What the heck was growing on my back?

December 18, 2008 9:19 AM

Help me interpret these biopsy results - Junctional Nevus with Mildly Displastic Features.

I recently was referred to a dermatologist by my primary care physician due to a mole on my lower back that was getting irritated by my pants. He did a scan over my body and basically said "Nothing looks abnormal but I'd like you to get a full body scan by a dermatologist."

Two weeks later went to dermatologist who looked me over head to toe and recommended cutting out three lesions. Biopsy results came back and one had the above diagnosis. There is notes (summarized) stating "The limited margins appear to be free of the process but clinical correlation in regard to treatment planning is recommended."

I have a follow-up scheduled in 3 months to review further and probably have a few more lesions removed. The nurse I spoke with basically said it's nothing to be concerned with but I'd like to just get an idea of what this could eventually have turned into and what long term this could mean.

Personal info - 27 year old white male, very light skinned. No other medical conditions to speak of.

posted by Octoparrot to health & fitness (10 comments total)

My 37-year-old husband had this exact same diagnosis about 6 months ago (also on his lower back). They cut out about a half-inch section of skin around where the mole was, stitched it up, and he followed up about 2 weeks later. By then they had studied the portion that was removed and the skin around it was fine, so the displasticness (sorry, I know there's a better word) hadn't spread.

I know it's scary to hear a diagnosis like that, especially when you don't really know what it means. Just keep an eye on it and make sure to keep your follow-up appointment, and discuss your concerns with your doctor.
posted by cloudsandstars at 9:31 AM on December 18, 2008

I would call your doctor and ask instead of freaking out about this for three months.
posted by desjardins at 9:56 AM on December 18, 2008 [1 favorite]

IANAD but I have a significant number of hematomas and cysts.

A displastic feature indicates that the item is 'atypical'. The item has a somewhat greater chance of turning cancerous at some point in the future, but this is not something you need to be scared about necessarily. Junctional isn't a term i've heard before, but if the item was vascular, it would indicate an area where two hematologic features had joined I think.
posted by arimathea at 10:43 AM on December 18, 2008

IANAD(y), but I don't think you have anything to be concerned about. The requisite scary bit is that a junctional nevus has a slight risk of developing into melanoma, which is pretty nasty. The first step down that road would be dysplasia, when the cells start growing funny and looking weird, but they're still contained and not going anywhere. The good news is that if the pathologist had a look and found mild dysplasia that didn't extend past the area that was cut out, that pretty much means it's gone for good, as cloudsandstars said. Let your derm handle the other lesions and don't worry about it. :)
posted by greatgefilte at 10:47 AM on December 18, 2008

As someone covered in atypical (dysplastic) nevi, definitely don't freak out. Take a gander at wikipedia's article on the subject--it might help calm you down.

Long term, this means monitoring your moles and getting checked out by a dermatologist yearly, because you're at an elevated risk for skin cancer if you're 1. pale and 2. have atypical moles.
posted by PhoBWanKenobi at 10:47 AM on December 18, 2008

On wikipedia: Junctional nevus.

So, a mole between the epidermis and dermis layers of the skin, which is mildly atypical and may have a higher risk of developing into a malignant melanoma.
posted by splice at 10:51 AM on December 18, 2008

I'd like to just get an idea of what this could eventually have turned into

Hypothetically, melanoma.

what long term this could mean

Most nevi never do anything. About half of melanomas are never associated with a nevus. Having many of them is considered a risk factor for melanoma, but the prevalence of having at least one is quite high in whites. Your dermatologist will maybe recommend getting head-to-toe surveillance every so often (depending on other risk factors, etc), let you know what some bad signs for a mole are, and tell you about sunblock. That is, however, their business and depends on lots of details.
posted by a robot made out of meat at 10:59 AM on December 18, 2008

"nevus" = mole

"junctional" = a flat mole just under the skin

"dysplastic" = weird-looking

"the margins appear to be free of the process" = the edges of the biopsy sample look OK

So, you're fine, the biopsy is negative, but:

"clinical correlation in regard to treatment planning is recommended" = a standard cover-your-ass phrase in lab results meaning "you should interpret these results based on whatever else you know about the patient, don't blame us if the guy gets sick"
posted by nicwolff at 11:03 AM on December 18, 2008 [2 favorites]

Seems normal to me.
posted by zouhair at 2:24 PM on December 18, 2008

Thank you all for your answers.

I would call your doctor and ask instead of freaking out about this for three months.
posted by desjardins

I'm really not freaking out at all I'm just curious what this means. The doctor even gave me a copy of what he sent my primary physician and it sounds like this is nothing to be concerned about in the near term.
posted by Octoparrot at 3:10 PM on December 18, 2008