Best practices in contemporary diagnostic immunohistochemistry: panel approach to hematolymphoid proliferations

Abstract

Context: The complexities of diagnostic hematopathology in the modern era are well known, and even in this molecular era, immunophenotypic studies, together with routine histopathology, remain a critical component in the evaluation of many lymphoid proliferations. With numerous antibodies that can be used on routinely fixed, paraffin-embedded tissue sections, immunohistochemistry has become increasingly valuable. It then becomes a challenge knowing the best approach to the selection of antibodies to use and how to interpret them.

Objective: To present a pragmatic immunohistochemical approach to the evaluation of lymphoid proliferations that stresses the utility of 2 limited panels to deal with the most commonly encountered lymphomas.

Data sources: English-language literature published between 1990 and 2008.

Conclusions: A relatively limited panel of immunohistochemical stains may be used to diagnose and subclassify many of the more common lymphomas, although some cases will require additional stains and others fewer, depending on the case complexity. Immunohistochemical stains must always be interpreted in the context of the histopathologic and other ancillary studies.