Pathology/Help interpreting biopsy results
Hello, a week ago I had a mole on my shoulder that was shave biopsied. This is the pathology report:
Diagnosis: Clark nevus, compound
Note: The lesion extends to all margins.
Clinical data and history: Shave with margins, dn
Microscopic description: There are nests and solitary units of relatively monomorphous melanocytes at the dermal-epidermal junction and nests of melanocytes in the upper part of the dermis.
What does this mean? Is it serious?
A nurse called me and said that the doctor wants to shave the mole again to clean the margins. I'm not sure if I want that, I think I would feel better if he would excise it with stitches. What's the best way to treat this mole?
Clark nevus, is also known as dysplastic nevus. It is a type of mole with architectural and or cellular atypia. In other words the cells may be organized in a disorderly fashion and or also be themselves abnormal.
In your biopsy there is evidence of architectural disorder ...solitary cells and nests (groups) of melanocytes or pigment cells of the skin. The report does not mention cellular abnormality, it just indicates the cells are monomorphous or similar in appearance. These cells are present at the junction of two layers of skin ( epidermis is superficial and deeper to it is dermis) also in upper part of the deeper layer. In addition these pigment cells are found right upto the edge of the biopsy. The significance of this is some part of the mole is left behind, ideally the entire mole should be removed and margins should be clear to rule out if anything more serious is present.
The overall significance of your nevus also depends on size of this lesion, borders were smooth or irregular, how many you have, your age and family history of melanoma ( cancer of pigment cells).
If this is just a single or couple of lesions, less than 6 mm with regular border, no family history of melanoma, you have no cause for worry. If indeed it is larger in size, irregular then regular follow up is required in case any other moles appear.
However, regardless of size and shape, it's best have it removed completely. Shave or excision decision will depend on your treating physician who has actually seen the lesion. I am not an expert on the treatment part.
In general does not sound to be a particularly aggressive or threatening mole, but I would focus more on getting the entire thing out and follow up, if there is any recurrence.
I hope this helps. Wish you good health.