Immunohistochemistry: Difference between revisions
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The main approaches to immunohistochemistry ordering are: | The main approaches to immunohistochemistry ordering are: | ||
*Look for a specified '''panel''' for the presentation at hand. For example, for an undifferentiated tumor with no clear lineage differentiation, an initial panel of CK, S100, vimentin and LCA can be used.<ref name="pmid25427040">{{cite journal| author=Lin F, Liu H| title=Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. | journal=Arch Pathol Lab Med | year= 2014 | volume= 138 | issue= 12 | pages= 1583-610 | pmid=25427040 | doi=10.5858/arpa.2014-0061-RA | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25427040 }} </ref> | *Look for a specified '''panel''' for the presentation at hand. For example, for an undifferentiated tumor with no clear lineage differentiation, an initial panel of CK, S100, vimentin and LCA can be used.<ref name="pmid25427040">{{cite journal| author=Lin F, Liu H| title=Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. | journal=Arch Pathol Lab Med | year= 2014 | volume= 138 | issue= 12 | pages= 1583-610 | pmid=25427040 | doi=10.5858/arpa.2014-0061-RA | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25427040 }} </ref> | ||
*Coming up with the most relevant '''differential diagnoses''' for the case at hand, and find the immunohistochemistry stains that best distinguish them. Immunohistochemistry profiles for diseases and conditions, as well as their main differential diagnoses, is generally found at '''[https://www.pathologyoutlines.com/ Pathology Outlines]''', or you can pay for a subscription to '''ImmunoQuery'''{{ImmunoQuery COI declaration}}, | *Coming up with the most relevant '''differential diagnoses''' for the case at hand, and find the immunohistochemistry stains that best distinguish them. Immunohistochemistry profiles for diseases and conditions, as well as their main differential diagnoses, is generally found at '''[https://www.pathologyoutlines.com/ Pathology Outlines]''', or you can pay for a subscription to '''[https://www.immunoquery.com/ ImmunoQuery]'''{{ImmunoQuery COI declaration}}: | ||
===Using Immunoquery=== | |||
The main page of [https://www.immunoquery.com/ ImmunoQuery] gives you the "Diagnoses" option, where you enter up to 3 differential diagnoses to generate the optimal immunohistochemistry panel to differentiate them (you may need to click ''∨ Suggested Panel'' to show it if it is collapsed). It also displays an automatic message when the included antibodies are '''not sufficient''' for a satisfactory panel, in which case you can: | |||
*Choose additional stains from the '''"Comprehensive panel"''' displayed below the suggested one. | |||
*Switch the '''"Sensitivity"''' setting (seen at top) from 1 (which means that diffuse, focal as well as not specified staining count as positive) to 3 (which means that only diffuse staining counts as positive whereas both focal and absent staining count as negative, and references without any specified staining pattern are omitted from the analysis). This has less data to support the suggested stains (since many references do not specify whether positivity was diffuse or focal), but can sometimes state a better distinction between conditions. When including a stain based on its distinguishing features on a sensitivity setting of 3, you need to keep the practice of classifying only diffuse staining counts as positive, and focal to absent staining as negative. | |||
==Immunohistochemistry evaluation== | ==Immunohistochemistry evaluation== | ||