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        Overview of Immunocytochemical Approaches to the Differential Diagnosis of Tumors

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        622
        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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