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4 - The value of immunohistochemistry as a diagnostic aid in gynaecological pathology

Published online by Cambridge University Press:  06 January 2010

Nigel Kirkham  and
Neil A. Shepherd
By
W. Glenn McCluggage
Nigel Kirkham
Affiliation:
Royal Victoria Infirmary, Newcastle
Neil A. Shepherd
Affiliation:
Gloucestershire Royal Hospital
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Summary

INTRODUCTION

In recent years there has been a rapidly expanding literature investigating the value of immunohistochemistry as a diagnostic aid in gynaecological pathology [1]–[3]. The aim of this review is to provide a critical appraisal of the uses of immunohistochemistry in diagnostic gynaecological pathology that pathologists will find of practical value in their routine day-to-day practice. The value of immunohistochemical prognostic factors in various gynaecological malignancies is not covered since, although there is an extensive literature on this subject, little has found a role in routine pathological practice. Before detailing the uses of immunohistochemistry as a diagnostic aid in gynaecological pathology, several points are stressed: (a) most cases do not require immunohistochemistry, which should be reserved for those cases where there is genuine diagnostic confusion; (b) the results of immunohistochemistry should always be carefully interpreted in the context of the morphology; (c) no antibody is totally specific; and (d) in general, panels of antibodies should be used rather than relying on a single antibody. In this review I will detail what I consider to be useful applications of immunohistochemistry in gynaecological pathology site-by-site in the female genital tract.

OVARY AND PERITONEUM

ANTIBODIES OF VALUE IN DISTINGUISHING BETWEEN PRIMARY AND METASTATIC ADENOCARCINOMA

The histological distinction between a primary ovarian adenocarcinoma and a metastatic adenocarcinoma may be difficult. In some cases of metastatic adenocarcinoma the presence of a primary neoplasm elsewhere is known, but in other instances an ovarian metastasis is the first manifestation of an adenocarcinoma.

Type
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Information
Progress in Pathology , pp. 73 - 100
Publisher: Cambridge University Press
Print publication year: 2007

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