I hope someone can help me understand this...

[ryan24]

I recently had 3 moles removed from my back and sent to a pathologist.  My regular Dr. called and suggest that I set an appointment with a skin center (that specializes in skin cancer) immediately.  I asked my Dr. for as much info. about my condition, but never received a straight answer.  So, I then asked her for a copy of the pathology report, hoping that I'd be able to make some sense of this. Unfortunately, it just leave me more confused.  Here what it said:

Moles 1 & 2 - Melanocytes are present along the junction and within the dermis.  An aberrant architecture is observed with both stromal fibroplasia  and a lymphocytic host response.  There is atypia of the melanocytic cells characterized as marked with nuclear variability and hyperchromasia.  Though a nested pattern is present, a few single cells are also seen.  With the marked cytological atypia, this is classified as a dysplastic nevus with sever melanocytic atypia.  This is a high-grade dysplasia that borders on early evolving melanoma.  Atypical changes extend to the edges of the biopsy.  In view of the atypia, it would be prudent to ensure that the lesion is completely, but conservatively, excised.

Mole # 3 - There is a proliferation of atypical melanocytes arranged in solitary units and in nests at the dermal epidermal junction. The dermis contains infiltrates of lymphocytes and there are zones of fibroplasia.  Nests of benign appearing nevus cells are also present in the dermis.  The changes are not sufficiently developed to classify this lesion as melanoma in situ, but there is a high grade (moderately severe) atypia.  Atypical changes extend to the edge of the biopsy.  In view of the degree of atypia,it would be prudent to ensure that the lesion is completely, but conservatively, excised.

I have an apt. schedule in 3 weeks to have the moles "excised".  If anyone could help me understand the severity of this report, I'd be most thankful.

34yrs/White/Male.

Thanks,

Ryan

[Fernando Roque, MD]

Hi.  "Atypia" is a term that doctors use to describe cells which are abnormal looking in appearance compared with the usual cells found in a given type of tissue.  In your case, they found the melanocytes (the pigment-containing cells of the skin) to have that abnormal appearance.  Atypia implies that the abnormal cells are not yet cancer, but have a high chance of developing into cancer later on.  That's why the pathologist is recommending that the moles be removed or excised.  "Conservative" excision means that the mole should be removed with a minimum of normal tissue included in the excision.

So basically, what you have is a pre-cancerous skin lesion or a very early form of skin cancer, which is quite treatable at this stage.