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23063 Tissue Immunohistochemistry, Surgical Pathology

Tissue Immunohistochemistry, Surgical Pathology
Test Code: HMISC
Synonyms/Keywords
​Histology, Immunohistochemistry, IHC, Surgical Pathology, Paraffin Blocks
Useful For
​Immunohistochemistry (IHC) and In Situ Hybridization (ISH) are techniques that use specific antibodies/probes to detect and bind to their specific antigens/nucleic acids in tissues/cells. In identifying specific molecules, their presence, or absence, distribution, and/or amount can help to diagnose and classify disease, normal, or benign processes. Used in conjunction with surgical pathology, abnormal cells characteristically found in particular cancerous tumors can be interpreted and classified, microorganisms identified, and prognostic and therapeutic options determined.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Paraffin Embedded Tissue Block or Unstained Slide​ Transport Container for Block and/or Slide Holders​
Collection Processing Instructions
All (With or Without Interpretive Consult)
 
-List type of fixative, if other than NBF.
-Completed histology requisition form, with pertinent patient history and tissue source.
-One paraffin-embedded tissue/cell block and/or 3-4 micron, unstained (tissue sections placed on charged slides, then air-dried.
-H&E slide.
-Out Side Accounts - Surgical/Cytology Pathology Report.
 
Interpretation of stains requires a consult.
 
Antibody validations were performed on 10% neutral buffered, formalin-fixed, paraffin embedded tissues/cell blocks. Many validations also included testing on alcoholic, zinc formalin fixed, paraffin embedded bone marrow specimens.
 
All blocks and slides will be returned to the requestor, including controls.
Acceptable Specimen Types
​Paraffin-Embedded, Formalin Fixed Tissue Blocks, H&E Slide, and/or Unstained Air-Dried, Charged Slides
Specimen Stability Information
Specimen Type Temperature Time

​Paraffin Tissue / Cell Block

Fixed in 10% Neutral Buffered Formalin

​Room Temperature
​Unstained, Air-Dried, Charged Slides ​Room Temperature Age of a cut paraffin section can affect immunoreactivity.  Stability thresholds vary widely among published literature and are antigen-dependent.  Best practice is for paraffin sections to be cut fresh. 
Rejection Criteria
Unstained Slides (No Charge on Slides)
​Insufficient Data (Incomplete Requisition Form)
Interference
​Procedures have been validated on tissues fixed in 10% Neutral Buffered Formalin (NBF). Poorly fixed tissue, use of fixatives other than NBF, and/or decalcified tissue may cause unexpected or poor results.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday - Friday IHC & ISH Polymer-Based/Automated​
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
For List of Specific Stains see:
 
Blocks, H&E slides, Stained Slides, and their controls will be returned to sender upon test completion.
Reference Range Information
Performing Location Reference Range
​Marshfield
Interpretation
With Consultation - See Surgical Pathology Report.​
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
88342T​ IHC Stain Without Consultation​ & Interpretation Each​ first stain
88341T IHC Stain Without Consultation​ & Interpretation Each​ additional stain on the same specimen
​88342 ​IHC Stain With Interpretation & Additional Consultation Charge ​Each first stain
​88341 ​IHC Stain With Interpretation & Additional Consultation Charge ​Each addtional stain on same specimen
88365T ISH Stain Without Consultation​ & Interpretation Each​ first probe
88364T ISH Stain Without Consultation & Interpretation​ Each​ additional probe on the same specimen
​88365 ​ISH Stain With Interpretation & Additional Consultation Charge ​Each first probe
​88364 ​ISH Stain With Interpretation & Additional Consultation Charge ​Each addtional probe on the same specimen
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
Synonyms/Keywords
​Histology, Immunohistochemistry, IHC, Surgical Pathology, Paraffin Blocks
Ordering Applications
Ordering Application Description
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Paraffin Embedded Tissue Block or Unstained Slide​ Transport Container for Block and/or Slide Holders​
Collection Processing
All (With or Without Interpretive Consult)
 
-List type of fixative, if other than NBF.
-Completed histology requisition form, with pertinent patient history and tissue source.
-One paraffin-embedded tissue/cell block and/or 3-4 micron, unstained (tissue sections placed on charged slides, then air-dried.
-H&E slide.
-Out Side Accounts - Surgical/Cytology Pathology Report.
 
Interpretation of stains requires a consult.
 
Antibody validations were performed on 10% neutral buffered, formalin-fixed, paraffin embedded tissues/cell blocks. Many validations also included testing on alcoholic, zinc formalin fixed, paraffin embedded bone marrow specimens.
 
All blocks and slides will be returned to the requestor, including controls.
Acceptable Specimen Types
​Paraffin-Embedded, Formalin Fixed Tissue Blocks, H&E Slide, and/or Unstained Air-Dried, Charged Slides
Specimen Stability Information
Specimen Type Temperature Time

​Paraffin Tissue / Cell Block

Fixed in 10% Neutral Buffered Formalin

​Room Temperature
​Unstained, Air-Dried, Charged Slides ​Room Temperature Age of a cut paraffin section can affect immunoreactivity.  Stability thresholds vary widely among published literature and are antigen-dependent.  Best practice is for paraffin sections to be cut fresh. 
Rejection Criteria
Unstained Slides (No Charge on Slides)
​Insufficient Data (Incomplete Requisition Form)
Interference
​Procedures have been validated on tissues fixed in 10% Neutral Buffered Formalin (NBF). Poorly fixed tissue, use of fixatives other than NBF, and/or decalcified tissue may cause unexpected or poor results.
Useful For
​Immunohistochemistry (IHC) and In Situ Hybridization (ISH) are techniques that use specific antibodies/probes to detect and bind to their specific antigens/nucleic acids in tissues/cells. In identifying specific molecules, their presence, or absence, distribution, and/or amount can help to diagnose and classify disease, normal, or benign processes. Used in conjunction with surgical pathology, abnormal cells characteristically found in particular cancerous tumors can be interpreted and classified, microorganisms identified, and prognostic and therapeutic options determined.
Reference Range Information
Performing Location Reference Range
​Marshfield
Interpretation
With Consultation - See Surgical Pathology Report.​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday - Friday IHC & ISH Polymer-Based/Automated​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
88342T​ IHC Stain Without Consultation​ & Interpretation Each​ first stain
88341T IHC Stain Without Consultation​ & Interpretation Each​ additional stain on the same specimen
​88342 ​IHC Stain With Interpretation & Additional Consultation Charge ​Each first stain
​88341 ​IHC Stain With Interpretation & Additional Consultation Charge ​Each addtional stain on same specimen
88365T ISH Stain Without Consultation​ & Interpretation Each​ first probe
88364T ISH Stain Without Consultation & Interpretation​ Each​ additional probe on the same specimen
​88365 ​ISH Stain With Interpretation & Additional Consultation Charge ​Each first probe
​88364 ​ISH Stain With Interpretation & Additional Consultation Charge ​Each addtional probe on the same specimen
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
For most current information refer to the Marshfield Laboratory online reference manual.