AN UPDATE IN IMMUNOHISTOCHEMISTRY (PART I and II)

This 2-part special issue features 14 review articles with an attempt to cover IHC automation, standardization of diagnostic IHC, and the role of IHC in diagnosing tumors in major organs and tumors of unknown primary. This series begins with an article emphasizing standardization of diagnostic IHC in the preanalytic, analytic, and postanalytic phases, with a specific focus on (1) newly proposed guidelines on antibody validation from the College of American Pathologists Pathology and Laboratory Quality Center, (2) testing/optimizing a new antibody and troubleshooting, (3) interpreting and reporting IHC assay results, (4) continuing quality improvement programs, and (5) developing and implementing the concept of best practices in IHC.

from Fan Lin (2014) Evolving Practices of Diagnostic Immunohistochemistry. Archives of Pathology & Laboratory Medicine: December 2014, Vol. 138, No. 12, pp. 1561-1563.

PART I

Standardization of Diagnostic Immunohistochemistry: Literature Review and Geisinger Experience

Overview of Automated Immunohistochemistry

Immunohistochemistry in Undifferentiated Neoplasm/Tumor of Uncertain Origin

Utility of Immunohistochemistry in the Diagnosis of Pleuropulmonary and Mediastinal Cancers: A Review and Update

Application of Immunohistochemistry in Breast Pathology: A Review and Update

The Application of Immunohistochemical Biomarkers in Urologic Surgical Pathology

New Immunohistochemistry for B-Cell Lymphoma and Hodgkin Lymphoma

PART II

Application of Immunohistochemistry in Gastrointestinal and Liver Neoplasms: New Markers and Evolving Practice

Utility of Immunohistochemistry in the Pancreatobiliary Tract

The Utility of Immunohistochemistry in the Differential Diagnosis of Gynecologic Disorders

Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors

Application of Immunohistochemistry in Thyroid Pathology

Immunohistochemistry in Dermatopathology

An Update on the Application of Newly Described Immunohistochemical Markers in Soft Tissue Pathology

Don't miss the gynecopathology free issue!

Il numero free di Histopathology dedicato ai più recenti topics sulla patogenesi e la diagnostica delle neoplasie del tratto genitale femminile.

Histopathology, January 2013, Annual review issue: gynaecological pathology.

Surgical Pathology Snapshot #10: a 1.600 years old woman

Woman, aged 30-40 at the time of the death.

What's your diagnosis?

Discovered on (but not restricted to) GIST

L' Anoctamin-1 (ANO1) è una proteina canale del cloro calcio-attivata inizialmente descritta nei GIST, nota anche con il nome di Discovered on Gist 1 (DOG1). L' anticorpo commerciale anti-DOG1 è quindi  entrato rapidamente a far parte della famiglia dei markers per i GIST ed è utile soprattutto nei rari GIST negativi per cKIT. Studi successivi hanno però mostrato come l' espressione di questa proteina non fosse limitata ai soli GIST. Infatti DOG1 rappresenta un marker di differenziazione acinare sia nelle ghiandole salivari che nel pancreas ed è stato osservato inoltre anche nei condroblastomi. Ma nulla e più preoccupante, dal punto di vista diagnostico differenziale, dell' espressione di DOG1 in un subset di leiomiomi, sarcomi sinoviali e leiomiosarcomi, in questi ultimi anche (raramente) in associazione con il cKIT. Questo ci ricorda la necessità di adoperare sempre con cautela le nostre armi immunoistochimiche, da utilizzare preferibilmente in associazione e inscrivendole nel più ampio quadro clinico e morfologico.

Bibliografia:

Miettinen M, Wang ZF, Lasota J. DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumors: a study of 1840 cases. Am J Surg Pathol. 2009 Sep;33(9):1401-8.

Chênevert J, et al.  DOG1: a novel marker of salivary acinar and intercalated duct differentiation. Mod Pathol. 2012 Jul;25(7):919-29.

Bergmann F, et al. Discovered on gastrointestinal stromal tumor 1 (DOG1) is expressed in pancreatic centroacinar cells and in solid-pseudopapillary neoplasms--novel evidence for a histogenetic relationship. Hum Pathol. 2011 Jun;42(6):817-23.

Akpalo H, Lange C, Zustin J. Discovered on gastrointestinal stromal tumour 1 (DOG1): a useful immunohistochemical marker for diagnosing chondroblastoma. Histopathology. 2012 Jun;60(7):1099-106.

Sah SP, McCluggage WG. DOG1 immunoreactivity in uterine leiomyosarcomas. J Clin Pathol. 2013 Jan;66(1):40-3.

Consensus Recommendations for Anogenital HPV-Associated Lesions

Il dott. Merolla ci segnala un (denso) e importante articolo su standardizzazione della terminologia e raccomandazioni per la diagnosi delle lesioni squamose ano-genitali HPV associate. Un must-read per tutti quelli che si occupano di questo tipo di lesioni.

Darragh TM. et al, The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Arch Pathol Lab Med. 2012 Jun 28.

Changes to the terminology and number of tiers used to describe cervical precancer over time with corresponding management options(procedure). CKC, cold knife conization; Cryo, cryotherapy; RX, treatment. Da Darragh TM. et al, 2012.

Ovarian carcinomas as five distinct diseases.

Based on histopathology and molecular genetic alterations, ovarian carcinomas are divided into five main types (high-grade serous (70%), endometrioid (10%), clear cell (10%), mucinous (3%), and low-grade serous carcinomas (<5%)) that account for over 95% of cases. These types are essentially distinct diseases, as indicated by differences in epidemiological and genetic risk factors, precursor lesions, patterns of spread, and molecular events during oncogenesis, response to chemotherapy, and prognosis. For a successful specific treatment, reproducible histopathological diagnosis of the tumor cell type is critical. 

(Dall' Abstract di Prat J. Ovarian carcinomas: five distinct diseases with different origins, genetic alterations, and clinicopathological features).

Bibliografia:

Prat J. Ovarian carcinomas: five distinct diseases with different origins, genetic alterations, and clinicopathological features. Virchows Arch. 2012 Mar;460(3):237-49.

Representative examples of the five main types of ovarian carcinoma, which together account for 98% of cases: a High-grade serous carcinoma; b Low-grade serous carcinoma; c Mucinous carcinoma; d Endometrioid carcinoma; and e Clear cell carcinoma (da Prat J, Virchows Arch. Mar. 2012).

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Histology of micro polyps in chronic endometritis.

A pathologist can be strongly challenged when diagnosing endometritis. [...] chronic endometritis is always characterized by the presence of an inflammatory infiltration containing plasma cells. [...] Another element supporting the diagnosis of endometritis is the ‘spindle cell’ alteration in the endometrial stroma, described first by Kurman and Mazur. [...] Direct observation of the endometrial cavity by hysteroscopy has highlighted a particular macroscopic aspect: small regular polyploidy excrescences in the mucosa whose width is <2 mm. This pattern is always related to a histological diagnosis of chronic endometritis. In this communication we wanted to show the histological equivalent of ‘hysteroscopic’micro polyps. 

Da Resta L, et al, Histology of micro polyps in chronic endometritis. 


Bibliografia:

Resta L, et al, Histology of micro polyps in chronic endometritis. Histopathology. 2012 Mar;60(4):670-4. 

Hysteroscopic view of micro polyps in a case of chronic endometritis and matching histological pattern. (da Resta L. et al, Histology of micro polyps in chronic endometritis)