Question: I have a question about a mole. I had a mole biopsied a few week back and the pathology report came back as: The pathologic process is that of a proliferation of nevomelanocytes within the epidermis and focally within the dermis. Cytologic atypia is present and manifests as large nuclei, pleomorphism, and abnormal chromatin
patterns. No atypical mitotic figures are identified. Architectural disorder is present and manifests as lentiginous hyperplasia, horizontal growth pattern, individual melanocytic hyperplasia and abnormally formed junctional nests that focally demonstrate bridging adjacent rete ridges. There is junctional asymmetry. The melanocytic cells extend to the deep margin and to both lateral margins.

The pathologist called it a "mild to moderate" atypical mole and suggested that I get it excised, which I did. However, when they went to check the margins, it was upgraded from "mild to moderate" to "severe." My question is how concerned should I be about this? And why would a mole be upgraded upon excision? They are recommending another excision as some of the cells were left behind. Which I will do within the next few weeks.

Hi - thank you for your reply. That makes more sense to me. Should I be concerned that the cells are - per the pathology report - in the dermis as well as the epidermis? I've had many, many mildly atypical moles where the cells were also in the dermis. They recommended a re-exicision within three weeks - is that, in your opinion, sufficient?

My understanding is that a compound nevus has a dermal component where a junctional is more epidermis - is that correct? Also are atypical cells in the dermis of any concern or is that just what happens in dysplasia?