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What does my biopsy report indicate?

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Posted on Thu, 10 May 2018
Question: What would a rare mitotic figure mean on a shave biopspy of a mole that had been picked and traumatized?
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Answered by Dr. Kakkar S. (42 minutes later)
Brief Answer:
Mitotic figures do not preclude Benignity

Detailed Answer:
Hello. Thank you.
I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern.

Benign melanocytic nevi may show mitotic activity within dermal melanocytes.. In a single specimen, single mitotic figures are most common as compared to 2 or 3 mitotic figures.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. (6 minutes later)
The full report says the findings are most consistent with an atypical combined nevus variant displaying nevoid and atypical epitheloid cell components. A rare dermal mitosis is noted in the latter cellular population. The area of scarring is consistent with prior irritation or trauma. Nonetheless, the intradermal component extends to teh base. The lateral edges are uninvolved. Reexcision to ensure complete removal is suggested. Multiple levels have been examined. THe majority of melanocytes within the dermis are arranged as orderly nests and cords with nevocellular features.

The doctor said this is not melanoma, but I am worried. It was a symmetrical raised red bump that resembled a cherry angioma that I picked off and had scabbed over when biopsied.does this sound worrisome to you for melanoma?
doctor
Answered by Dr. Kakkar S. (57 minutes later)
Brief Answer:
Atypical nevus. Not melanoma

Detailed Answer:
Hi.

This is an atypical nevus. Not yet a melanoma. In a melanoma mitotic figures are more prominent, atypical and numerous and melanocytes are arranged as nests of variable sizes and shapes rather than as orderly nests.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. (6 hours later)
The doctor is recommending doing a deeper shave but waiting one month for my skin to heal from the shave biopsy. Would it be better to do a full excision? It seems the report recommends a full excision. Is it safe to wait a month as the doctor recommends? I would prefer to just go ahead and remove it ASAP. Thanks
doctor
Answered by Dr. Kakkar S. (13 hours later)
Brief Answer:
Go with your doctor

Detailed Answer:
Hi.

The lateral edges are uninvolved. It's only the deeper margin that need to be completely excised. So a deeper shave followed by the margin check would be OK. Morever it's not a melanoma. A low grade dysplasia in an atypical nevus is not much of a risk even if some of the margin is left behind as most of these would never progress to a melanoma. On the other hand a high grade dysplasia requires complete meticulous excision.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8962 Questions

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What does my biopsy report indicate?

Brief Answer: Mitotic figures do not preclude Benignity Detailed Answer: Hello. Thank you. I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern. Benign melanocytic nevi may show mitotic activity within dermal melanocytes.. In a single specimen, single mitotic figures are most common as compared to 2 or 3 mitotic figures. Regards