Identifies epithelial membrane protein (EMA), a transmembrane glycoprotein encoded by the MUC1 gene and stains normal and neoplastic cells from various tissues, including mammary epithelium, sweat glands, and squamous epithelium. Expression distinguishes metastatic from primary liver cancers, nerve sheath tumors, meningioma, anaplastic large cell lymphoma, and other tumors. Hepatocellular carcinoma, adrenal carcinoma, and embryonal carcinomas are consistently EMA negative, therefore keratin positivity with negative EMA indicates one of these tumors. When positive in meningioma, it can be useful in distinguishing it from other intracranial neoplasms such as Schwannomas. Negative EMA is also characteristic of tumors such as adrenal carcinoma, seminomas, paraganglioma, and hepatoma.
ERG is a member of the ETS transcription factor gene family and is strongly overexpressed in endothelial cells and is a highly specific and sensitive marker of vascular neoplasms, and expression has been shown to be a highly specific marker for prostate cancer. ERG expression is lacking in a wide variety of normal epithelial tissues and tumors, therefore detection of ERG by IHC is a useful tool for diagnosing prostate cancer or determining prostatic origin.
Identifies estrogen receptor, a receptor that belongs to a superfamily of nuclear hormone receptors and is expressed in about 85% of invasive breast cancers. It is a weak prognostic factor but strong predictive factor for response to endocrine therapies, both in adjuvant and metastatic settings. The primary use of assessing ER in breast cancer is to predict response to hormonal therapies such as tamoxifen, other selective estrogen receptor modulators, and aromatase inhibitors. In univariate analysis, moderate to strong staining in even 1% of invasive tumor cells is associated with significant improvement in disease-free survival compared to those patients without ER expression in a tumor.
A nuclear transcription factor that is reportedly the first nuclear marker of endothelial differentiation. It labels hemangiomas, angiosarcomas, Kaposis sarcoma, and Ewings and Merkel cell carcinoma. It is also expressed in normal endothelial cells, megakaryocytes, and normal breast epithelia.
Follicle Stimulating Hormone is a pituitary hormone involved in the maturation of ovarian follicles and estrogen secretion in females produced by gonadotrophs in the pituitary gland. In males, FSH stimulates the secretion of testosterone. It is used in the identification of FSH in pituitary adenomas and to distinguish primary ovarian failure from secondary ovarian failure.
Identifies von Willebrand factor, which is synthesized by endothelial cells and stored in the Weibel-Palade granules. The Factor-VIII related antigen is one of the available immunohistochemical markers of endothelial cells and has also been demonstrated in platelets and megakaryocytes. IHC staining of this antigen is also useful for diagnosis of vascular neoplasms and for identification of vascular invasion by neoplasms.
Identifies a dermal dendrocyte marker used for histiocytic phenotyping that has been reported to mark capillary hemangiomas and tumors of the central nervous system. It has also been used with CD34 to differentiate between dermatofibroma and dermatofibrosacroma protuberans.
Identifies a highly conserved actin-bundly protein expressed predominantly in dendritic cells. Because lymphoid cells, myeloid cells, and plasma cells are negative for staining and Reed-Sternberg cells in Hodgkin lymphoma are positive, fascin expression can be used to distinguish between anaplastic large cell lymphoma (negative) and Hodgkin lymphoma (positive). Epstein-Barr virus may induce expression of fascin in B-cells.
This antibody is specific to a 15kDa monomer protein expressed in apocrine epithelia, lacrimal, ceruminous, and Moll's glands, as well as in numerous serous cells of the submandibular, tracheal, bronchial, sublingual, and minor salivary glands. It is used to identify breast carcinoma, sweat gland carcinoma, and a subset of salivary gland carcinoma. It can also be present in 10% of primary lung adenomacrinoma.
Glial Fibrillary Acidic Protein (GFAP), an intermediate filament protein expressed almost exclusively in glial cells and tumors of the central nervous system. Gliomas are the most common cerebral neoplasm in adults and include astrocytomas, oligodendrogliomas and glioblastomas. It can also be demonstrated in ependymal cells, ependymomas, subependyomas, glioblastomas, mixed central nervous system neoplasms, and gangliomas. It is detected in immature but not mature oligodendrocytes and neurons, and anti-GFAP antibodies do not cross-react with neurons, fibroblasts, or muscle cells. These antibodies are useful in differentiating primary gliomas from metastatic lesions in the brain and for documenting astrocytic differentiation in tumors outside the central nervous system. GFAP is also expressed in a restricted subset of epithelial tumors, including salivary gland pleomorphic adenomas.
A marker of growth hormone, which is produced in the somatotroph cells in the pituitary, used to classify pituitary tumors and pituitary diseases such as hypopituitarism and acromegaly.
Demonstrates fungal organisms in tissue sections.
Identifies a protein of the lectin family, cytoplasmic proteins that can be translocated into the nucleus, that is upregulated in thyroid carcinoma and can be employed as part of a panel of markers to assist in the distinction of thyroid carcinomas from adenomas. It is strongly and diffusely positive in papillary thyroid carcinomas, but weakly and focally positive in adenomas, and it is also a useful marker to differentiate benign from malignant thyroid neoplasms.
A polypeptide hormone that occurs naturally in three forms and is expressed by G cells of the stomach antrum and in a subset of pancreatic islet cell tumors (gastrinomas). This antibody labels gastrin or gastrin-analogue producing cells in gastrin-secreting tumors and G cell hyperplasia.
A zinc finger nuclear transcription factor and member of the GATA family that is a highly sensitive marker of carcinomas primary to the bladder and breast. It is involved in luminal cell differentiation in the mammary gland and appears to control a set of genes involved in the differentiation and proliferation of breast cancer. It is also expressed in a subset of squamous cell carcinomas, skin adnexal tumors, mesotheliomas, and salivary gland tumors and is associated with the expression of estrogen receptor-alpha (ER) in breast cancer. It stains almost all urothelial carcinomas, but no prostate or renal carcinomas.
Stians peripheral blood and bone marrow smears for study of blood cell morphology.
Identifies a hormone expressed in the alpha cells of the pancreatic islet and identifies a subset of pancreatic islet call tumors (glucagonomas) and glucagon-produced hypoglycemic disorders
Identifies glucose transporter 1, which facilitates the transport of glucose across the plasma membranes of mammalian cells and is expressed in colon, lung, stomach, esophagus, and breast tissues. Overexpression is associated with aggressive behaviors in some cancers, including breast, renal, and bladder carcinoma. Expression can also help distinguish between malignant mesothelioma and reactive mesothelial proliferations.
Identifies one of the two transmembrane proteins exposed on the outer surface of normal human erythrocytes and a marker of erythroid differentiation in myeloid processes. This antibody reacts with an epitope located on the extracellular domain of glycophorin A and does not cross-react with glycophorin D. Glycophorin A is expressed during all stages of differentiation in human astrocytes and once it is maximally expressed, the quantity of glycophorin A in each red blood cell remains constant. It has also been located in the blast cells of cases of erythroleukemia, but does not react in cases of acute lymphoblastic and myeloblastic leukemia.
Identifies a heparan sulfate proteoglycan that is a reliable marker for hepatocellular carcinoma, with a sensitivity and specificity exceeding both alpha-fetoprotein and HepPar1. It is also a marker of yolk sac tumors in the context of other germ cell neoplasms. Additionally, it is a useful marker to differentiate between benign (negative) and malignant (positive) liver diseases.
A useful biomarker for cytotoxic T-lymphocytes (CTL) and NK cells, and may be useful in differentiating between tumors arising from these cell types and tumors arising from other hematolymphoid cell types. It is also useful for identifying anaplastic large cell lymphoma, large granular lymphocytic leukemias, hepatosplenic T-cell lymphomas, intestinal T-cell lymphomas, NK-like T-cell lymphomas, NK-cell lymphomas, nasal T/NK-cell lymphomas, and subcutaneous panniculitic T-cell lymphomas of T or NK phenotype.
Identifies a nuclear protein involved in the modification of DNA by protein Histone H3 and this antibody is used to identify malignant peripheral nerve sheet tumors (MPNST), about half of which show complete loss of expression of this nuclear protein. This loss of expression is highly specific to MPNST and can help distinguish it from other sarcomas and spindle cell melanomas.
An anti-mesothelial monoclonal antibody that recognizes an unknown antigen on the microvilli of mesothelioma cells by staining normal mesothelial cells as well as epithelial mesotheliomas in a thick membrane pattern. It has also been found to be useful as part of a panel of markers in the distinction of thyroid carcinomas from adenomas and reacts with some carcinomas showing cytoplasmic immunostaining.
Identifies hepatitis B infected cells in the liver and other cites. The core antigens of hepatitis B virus are localized within the nuclei, whereas surface antigens are present in the cytoplasm of the infected cells. Antibodies to the core antigens are detected in blood after several weeks, as opposed to surface antigens which appear in circulation at an early stage of infection.
Identifies hepatitis B infected cells in the liver and other sites. The antibodies to surface antigens appear at an early stage of infection.
Identifies the hormon produced by trophoblasts and secreted in large quantities by the placenta and normally found in maternal circulation during early fetal development. This antibody is useful for the identification of cells manifesting trophoblastic differentiation, e.g., in germ cell tumors.
Identifies HER2, a member of the epidermal growth factor receptor family and a transmembrane protein with tyrosine kinase activity. Gene amplification and protein overexpression of HER2 have been found in a variety of tumors and is a prognostic and predictive marker. It is also the target of trastuzumab and other HER2 targeted therapies.
Identifies a nuclear protein expressed by cells infected with Human Herpes Virus 8, which is expressed in both Kaposi's sarcoma and HHV8-associated lymphoproliferative disorders, including primary effusion lymphomas and multicentric Castleman's disease. HHV8 encodes a latent nuclear antigen (LANA) that is the product of the viral gene 73.
Identifies the gp100 protein, a melanoma-specific antigen found in premelanosomes. The antibody reacts with melanoma cells, nevus cells, and neonatal melanocytes, and because of this, it is a highly sensitive and specific marker of melanoma. It is expressed on the majority of malignant melanoma cases as well as on tumors of melanocytic differentiation, and it is also an excellent marker of clear cell sarcoma as well as PEComas.
A polypeptide hormone synthesized in syncytiotrophoblastic cells of the placenta and used as a tissue marker for certain trophoblastic tumors and evaluates placental function. The test is of great value in a hypertensive patient.
Identifies Herpes simplex viruses I and II infected cells by reacting with all the major glycoproteins present in the viral envelope and at least one core protein as determined by crossed immunoelectrophoresis. Neither antibody cross-reacts with cytomegalovirus or Epstein-Barr virus and the cocktail is well suited for the detection of HSV in human cellular material obtained from superficial lesions or biopsies and for the early identification of HSV in infected tissue cultures.
Used to diagnose hairy cell leukemia and hairy cell leukemia-variant. Available as global only. This add-on panel is available to clarify findings on samples currently having flow cytometry analysis at Vitro Molecular Laboratories. Markers are CD11c, CD19, CD20, CD22, CD25, CD45, CD103, kappa, and lambda (9 markers).
Identifies Heliobacter pylori organisms in gastric mucosa and on the surface and in the cytoplasm of epithelial cells of stomach biopsies. H. pylori plays an important role in the etiology of chronic active gastritis and the development of peptic ulcer disease.
Hematology Profile Plus combines expression and fusion with mutation analysis in DNA and RNA. The test covers 284 DNA genes and more than 1600 RNA genes. This is a comprehensive evaluation for all hematologic neoplasms. However, it is especially recommended for:
Acute Myeloid Leukemia (AML): Translocations in AML are very important for diagnosis, prognosis and therapy selection. This comprehensive test can provide a complete evaluation of fusion mRNA and mutations. It also helps in determining a diagnosis in acute leukemia with ambiguous phenotype.
Clonal Hematopoiesis of Indeterminate Potential (CHIP): Distinguish CHIP from clinically active and relevant hematologic neoplasm based on an internally developed algorithm using variant allele frequency, chromosomal structural abnormalities, clinical and laboratory data and longitudinal data. This distinction is particularly important when evaluating minimal residual disease and in the presence of other neoplastic processes.
VEXAS Syndrome: Recently described VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is caused by mutations in the UBA1 gene. This is an adults-onset fatal disease that may present as myelodysplastic syndrome, aplastic anemia or multiple myeloma, but is also characterized by fevers, low white cell count, vacuoles in bone marrow cells, dysplastic bone marrow, pulmonary inflammation, chondritis, and vasculitis. Detecting the presence of mutations in the UBA1 gene is the only way to confirm the diagnosis of this syndrome.
Acute Lymphoblastic Leukemia (ALL): This comprehensive assay is designed to confirm the diagnosis of Ph+ (BCR::ABL1-positive) ALL and Ph-like (BCR::ABL1-like) ALL and distinguish them from other types of ALL. It can be used for diagnosis as well as for monitoring. The incidence of Ph-like ALL is 20% to 25% of adult ALL and 15% of pediatric ALL. Diagnosis of Ph+-ALL and Ph-like ALL is very important because TKI therapy can be helpful in most of these patients. This assay can determine most of the mutations, translocations, and expression of genes (CRLF2) associated with Ph+ ALL and Ph-like ALL.
Diffuse Large B-cell Lymphoma (DLBCL) and Other Types of Lymphoma or Plasma Cell Neoplasms: This assay can provide very valuable information for the management and monitoring of patients with DLBCL. It can distinguish between activated B-cell-like (ABC) and germinal center B-cell-like (GCB) and can help in the diagnosis of double hit lymphoma. The assay is also useful for other types of lymphoma, including follicular lymphoma and T-cell neoplasms, as well as multiple myeloma.
IgVH Mutation Status: Very important for prognosis and therapy selection in patients with chronic lymphocytic leukemia (CLL).
T-cell and B-cell Clonality Detection: The detection of T- and B-cell clonality is important because it can help diagnose and monitor certain types of malignancies. When a malignant transformation occurs in a T- or B-cell, the cells can undergo uncontrolled clonal expansion, resulting in the accumulation of a large number of identical cells with the same T- or B-cell receptor.
Epstein-Barr Virus (EBV): Important for diagnosis and classification of lymphoproliferative neoplasms.
Torque Teno Virus (TTV): This virus was first discovered in a patient with non-A-E hepatitis and is now regarded as a part of the human virome. In general, TTV does not cause pathology in immunocompetent individuals. This virus is considered as a marker of the degree of immune competence in patients with immunological impairment and inflammatory disorders. High TTV load is associated with increased risk of infection. In patients with organ transplant, low TTV load is associated with an increased risk of rejection.
Other Features of Hematology Profile Plus:
- HLA class I genotyping
-Enrichment for CD138-positive plasma cells is performed on bone marrow specimens with the clinical indication of multiple myeloma
-A preliminary report will be issued for any patient positive for FLT3-ITD by fragment analysis or with a clinical indication of acute leukemia
Hematology Profile Plus combines expression and fusion with mutation analysis in DNA and RNA. The test covers 284 DNA genes and more than 1600 RNA genes. This is a comprehensive evaluation for all hematologic neoplasms.
Identifies carbamoyl phosphate synthetase 1, a mitochondrial protein present in hepatocytes and hepatocellular carcinoma. The antibody also recognizes other benign and malignant liver derived tumors such as hepatoblastoma and hepatic adenoma. It typically stains in a granular cytoplasmic pattern and is useful in distinguishing hepatocellular carcinoma from cholangiocarcinoma and metastatic carcinomas to the liver. It is also useful in differentiating hepatoblastoma from other small round cell tumors. It is also expressed in a. subset of gastric carcinomas as well as "hepatoid" carcinomas of various organs.
Identifies isocitrate dehydrogenase 1, an enzyme that participates in the citric acid cycle and is mutated in a high fraction of gliomas and oligodendrogliomas, particularly in grade II and grade III neoplasms. These mutations are frequent genetic alterations in low-grade diffuse gliomas and secondary glioblastoma (70%), and has been observed in fewer than 10% of primary glioblastoma cases. The antibody is a diagnostic tool in assessing the mutational status of codon 132 (R132H) and does not cross react with the native protein, helping differentiate GBM tumors from others. Because these mutations do not occur in reactive gliosis, these can often be separated from diffuse gliomas, which are usually positive for the mutation.
Identifies the gene product of the INI-1 gene, a tumor suppressor gene, and inactivation through mutation or other mechanism characterizes a unique subset of tumors that includes renal and extrarenal rhabdoid tumors, atypical teratoid/rhabdoid tumors of the central nervous system, distal and proximal variants of epithelioid sarcoma, as well as a subset of mesenchymal chondrosarcomas, epithelioid malignant peripheral nerve sheath tumors, and soft tissue myoepitheliomas. A lack of nuclear expression of INI1 is characteristic of malignant rhabdoid tumors and epithelioid sarcomas.
Identifies a transcription factor that is a sensitive and specific marker for neuroendocrine tumors. As a nuclear stain, it is as good as or better than synaptophysin and is superior to chromogranin. It is rarely expressed on adenocarcinoma or squamous cell carcinomas without neuroendocrine differentiation.
This antibody reacts with immunoglobulin Ig alpha chains to identify IgA-positive plasma cells and plasma cell neoplasms, as well as leukemias, plasmacytomas, and B-cell lymphomas.
This antibody reacts with immunoglobulin Ig delta chains, cytoplasmic proteins strongly expressed by naive/mantle zone B-cells and a small subset of plasma cells, and weakly expressed by germinal center B cells. This antibody is useful in identifying leukemias, plasmacytomas, and B-cell lineage lymphomas, as well as a subset of B-cell non-Hodgkin lymphomas and normal mantle zone B-lymphocytes.
This antibody reacts with immunoglobulin Ig gamma chains to identify plasma cell neoplasms and B-cell lineage lymphomas. It is also used in conjunction with IgG4 staining to asses for IgG4 associated disease.
This clone identifies IgG4 positive plasma cells, which are present in the pancreatic tissue from patients with autoimmune pancreatitis. Autoimmune pancreatitis typically produces an enlarged pancreas with the narrowing of the pancreatic duct, and can mimic carcinoma. IgG4 staining in patients with chronic alcoholic pancreatitis and pancreatic ductal adenocarcinoma was rarely observed, and IgG4-positive plasma cells are a useful marker for the tissue diagnosis of autoimmune pancreatitis.
This antibody identifies IgM positive plasma cells and plasma cell neoplasms by reacting with immunoglobulin Ig mu chains. It is useful when identifying leukemias, plasmacytomas, and B-cell lineage lymphomas.
Identifies Inhibin-alpha, a peptide hormone which forms a pituitary FSH secretion inhibitor. It is expressed by granulosa cells and granulosa cell and other sex cord stromal tumors, as well as adrenal cortical cells and tumors. It stains most adrenal tumors but no cases of renal cell carcinomas and is useful in differentiating between adrenocortical tumors and renal cell carcinoma.
Used to evaluate for insulin producing neoplasms (islet cell tumor, insulinoma), or pancreatic islet cell hyperplasia to work up hypoglycemia to evaluate insulin production in diabetes mellitus. It is unable to distinguish endogenous insulin in patients receiving exogenous insulin.
Used to detect ferric (Fe3+) iron in tissue preparations, blood smears, or bone marrow smears, minute amounts of which are commonly found in bone marrow and in the spleen.
Identifies Kappa and lambda immunoglobulin light chains, which are expressed by plasma cells and plasmacytoid lymphocytes, and less reliably detected on B cells with small amounts of cytoplasm. This antibody is useful in the identification of leukemias, plasmacytomas, and certain non-Hodgkin lymphomas. Demonstration of monotypism in lymphoid infiltrates is a surrogate for clonality, and therefore malignancy.
This test targets the kappa light chain immunoglobulin mRNA in the cytoplasm of immunoblastic cells, plasma cells, and plasmacytoid cells. In-situ hybridization is used to assess the light chain immunoglobulin restriction status for plasma cell and plasmacytoid B cell populations in order to make the distinction between neoplastic and reactive lymphoid proliferations and the evaluation of multiple myeloma, plasmacytoma, lymphomas with plasmacytoid features, immunoblastic lymphomas, and reactive plasma cell proliferations.
Identifies a member of the type A (acidic) subfamily of high molecular weight keratins which has been studied as a prognostic marker in breast cancer. CK14 distinguishes stratified epithelial cells from simple epithelial cells and has been reported useful in the identification of squamous cell carcinomas.
Identifies a subset of epithelia and carcinomas and distinguishes myoepithelial cells from luminal epithelium of various glands (mammary, sweat, salivary, bronchial, tracheal, laryngeal, esophageal) and benign from malignant forms of tumors. Expression can also help identify primary carcinomas of the pancreatobiliary tract, distinguishing them from ovarian mucinous adenocarcinomas and carcinnomas of the stomach, among others. Predominant expression of CK17 is the characteristic feature of basal cell carcinomas.
Identifies a member of the type I acidic subfamily of keratins, expressed in various different human tissues. It labels ductal and glandular epithelia, prostatic epithelia, and non-keratinizing squamous epithelia. It is also useful in the diagnosis of breast and cervical carcinoma. Because CK19 is not expressed in hepatocytes, the antibody to CK19 is also useful in the distinction of liver metastasis from hepatocellular carcinomas. Published studies suggest that CK19 expression, along with expression of galectin-3 and HBME-1, is useful in differentiating papillary carcinomas of the thyroid from benign thyroid lesions.
This antibody is positive in the majority of adenocarcinomas of the colon, mucinous ovarian carcinomas, transitional cell, and Merkel cell carcinomas, and frequently in adenocarcinomas of the stomach, bile system, and pancreas. Co-analysis of expression of cytokeratin 7 can be helpful in the identification of the primary site of carcinomas presenting at metastatic sites. CK7/CK20 immunostaining patterns may also be helpful in separating pulmonary from colonic adenocarcinomas.
This antibody identifies squamous and transitional cell epithelia, mesothelium, ductal epithelium, and their corresponding carcinomas. In complex epithelia such as normal prostate glands, the basal cells in most cases express CK5, and expression can also be seen in some nonsquamous carcinomas, e.g., pancreatic adenocarcinoma.
N/A
This antibody reacts with proteins found in most ductal, glandular, and transitional epithelium of the urinary tract and bile duct epithelial cells. Lung and breast epithelium stain positive, and colon and prostate epithelial cells are negative. It also reacts with many benign and malignant epithelial lesions, e.g. adenocarcinomas of the ovary, breast, and lung. Transitional cell carcinomas are positive and most prostate cancers are negative. Co-analysis with expression of CK20 can be helpful in the identification of the primary site of carcinomas presenting at metastatic sites.
A cocktail of two monoclonal antibodies that recognize the acidic and basic subfamilies of cytokeratin (non-overlapping) that are expressed by a wide range of epithelial tumors. Cytokeratin expression is a marker for carcinoma and can identify carcinomas in the context of undifferentiated malignancies. It has also been used to differentiate epithelial from non-epithelial tumors, although cytokeratins can be expressed in a restricted subset of non-epithelial tumors (e.g. melanoma, smooth muscle tumors, etc.) albeit at a lower level.
Identifies cytokeratins 1, 5, 10, and 14 that are found in complex epithelia and is an excellent marker of squamous differentiation, as well as a marker of the outer cell layer in prostatic glands, which is absent in carcinoma. There is no reactivity with cells derived from simple epithelia, mesenchymal tumors, lymphomas, melanomas, neural tumors, and neuroendocrine tumors.
Identifies many members of the cytokeratin group of cytoskeletal proteins and reacts with most epithelial types, including bile ducts and hepatocytes in liver, bladder epithelium, breast ducts, bronchial epithelium, endometrium, intestinal epithelium of stomach, duodenum, ileum, colon, rectum, pancreas, ovarian epithelium, pancreatic acini, pituitary acini, pneumocytes, prostate, thyroid, skin (positive on the basal layer), and apocrine and sweat glands. In tumors, it is reactive with most carcinomas, including breast, transitional cell, renal cell, lung adenocarcinoma, lung small cell, lung squamous cell, endometrial, prostate, ovarian, hepatocellular, colorectal CA, stomach, and thyroid. It is negative in certain normal tissues, including brain, lymphocytes and all cells of hematolymphoid origin, muscle, brain, nerves, endothelium, and in certain tumors including most melanomas, sarcomas, lymphomas, primitive neuroectodermal tumors, and gastrointestinal and stromal tumors. It is positive on some dendritic cells in lymph nodes, some endothelia, and some muscle cells.
Identifies a nuclear protein expressed in proliferating (i.e. non-G0) cells. It is preferentially expressed during late G1, S, M, and G2 phases of the cell cycle, while cells in the G0 phase are negative. It is used as a quantitative marker of cell proliferation in tumors, where increased proliferative activity is associated with more aggressive tumor and decreased disease-free survival period.
Identifies lymphoid enhancer-binding factor 1, a nuclear transcription factor in the WNT/beta-catenin signaling pathway that is normally expressed in T cells and immature pro-B cells, but not in normal mature B cells. LEF1 overexpression is highly associated with CLL/SLL among small B-cell lymphomas and may serve as a useful marker for diagnosis and differential diagnosis of the disease, but it is almost always negative in mantle cell lymphoma, marginal zone lymphoma, and low-grade follicular lymphoma, and therefore may be helpful in distinguishing CLL/SLL from mantle cell lymphoma.
Identifies Luteinizing Hormone (LH), a tropic hormone that modulates the secretory of other endocrine glands and is produced in the anterior hypophysis of the pituitary gland. It is useful for the labeling of normal gonadotropic cells of the pituitary and for assessment of hypothalamic and pituitary function, as well as for the classification of pituitary adenomas, the differential diagnosis of primary and metastatic tumors of the pituitary, and to distinguish between primary and secondary gonadal failure.
Identifies a cysteine-rich protein that plays a central and crucial role in hematopoietic development and is expressed in normal human germinal-center (GC) and GC-derived lymphomas. It is also expressed at high levels in endothelial cells, spleen, hematopoietic precursors, and a significant proportion of acute lymphoblastic and myeloid leukemias. In the setting of diffuse large B-cell lymphomas (DLBCLs), LMO2 has high sensitivity in differentiating between germinal center B-cell DLBCLs and non-germinal center B-cell DLBCLs. It is rarely expressed in mature T, NK, and plasma cell neoplasms and is absent from non-hematolymphoid tissues, except for endothelial cells.
The antibody to the lambda light chain of immunoglobulin is reportedly useful in the identification of leukemias, plasmacytomas, and certain non-Hodgkin lymphomas. Marked decreases in the ration of kappa-positive cells to lambda-positive cells in normal/polyclonal B cell and plasma cell populations indicate lambda light chain-restriction, which is conventionally used as a surrogate for clonality among B cell neoplasms, and therefore malignancy.
The target of this test is the lambda light chain immunoglobulin mRNA in the cytoplasm of immunoblastic cells, plasma cells, and plasmacytoid cells. The detection of mRNA transcripts can be a useful surrogate for protein expression to determine the light chain restriction status for plasma cell and plasmacytoid B cell populations and aids in the distinction between neoplastic and reactive lymphoid proliferations and the evaluation of multiple myeloma, plasmacytoma, lymphomas with plasmacytoid features, immunoblastic lymphomas, and reactive plasma cell proliferations.
Identifies Langerin, a protein encoded by the CD207 gene, which is a transmembrane cell surface receptor produced by Langerhans cells and Langerhans cell neoplasms. It is a highly selective marker for Langerhans cells and the lesional cells of Langerhans cell histiocytosis. Langerin protein expression has utility in differentiating Langerhans cell histiocytosis from other non-Langerhans cell histiocytic proliferations.
Identifies a glycoside hydrolase that is a marker for granulocytes and granulocytic neoplasms. It is synthesized predominantly in reactive histiocytes rather than in resting, unstimulated phagocytes. This antibody labels myeloid cells, histiocytes, granulocytes, macrophages, and monocytes. It is helpful in the identification of myeloid or monocytic nature of acute leukemia.
This test detects MDM2 gene amplification for the diagnosis of certain adipocytic tumors, specifically well-differentiated liposarcomas, atypical lipomatous tumors, and dedifferentiated liposarcomas containing cytogenic alterations of the 12q13-15 region. Benign lipomas and lipocytic tumors as well as most other non-lipomatous sarcomas and mesenchymal neoplasms have been shown to be negative for MDM2 amplification, and this test aids in distinguishing lipomatous/dedifferentiated liposarcomas from nonlipocytic sarcomas and mesenchymal neoplasms. Amplifications are detected infrequently in other soft tissue sarcomas, and are not detected in benign lipomas.
Identifies a DNA repair enzyme that is associated with the DNA-alkylating therapies employed in the treatment of gliomas. Methylation or hypermethylation of the MGMT gene promoter down-regulates or inactivates the normal DNA-repair function of the MGMT enzyme, which can make tumors more susceptible to radiation or alkylating agent-based therapy. Testing is particularly useful in gliomas, as glioblastoma patients have shown improved survival when treated with radiation and temozolomide over patients with non-methylated tumors. Methylation has also been associated with improved survival in anaplastic gliomas, regardless of treatment. MGMT methylation has also been reported in other tumors including colorectal, lung, and lymphoma.
Identifies a nuclear protein that regulates the development and survival of melanocytes that is expressed in the majority of primary and metastatic epithelioid malignant melanomas as well as in normal melanocytes, benign nevi, and dysplastic nevi. MITF is restricted to the melanocyte cell lineage.
Detects a mismatch repair protein involved in maintaining the integrity of genetic information. Mutations in the MLH1 gene have been reported to be found in tumors with microsatellite instability (MSI). Loss of gene expression can help define MSI type colonic carcinomas, a subset of sporadic carcinomas, and breast cancer. Loss of expression of MLH1 has also been reported in acute lymphoblastic leukemia, endometrial carcinoma, gastric carcinoma, and ovarian carcinoma.
Identifies epithelial glycoprotein 2, a cell surface protein present on epithelial cells but not on mesothelial cells. The expression of this protein has been demonstrated to help in the distinction of adenocarcinoma (positive) from mesothelioma (negative). MOC31 also does not label liver as well as hepatocellular carcinoma, therefore it is useful in the differential diagnosis of liver metastases versus hepatocellular carcinomas.