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Overview of Immunocytochemical Approaches to the Differential Diagnosis of Tumors

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In 1974, the presence of intracytoplasmic immunoglobulins in plasma cells was demonstrated in routinely processed paraffin tissue (the mainstay of diagnostic pathology) using an immunoperoxidase technique (1 ). This new capability has introduced the surgical pathologist to a technique that can aid in reaching a diagnosis on already available material, including cytological smears and touch preps, frozen sections, and paraffin-embedded tissues fixed in formalin, ethanol, and other fixatives (see Table 1 ; Chapters 9–12). This novel approach of combining the sensitive and specific antibody-antigen reaction with the morphologic interpretation rendered by the experienced trained eye of the pathologist marks probably the most important advance in the world of diagnostic pathology in the last 20 yr.

Table 1 Pathology Preparations for Immunocytochemistry a

Source

Preparation

Fixation

Tissue

Paraffin-embedded

Formalin, ethanol, B5,

 

block

Bouin’s, or Carnoy’s

 

Frozen sections

Air-dried-acetone

Cytologic fine needle

Smear/filter

Ethanol

aspirates, brush, wash,

Cytospin

Air-dried-acetone

body fluids

Cell block

Formalin or ethanol

Sputum/gynecologic PAP

Smear

Ethanol with detergent

smear

   

Imprints (touch preps),

Smear

Ethanol or air-dried-acetone

squash preps, scrape preps

   

a Sources of specimens, the type of preparation, and the fixation needed for immunocytochem-

istry. Almost any type of specimen preparation or fixative can be used. The gentlest fixation is

air-dried-acetone, which consists of first air-drying the slide followed by a brief acetone

postfixation (see Chapters 9-12).

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