הסרת נגע ותוצאות פתלוגיה

עשיתי ניתוח להסרת נגע חשוד פלוס פתלוגיה. הרופא המנתח המליץ שאבוא להרחבת הצלקת עקב נגע זה מה שנרשם בפתולגיה ואני מתלבטת לגבי ההמלצה, אשמח לעוד חוות דעת, תודה. Biopsy: excision. The specimen (received in formalin, labeled with the patient's name and ID) consists of an elliptical skin fragment measuring 9x5x3 mm, unmarked, with single brown macule 3x3 mm, localized on the skin, non-ulcerated. Minimal distance to surgical lateral margins 1 mm. Surgical edges inked. The specimen is entirely submitted as sliced sections into 1 cassette Atypical lentiginous compound melanocytic lesion, in favor of a dysplastic nevus (see note). Maximal depth of the lesion ~0.45 mm. The junctional component is focally present at the margin, conservative re excision with safe margins and follow up of the patient are mandatory. Note: This is a compound lentiginous atypical melanocytic lesion showing some a symmetry and composed of single and nested medium sized melanocytes, some of which show a prominent nucleolus (seemingly more within the junctional component). There is some fusion of the rete ridges and some papillary dermal fibrosis. A mild superficial perivascular lymphocytic infiltrate with few melnaophages is also present. On immunostains the lesion is highlighted by Melanoma cocktail which shows minimal if any upward migration of melanocytes into the epidermis. PRAME is positive in a significant amount of the cells (mostly with a moderate intensity). Despite the PRAME positivity and in light of the other features of this lesion, a dysplastic nevus is favored. The immunostains demonstrated only a tiny amount of the dermal component at the tissue block seems to be exhausted from this component of the lesion.