NCCN Guidelines for Patients® | Melanoma - page 21

NCCN Guidelines for Patients
Melanoma, Version 1.2014
Tests for melanoma
The pathology report
The pathology report
A pathology report is a document with information
about tissue removed from your body during a
biopsy or surgery. A pathologist examines the
tissue with a microscope to check for cancer cells
and then writes the results in the pathology report.
Your doctors will use this information to decide
which treatment is best for you. The pathology
report includes many important test results and
details. It states whether cancer cells were found
and, if so, what types of cancer cells. Other results
in the pathology report are used to determine the
extent of the cancer. This is called staging and it is
explained in Part 3.
The process of preparing the tissue, examining it,
and giving the results to your doctor often takes at
least several days. At times, the pathologist may
have questions and request a 2
opinion from
another pathologist. For melanoma, the tissue
samples should be sent to a dermatopathologist
to examine. A dermatopathologist is a doctor
who’s an expert in testing skin cells and tissues for
disease. Contact your treatment team if you have
questions about your pathology report or if you
would like a copy of it.
Pathology results
Type of melanoma found, for example,
superficial spreading melanoma.
Breslow thickness.
How deep the tumor has grown
into the skin, measured in millimeters.
Ulceration status.
Whether or not the tumor’s top skin
layer is present and intact (not ulcerated) or is broken or
missing (ulcerated).
Dermal mitotic rate.
A measure of how many
melanoma cells are actually growing and dividing.
Clark level.
A scale of tumor depth with 5 scores based
on which layer of skin the tumor has grown into.
Peripheral margin status.
Presence or absence of
cancer cells in the normal-looking tissue around the
sides of a tumor removed during surgery.
Deep margin status.
Presence or absence of cancer
cells in the normal-looking tissue under a tumor removed
during surgery.
Tiny tumors (satellites) that have
spread to skin within 2 centimeters of the first melanoma
tumor and can only be seen with a microscope.
Tumor location.
The area of the body where the tumor
is found.
Tumor regression.
A decrease in the size of the tumor.
Tumor-infiltrating lymphocytes.
Presence or
absence of white blood cells.
Vertical growth phase.
Direction of tumor growth is
down into the skin.
Angiolymphatic invasion.
Melanoma has grown into
(invaded) lymph or blood vessels.
Melanoma cells are able to grow into
(invade) nerves.
Histologic subtype.
Grouping of cancer types based
on cancer cell qualities.
Pure desmoplasia.
Presence or absence of dense
connective tissue.
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