Role of immunohistochemistry as a real mentor in diagnostic histopathology

Abstract

: The goals and objectives of this study are to find out the number of cases where IHC was used to solve discrepant cases of histopathology. This gives an idea as to what percentage of cases required IHC for diagnostic evaluation. : This research is a combined retrospective and prospective analysis of a three-year time frame, beginning in January 2017 and ending in December 2019. Only those cases of benign and malignant neoplasms which have undergone IHC in our department are part of this study. Total of 67 cases were studied using routine H&E and IHC stain. Slides were evaluated by light microscopy. Using specific monoclonal or polyclonal antibodies, paraffin sections were stained immunohistochemically (IHC) using a Peroxidase antiperoxidase (PAP) technique. : There were a total of 23,558 biopsy reports made in the field of surgical pathology. Out of a total of 67 cases requested for IHC, 36 cases (53.7%) had histopathological diagnosis concordant with IHC diagnosis. While in 25 cases (37.31%) histopathological diagnosis was discordant with IHC diagnosis. In 6 cases (8.95%) conclusive diagnosis could not be derived. : From this study, we concluded that IHC plays a significant role in the definitive typing and grading of tumours. When trying to characterise a tumour, it's best to use an antigenic profile of both positive and negative markers, which may be achieved by a panel method consisting of well-chosen antibodies. It also brings about the conclusion that internal and external quality control plays an important part in routine Histopathology, which should not be undermined. Both QC and IHC must be made a routine part of Histopathology. Since we began comparing histology and IHC diagnosis three years ago, we've seen a significant uptick in the quality of our performance evaluations, patient care, and general laboratory practises.