Expert: Neha Dahiya MD - 9/12/2009

Question
Hello Neha.

You have very beautiful name by the way. I had 4 Dysplastic naevus. The pathology report said " Proliferation of slightly enlarged melanocytes arranged as single units and nests at the dermoepiderml junction and Focally within the Dermis....What does Focally within the Dermis ?
There are dermal fibrosis and mild infliltrate lymphocytes and melanophages. No pagoid migration. No evidence of maligancy.

Conclusion: Counpound DN with Moderate and Focal Cytologic Atypia?

What does Focal atypia means?

Could simple benin nevus have those caractheristic too?

I got few other ones with the same report from another pathologist saying Benin coupound Naevus.

So why this pathologist classified it at DN?

Can you find lymphocytes inflitration on benin naevus too?

Because when I called the Lab, they told me that because lymphocytes infliltration was present then DN was more likely to be the right diagnosis.

I also had a body rash during the biopsy could this have affected the reading of the biopsy?

Is it normal for naevus to be located in the dermis or epidermis?

If in the dermis are they more dangerous?

Melanoma spreads in the hypoderm or in the dermis?

Thanks a lot

Answer
Hello Tony:

A benign nevus or mole can be located in the epidermis, dermis or at the junction of dermis and epidermis.

When it involves both these layers of skin it is classified as a compound Nevus.

Your diagnosis is Compound Dysplastic Nevus. The dysplastic or atypical cells are focal...which means there are located only in some areas and not seen throughout the biopsy tissue.

These cells are neither completely normal nor do they have clear cut features of cancer cells hence dysplastic or atypical cells. Such lesions increase the risk of melanoma (skin cancer). However they may or may not transform to cancer.

Any nevus can have inflammatory cells (lymphocytes) if it has been irritated...maybe because of injury / scratching etc.

Even inflammation can produce atypical changes in the cells.

Melanoma can spread anywhere.

I hope this helps answer your questions.