Melanoma is not to be taken lightly no matter what!
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- April 18, 2016 at 5:20 pm
Thanks to you both, I guess I just wanted to see if my thinkin g on this made sense. My derm was shocked when the lesion came back as melanoma- I don't think she even considered it which is probably why she didn't do a punch biopsy.
However, I don't think she should've told me it was very shallow so not to worry much after the WLE based on truly not knowing the depth. In fact, she told me I didn't need to see her for another 6 months after my first three month skin check because it has ten so small. I found the enlarged node two weeks after that appointment. Melanoma is not to be taken lightly no matter what!
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- April 18, 2016 at 5:20 pm
Thanks to you both, I guess I just wanted to see if my thinkin g on this made sense. My derm was shocked when the lesion came back as melanoma- I don't think she even considered it which is probably why she didn't do a punch biopsy.
However, I don't think she should've told me it was very shallow so not to worry much after the WLE based on truly not knowing the depth. In fact, she told me I didn't need to see her for another 6 months after my first three month skin check because it has ten so small. I found the enlarged node two weeks after that appointment. Melanoma is not to be taken lightly no matter what!
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