The title of this third edition of Diagnostic Immunohistochemistry has been lengthened to include the terms “Theranostic and Genomic Applications.” Fundamentally, the continuing challenge of this book is to assemble the vast body of knowledge of immunohistochemistry into a work that has meaning for the diagnostic surgical pathologist. The discipline of immunohistochemistry for the surgical pathologist has been evolving rapidly since the first edition of this book, and it can further be broken down into subsets of theranostic and genomic applications. The diagnostic aspect of immunohistochemistry in surgical pathology is straightforward. Pathologists use this tool to assign lineage to neoplasms that include carcinomas, melanomas, lymphomas, sarcomas, and germ cell tumors. The term “theranostics” is used to describe the proposed process of diagnostic therapy for individual patients—to test them for possible reactions to a new medication and/or to tailor a treatment for them based on a test result. Theranostics is a rapidly emerging field in oncology, and pathologists need to be prepared to serve oncologic patients with a vast and emerging array of individualized patient therapies. The prototype for understanding the concept of theranostics is hormone receptor testing for breast cancer and HER2/neu analysis. These were among the first and most widely known immunohistochemical tests with theranostic applications. With the proper application of these immunohistochemical tests, individualized therapy in the form of selective estrogen receptor modulation therapy for the patient with an estrogen-receptor positive breast carcinoma can be designed. Trastuzumab is administered for the patient with a HER2-positive breast carcinoma.
In addition, the genomic application of immunohistochemistry (i.e., genomic immunohistochemistry) is a tool for the surgical pathologist to facilitate recognition of specific genomic aberrations in the patients’ tissues by identifying (or not identifying) the presence or absence of specific proteins or immunohistochemical profiles that directly imply, or connote, a specific genomic abnormality, aberration, or gene signature. A prototype for genomic application could be immunohistochemical testing for microsatellite instability in colorectal carcinomas, where the surgical pathologist applies antibodies to detect proteins for MLH1, MSH2, MSH6, or PMS2. The presence or absence of this protein is in essence a genetic test, a direct genomic application for immunohistochemistry. A genetic signature application might include the identification of basal-like breast carcinoma, in which the signature profile typically is a high-grade ER, PR and HER2 negative, CK5 positive, CK14 positive, CK17 positive, variably EGFR positive tumor. Furthermore, immunohistochemical surrogate markers for gene expression profiles for breast carcinomas can further identify the gene expression profile subsets of carcinomas as luminal A, luminal B, and HER2 categories.
It becomes clear that immunohistochemistry is a powerful tool with overlapping features among diagnostic, theranostic, and genomic applications. Theranostic applications may also be genomic, and genomic immunohistochemistry may also be theranostic. These categories admittedly are artificial and simplistic but give the surgical pathologist and the student of surgical pathology a conceptual framework for recognition of the enormous power of the immunohistochemical test.
Molecular testing in surgical pathology has many important diagnostic, theranostic, and genomic applications as well, but it is the immunohistochemistry platform that lays the groundwork for our understanding of what is normal and what is diseased in tissue by virtue of the direct visualization of molecular morphology.
In this edition, most chapters have been completely revised, and there are several new authors. There is a new chapter on molecular anatomic pathology, with new authorships in non-Hodgkin lymphoma; immunohistology of the gastrointestinal tract; immunohistology of the pancreas, bile ducts, gallbladder, and liver; and immunohistology of the genitourinary system. An additional new chapter on immunocytology is patterned after the chapter that appeared in the first edition.
Each chapter format may include subsections that discuss relevant theranostic and genomic applications of immunohistochemistry. These are included to highlight to the pathologist that these important applications go beyond traditional diagnostic immunohistochemistry for individual organ systems.
Immunohistochemistry has undergone a tremendous change, with new stresses and demands throughout the last decade. A critical factor affecting the surgical pathologist/immunohistochemist is the proper standardization of procedures in the laboratory to assure the highest quality immunohistology for diagnostic, theranostic, and genomic applications. Recent recommendations by the CAP-ASCO and additional new recommendations for hormone receptor testing have highlighted the importance of proper standardization of procedures and internal and external quality assurance programs.
Once again, the challenge of putting this work together has been to assure that the base of knowledge in each chapter is relevant and robust long after the ink has dried. The contributions of expert authors in each discipline are unique to this work. The continuing goal of this book is to provide a reference for pathologists who practice contemporary surgical pathology and cytopathology.
With few exceptions, each chapter is designed to be a stand-alone work. Inherent in this design is a body of information that is reproduced and redundant throughout each chapter. Each chapter is comprehensive in a diagnostic sense, which should limit the need to do extensive cross-checking to other chapters. Each section is punctuated by key diagnostic points that summarize the section and that serve as a rapid summary reference for the most important points in that section.
Key Features
- Discusses diagnostic pitfalls through immunohistologic differential diagnosis wherever appropriate so you can provide the most accurate diagnoses.
- Presents chapters arranged by organ system for comprehensive coverage of all relevant information in a convenient and intuitive organization.
- Provides quick reference graphs for antibodies throughout the text that illustrate the frequency of immunostaining for a variety of antibodies in tumors.
- Includes Key Diagnostic Points boxes in every chapter for a quick summary of text areas that are of particular importance.
- Features an expert author for each chapter to ensure coverage of the current state of the art.
Website Features
- Consult the book from any computer at home, in your office, or at any practice location.
- Instantly locate the answers to your clinical questions via a simple search query.
- Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.
- Images: Browse a Library of all book images. Easily select, organize, and download your images into a presentation.
New to this edition
- Includes access to the full text online at expertconsult.com, along with a downloadable image bank and Path Consult.
- Provides guidance on the role of genomics in identifying genetic and molecular aspects of disease that may affect patient care and therapeutic approaches.
- Covers theranostic applications to enable you to evaluate therapeutic choices based on immunohistochemical results.
- Reflects the latest developments in the field through new chapters on molecular anatomic pathology and immunocytology, as well as updated chapters on immunohistology of the prostate, bladder, testis, and kidney and Non-Hodgkin's lymphoma.
- Discusses antibody specifications with tables that convey information on uses, clones, vendors, sources, antibody titers, and types of antigen retrieval.
- Presents key differential diagnoses boxes that provide tabular summaries of DDx and algorithms.
- Features discussions of ancillary anatomic molecular diagnostics as an adjunct to immunohistochemistry for a more well-rounded diagnostic approach.
Contents
Chapter 1 - Techniques of Immunohistochemistry: Principles Pitfalls, and Standardization
- Introduction
- Basic Principles Of Immunohistochemistry
- Antibodies As Specific Staining Reagents
- Blocking Non-Specific Background Staining
- Detection Systems
- Quality Control And Standardization
- Tissue Fixation, Processing, And Antigen-Retrieval Techniques
- Techniques, Protocols, And “troubleshooting”
- Conclusion
- References
Chapter 2 - Molecular Anatomic Pathology: Principles, Techniques, And Application To Immunohistologic Diagnosis
- General Principles Of Molecular Biology
- Genetic Polymorphism And Mutations
- Specimen Requirements For Molecular Testing
- Common Techniques For Molecular Analysis
- Detection Of Small-Scale Mutations
- Detection Of Chromosomal Rearrangements
- Detection Of Chromosomal Deletions/loss Of Heterozygosity Analysis
- Detection Of Microsatellite Instability
- DNA-Based Tissue Identity Testing
Chapter 3 - Immunohistology Of Infectious Diseases
- Introduction
- Viral Infections
- Bacterial Infections
- Fungal Infections
- Protozoal Infections
- Emerging Infectious Diseases
- Pathologists, Immunohistochemistry, And Bioterrorism
- Beyond Immunohistology: Molecular Diagnostic Applications
Chapter 4 - Immunohistology Of Soft Tissue And Osseous Neoplasms
- Introduction
- Biology Of Antigens And Antibodies
- Intermediate Filament Proteins
- Epithelial-Related Markers
- Additional Myogenic Markers
- Potential Markers of Schwannian Differentiation
- Endothelial Markers
- Fibrohistiocytic Markers
- Proposed Markers of Osteoblastic Differentiation
- Genomic Applications of Other Markers of Interest in Soft Tissue and Bone Tumors
- Specific Soft Tissue Tumors
- Benign Tumors of Soft Tissue
- Borderline Tumors of Soft Tissue
- Malignant Tumors of Soft Tissue
- Other Primary Neoplasms of Soft Tissue
Chapter 5 - Immunohistology Of Hodgkin Lymphoma
- Introduction
- Biology Of Antigens
- Antibody Specifications
- Diagnostic Immunohistochemistry
- Molecular Anatomic Pathology
- Beyond Immunohistochemistry: Anatomic Molecular Diagnostic Applications
- Theranostic Applications
- Summary
Chapter 6 - Immunohistology Of Non-Hodgkin Lymphoma
- Introduction
- Biology Of Antigens And Antibodies
- Non-Hodgkin Lymphoma And Reactive Conditions
- Non-Hodgkin Lymphoma And Other Malignancies
- Classification Of Non-Hodgkin Lymphomas
- B-Cell Neoplasms
- T- And Nk-Cell Neoplasms
Chapter 7 - Immunohistology Of Melanocytic Neoplasms
- Introduction
- Biology Of Antigens And Antibodies
- Neuroendocrine Markers In Melanocytic Lesions
- “sentinel” Lymph Node Biopsies For Metastatic Melanoma
- Putatively Prognostic Markers For Melanoma
Chapter 8 - Immunohistology Of Metastatic Carcinomas Of Unknown Primary
- Introduction
- Cups: Clinical Aspects And Economic Considerations
- Diagnostic Approach To The Study Of Cups: Specimen Preparation
- Determining Site Of Origin: A Stepwise Approach
- Combined Antibody (Panel) Approach To Solving Diagnostic Problems
- Special Clinical Presentations
- Beyond Immunohistochemistry: Anatomic Molecular Diagnostic Applications
Chapter 9 - Immunohistology Of Head And Neck Neoplasms
- Introduction
- Biology Of Antigens And Antibodies
- Squamoproliferative Lesions
- Nasal Cavity And Paranasal Sinuses
- Nasopharynx
- Oral Cavity And Oropharynx
- Larynx/hypopharynx
- Salivary Glands
- Ear/temporal Bone
- Paragangliomas And Malignant Paragangliomas
- Metastatic Tumors
Chapter 10 - Immunohistology Of Endocrine Tumors
- Introduction
- Biology Of Antigens And Antibodies
- Hormones
- Enzymes
- Chromogranins, Secretogranins, and Other Granule Proteins
- Synaptophysin and Other Synaptic Vesicle Proteins
- CD57
- Neural Cell Adhesion Molecule (CD56)
- Intermediate Filaments
- Transcription Factors
- Somatostatin Receptors
- Cell Cycle Markers
- Pitfalls of Immunohistochemistry of Endocrine Tumors
- Tumors Of Specific Sites
- Adenohypophysis
- Pineal Gland
- Thyroid Gland
- Parathyroid Glands
- Adrenal Cortex
- Adrenal Medulla and Extra-adrenal Paraganglia
- Gastrointestinal Endocrine Cells
- Pancreatic Endocrine Cells
- Pulmonary Endocrine Cells
- Endocrine Tumors in Other Sites
Chapter 11 - Immunohistology Of The Mediastinum
- Introduction
- Biology Of Antigens And Antibodies
- Algorithmic Immunohistochemistry Of Mediastinal Disease
- Immunohistologic Findings In Specific Diseases Of The Mediastinum
- Prognostic Markers In Mediastinal Neoplasms
Chapter 12 - Immunohistology Of Lung And Pleural Neoplasms
- Introduction
- Primary Lung Neoplasms
- Biology of Antigens and Antibodies
- Neuroendocrine Lung Neoplasms
- Rare Primary Lung Neoplasms
- Lymphoproliferative Disorders of the Lung
- Clear Cell Neoplasm/Sugar Tumor/PEComa
- Lymphangioleiomyomatosis
- Sclerosing Hemangioma
- Rhabdoid Tumor
- Inflammatory Pseudotumor
- Desmoplastic Small Round Cell Tumor
- Epithelial-Myoepithelial Neoplasm
- Granular Cell Tumor
- Salivary Gland Neoplasm
- Primary Intrapulmonary Thymoma
- Pulmonary Meningothelial Nodules
- Placental Transmogrification of Lung
- Variables and Pitfalls
- Theranostic Applications
- Beyond Immunohistochemistry: Anatomic Molecular Diagnostic Applications
- Pleural Neoplasms
- Positive Markers
- Negative Markers
- Miscellaneous Antibodies
- Diagnostic Considerations
- Rare Primary Pleural Neoplasms
- Variabilities and Pitfalls
- Molecular Biology and Theranostic Features in Diffuse Malignant Mesothelioma
Chapter 13 - Immunohistology Of Skin Tumors
- Introduction
- Epithelial Tumors Of The Skin
- Cutaneous Lymphohematopoietic Disorders
- Mesenchymal Tumors Of The Skin
- Special Topics In Cutaneous Immunohistochemistry
Chapter 14 - Immunohistology Of The Gastrointestinal Tract
- Introduction
- Biology Of Antigens: General And Tissue Specific
- Diagnostic Immunohistochemistry
- Genomic Applications
- Theranostic Applications
- Beyond Immunohistochemistry: Anatomic Molecular Diagnostic Applications
Chapter 15 - Immunohistology Of The Pancreas, Biliary Tract, And Liver
- Pancreas
- Extrahepatic Biliary Tract (Gallbladder And Extrahepatic Bile Ducts)
- Ampulla
- Liver
Chapter 16 - Immunohistology Of The Prostate, Bladder, Kidney, And Testis
- Introduction
- Immunohistology Of The Prostate
- Immunohistology Of The Urinary Bladder
- Immunohistology Of Renal Neoplasms
- Immunohistology Of Testicular Tumors
Chapter 17 - Immunohistology Of Pediatric Neoplasms
- Introduction
- Biology Of The Antigens And Antibodies
- Diagnostic Immunohistochemistry Of Specific Tumors
Chapter 18 - Immunohistology Of The Female Genital Tract
- Introduction
- Vulva, Vagina, And Cervix
- Uterus And Gestational Trophoblastic Disease
- Ovary
- Mesothelioma
- Fallopian Tube and Broad Ligament
- Genomic Applications
- Theranostic Applications
- Beyond Immunohistochemistry: Diagnostic Applications of Molecular Pathology
Chapter 19 - Immunohistology Of The Breast
- Introduction
- Myoepithelial Cells And Assessment Of Stromal Invasion
- Immunohistochemistry Of Papillary Lesions
- Proliferative Ductal Epithelial Lesions And In Situ Carcinomas
- Tumor Type Identification By Immunohistochemistry
- Paget Disease Of The Breast
- Detection Of Lymphatic Space Invasion
- Sentinel Lymph Node Examination
- Systemic Metastasis Of Breast Carcinoma
- Fibroepithelial Tumors
- Theranostic Applications
- Genomic Applications: Breast Cancer Molecular Classification And Immunogenomics
- Other Tumor Markers
Chapter 20 - Immunohistology Of The Nervous System
- Clinical And Radiographic Perspective Of Lesions
- Non-Neoplastic Brain Lesions
- Tumors
- Cysts
- Dementias
- Demyelination
- Epilepsy
- Pitfalls In Diagnosis
Chapter 21 - Immunocytology
- Introduction
- Immunocytology Techniques
- Specific Organ Cytology
- Carcinoma Of Unknown Primary
- Beyond Immunocytochemistry
- Theranostic Applications: Icc For Targeted Therapies
How To Use This Book
The first chapter of this book details the techniques and development of immunohistochemistry. This includes critically important updates of standardization as applied to theranostic testing, especially hormone receptor testing. The new second chapter on diagnostic molecular anatomic pathology is to be used as a reference guide to understanding molecular anatomic tests mentioned throughout this textbook. Molecular anatomic pathology has grown exponentially over the past decade, and the discipline supplies critically important testing that supplements diagnostic, theranostic, or genomic applications beyond immunohistochemistry. Each chapter, where relevant, will have subsections titled “Beyond Immunohistochemistry: Anatomic Molecular Diagnostic Applications.”
The third chapter, “Immunohistology of Infectious Diseases,” has been completely restructured. The remaining chapters continue as an organ system approach to diagnostic, theranostic, and genomic applications of immunohistochemistry. Each chapter has a liberal number of “immunohistograms” depicting immunostaining patterns of tumors, along with numerous tables, well structured for easy reference. Diagnostic algorithms are used where relevant. Many areas of the text are punctuated by summary “Key Diagnostic Points.” Diagnostic pitfalls are also cited where particularly relevant.
To maintain constant terminology throughout the chapters, the following abbreviations in the text and tables are used unless otherwise specified:
- +, the result is almost always strong, diffusely positive;
- S, sometimes positive;
- R, rarely positive, and if so, rare cells are positive;
- N or a (-), negative result.
These are exciting times indeed for the discipline of immunohistochemistry as well as for the rapidly evolving molecular tests that will significantly affect patients’ lives. This work should be viewed as a focal point, a punctuation mark in the continuous quality improvement of the knowledge base for immunohistochemistry for surgical pathologists.
Book Review
"The first edition of this book, published in 2002, rapidly became one of the standard works in the field. The second edition featured a more standardized format, a wider coverage of organ systems, and an extensive update of markers. It incorporated a large number of useful tables listing the various antibody groups, an algorithmic approach to differential diagnosis, and key diagnostic points for all the major subjects. Special attention was paid to the detailed description of the so-called predictive-type markers (such as HER2/neu in breast carcinoma and CD117 in GIST), which are playing an increasingly important role in the evaluation of tumors by the pathologist.
In this third edition, a new chapter has been added that describes, in a simplified and condensed fashion, the rationale, technology, and applications of molecular anatomic pathology techniques to aid the surgical pathologist in acquiring a basic understanding of these molecular tests.
A new, very timely chapter on immunocytology has been included by Dr. Chivukula, which discusses proper cytologic technique for fixation and processing specimens obtained for hormone receptors and HER2/neu testing.
Overall, each organ-based chapter addresses the state-of-the-art body of knowledge and is summarized in bulleted format for ease of understanding.
There are several new completely rewritten chapters with new authors, all of them experts in their respective fields, including N. Volkan Adsay, Jonathan Epstein, Alyssa M. Krasinskas, Alvin W. Martin, George Netto, and Yuri E. Nikiforov. The latest recommendations for proper fixation and processing of hormone receptor testing are authoritatively discussed by Dr. Clive R. Taylor.
The title of this new third edition has been changed to Diagnostic Immunohistochemistry: Theranostic and Genomic Applications to emphasize the fact that immunohistochemistry is no longer used solely for diagnosis. Rather, the growing body of knowledge of cancer genomics, transcriptomics, and the new therapeutic armamentarium of biologics forces pathologists to be cognizant of the emerging field of therapeutic and genomic applications of immunohistochemistry. Accordingly, each chapter of the book includes a synoptic coverage of theranostic and genomic applications. As a result, each organ-based chapter provides detailed information on how gene-based disease can be diagnosed through the microscope with immunohistochemistry. In a similar vein, the presence or absence of markers predictive of the beneficial effects of targeted therapies is determined, launching the age of theranostic immunohistochemistry.
Last but not least, each chapter provides a bridge to new molecular anatomic pathology menus for pathologists, in order to empower them with additional diagnostic modalities whenever immunohistochemistry falls short.
In summary, the authors have again brilliantly succeeded in producing an authoritative, comprehensive, and updated book that pathologists will find next to indispensable as a theoretical backbone for the various methods discussed and of invaluable assistance in their daily work."
-- Juan Rosai, MD, Milan, Italy
Product Details
- Hardcover: 960 pages
- Publisher: Saunders; 3 edition (2011)
- Language: English
- ISBN-10: 1416057668
- ISBN-13: 978-1416057666
- Product Dimensions: 11.2 x 8.9 x 1.7 inches
List Price: $389.00