CAP Pro Course - Histology - Immunohistochemistry Part 2

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Author: Carla Shoffeitt, MSM, HT(ASCP)
Reviewer: Alexandru Casapu, MBA, MLS(ASCP)^CM, PBT^CM

Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)
Florida Board of Clinical Laboratory Science CE Credit Hours -
General (Histology): 1 hour(s)

Objectives

Discuss immunohistochemistry (IHC) applications related to pathologic diagnosis.
Review diagnostic IHC breast markers.
Discuss specialized techniques in IHC staining.
Discuss the diagnostic use of immunofluorescence staining.
Identify appropriate quality control measures in IHC staining.
Troubleshoot and discuss factors affecting stain quality.

Course Outline

Discuss immunohistochemistry (IHC) applications related to pathologic diagnosis.

Anaplastic Tumor Workup
Immunohistochemistry (IHC) Stains for Specific Neoplasms
Diagnostic Immunohistochemistry (IHC) Markers in Lymphoid Processes
Diagnostic Immunohistochemistry (IHC) Markers for Skin
Proliferation Markers
Immunohistochemisty (IHC) Stains for Infectious Processes
The term "differential" is often referred to during the anaplastic tumor workup. Which of the following BEST describes the meaning of this term?
Dr. Brookes has diagnosed a liver biopsy as small cell carcinoma. Since small cell carcinoma is often metastatic, Dr. Brookes suspects that this neopl...
After review of a gastric biopsy slide, Dr. Sichon suspects the patient might be suffering from Helicobacter pylori. She decides to order an IHC stai...

Review diagnostic IHC breast markers.

Estrogen/Progesterone Receptors as Prognosis Predictors
Oncogenes
Regulatory Requirements Related to Estrogen Receptors (ER), Progesterone Receptors (PR), and HER2
Since assessment directly affects treatment and weighs heavily on prognosis, there is great concern with the analytical precision, reproducibility, ac...
IHC with DAB chromogen is routinely used to evaluate the amplification and/or overexpression of HER2. Staining results are interpreted quantitatively....

Discuss specialized techniques in IHC staining.

Immunohistochemical (IHC) Staining: Frozen Sections
Immunohistochemical (IHC) Staining: Cytology Preparations
Immunohistochemical (IHC) Staining: Double Stains
The antigenicity of cytocentrifuged slides and smears is BEST preserved with which of the following fixatives?
When staining acetone-fixed frozen section slides by immunohistochemistry, which procedural step can be eliminated?

Discuss the diagnostic use of immunofluorescence staining.

Direct Versus Indirect Methods of Immunofluorescent (IF) Staining
Immunofluorescent (IF) Staining: Renal Biopsy Specimens
Immunofluorescent (IF) Staining: Skin Biopsy Specimens
Immunofluorescent (IF) Staining: Disadvantages and False-positivity
Of the following statements, which one BEST describes the advantage of using indirect immunofluorescence (IF) staining methods?
Which of the following contributes to false-positive immunofluorescence (IF) staining?

Identify appropriate quality control measures in IHC staining.

Use of Control Slides and Control Reagents
Immunohistochemical (IHC) Antibodies and Suggested Tissue Controls
Optimization and Validation of New Primary Antibodies and New Lots of Ancillary Reagents
Antibody Diluents
Quality Control (QC) Documentation
Storage Considerations for Immunohistochemistry (IHC) Reagents
Vimentin is often used as a first tier stain in the anaplastic tumor workup. Which of the following tissue section types is BEST suited for use as a p...
The pH of antibody diluents is very important. Which of the following BEST describes the problem that can result from variations in the pH of the dilu...
Greyson has pulled the last remaining CD45 controls from the immunohistochemistry workstation and must replenish them. Which type of control is prefer...
Quan is organizing a new group of antibodies that were just validated. He understands that quality control (QC) documentation is required. Which of th...

Troubleshoot and discuss factors affecting stain quality.

Systematic Approach to Troubleshooting
False-negative Staining
False-positive Staining
Background Staining
Which of the following false-negative patterns of immunohistochemistry staining is the easiest to detect?
When using the diaminobenzidine (DAB) chromogen with peroxidase-based detection systems, which of the following stain quality issues is expressed simp...

References

References

Additional Information

Level of Instruction: Intermediate

Intended Audience: This program is designed as an educational and training tool for HT, HTL, MLS, MT, MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.

Author Information: Carla J. Shoffeitt, MSM, HT(ASCP) is the System Director of Anatomic Pathology for Emory Healthcare in Atlanta, Georgia. She holds a Master of Science Degree in Healthcare Management as well as a Bachelor of Science degree in Biology from Troy University, Troy, Alabama. She is certified as a Histotechnician and has 29 years of experience in the field of Histology.

Reviewer Information: Alexandru Casapu, MBA, MLS(ASCP)^CM, PBT^CM, has over 20 years of experience as a medical laboratory scientist, section supervisor, and laboratory manager. He is the former Director of Clinical Laboratory Technology Program at Georgia Piedmont Technical College. He is currently a Program Director at MediaLab, Inc. Alex holds BS degrees in Biology and Medical Technology from Clark Atlanta University and an MBA from the University of Georgia.

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