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Dermatology  (Expert Forum)
 | 
punch biopsy for lymphoma,lymphocytoma cutis
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.

punch biopsy for lymphoma,lymphocytoma cutis

by kalemegdan, Jun 29, 2009 06:02PM
Thank you doctor for your previous response. As you know, I am awaiting cell marker results but was wondering about the site chosen for the punch biopsy my doctor performed. At that time, June 8, I believe my lesion was a .5cm nodule and the doctor punched the portion BESIDE the highest point.(By the way, it was at my insistence that he do a biopsy as the lesion was suspicious to me, to him not so much) I asked him later if that would make a difference and he said no... but I can t help think that what he punched was just the inflammation part and not the >core< of this nodule on my face. ...Currently, the nodule seems to be split in two nodules measuring a total of 1cm max, separated by the cross punch biopsy incision. It feels a bit spherical under the surface and almost as if there are two keratin-like globules underneath. Does that sound like b cell lymphoma clinically..OR like a trapped keratin cyst that created another globule after incision...It is red and just does not want to go away... some days it seems like it shrinks to .8cm x .4cm... and SEEMS smaller in the morning... and less red..but still remains...
I would ask my doctor but he just brushes me off, and rushes me out of his office...saying 'we are on top of "..maybe his experience in this area is lacking as he was even surprised at the diagnosis of dense lymphocytic infiltrate...so, i would rather ask you :))) Please provide more insight as to what else would cause histology report with that diagnosis...you mentioned cyst...what kind of cyst...i know i am grasping at straw but i am just hoping it is not lymphoma...

Thanks again!
S

by Alan Rockoff, MD, Jun 29, 2009 08:50PM
To: kalemegdan
The truth is that at this point, I can't tell you anything more, and neither can he.  That may be why he appears to be brushing you off, because you want more definitiveness and specificity that is available without the rest of the data.  I understand your anxiety, but sometimes when there's a test, you just have to wait for the results.  He may have to do another biopsy.  Please be patient.  You can't psych out the result when it isn't available, and it isn't really fair to question the location of the biopsy without knowing what final test results are.  Again, I appreciate your anxiety, but you really have no choice but to wait.  If you want to get another opinion at some point, you can do that, but there's really no point right now, because anyone else who saw you would have to await the results, just as you are now.

Dr. Rockoff
Member Comments (2)

by kalemegdan, Jun 29, 2009 09:38PM
To: Dr. Rockoff
I am not expecting a definitive answer at all...rather some possibilities and professional opinions...so i can research them and be ready when a  diagnosis  is revealed to me instead of sitting there in shock never having heard of any of the stuff...
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