Hello, I'm new here. Was instructed by someone on another message board to come here, post my report, and ask for "Regs or Janner". Thanks in advance to all for your thoughts and advice, it is appreciated.
I had a small mole removed recently, after the pathology report came back the dermatologist said we needed to do further excision. This is the first mole I've had removed with any suspicious findings. Basically, the findings are equivocal, they say that they cannot exclude melanoma and report recommends conservative re-excision. This has already been scheduled, basically I need to know what questions to ask.
DX: Lentiginous compound nevus dysplastic type with severe dysplasia, extending to all the margins with postinflammatory pigmentary alteration. Conservative re-excision is advised. Comment: Pagetoid extension of melanocytes are seen. Special stains are pending.
Tissue measured 0.3x0.3cm in greatest dimension. Entire specimen submitted in one cassette.
Dermoepidermal junction contains a primarily nested melanocytic proliferation. Within the superficial dermis, discrete nests of melanocytes with slightly smaller nuclei are present. lateral to the dermal portion of the lesion moderately atypical melanocytes proliferate which bridge and fuse adjacent rete and are associated with a superficial fibrosis of the papillary dermis. There is a proflieration of solitary melanocytes at the dermal-epidermal junction. In the superficial dermis, melanophages and scattered mononuclear cells surround capillaries.
Immunohistochemical studies reveal with anti-melan-A stain, a diffuse melanocytic hyperplasia with focal pagetoid extension of melanocytes.
Comment: it is difficult to exclude an early, evolving malignant melanoma in situ, superficial spreading type, arising in association with compound nevus dysplastic type with severe dysplasia, extending to all the margins.
The pathology analysis was done by dermatopathologists, reviewed by a fellow as well as intradepartmental review session (all from a teaching hospital in NYC). All agreed on report.
My question is -- what stands out for you? what should I be asking my doctor? In the NYC area who should I ask for a 2nd opinion from? what will they be able to tell from this larger excision, if anything? if they still can't tell if it's melanoma, then what? Also, I'm in my mid-late 30s, female, if that's of use to know.