Labcorp Diagnostic Immunohistochemical Staining Program

LabCorp Diagnostic Immunohistochemical Staining Program

To order, specify the option required, and supply the clinical information below.

 484006 - Option I: Slides and controls are returned for your interpretation.  484006 - Option II: Slides and controls are returned with an immunostain interpretation.  980004 - Option IV: Full surgical pathology consultation (can be ordered with Option II.)

Note: Cytokeratin 903, Racemase, hematopoietic group, lymphoma group, and infectious disease group stains are available only as Option I or Option II with Option IV. These stains cannot be ordered as Option II.

Carcinoma Group Breast Carcinoma Sarcoma Group Liver Group Neuroendocrine Non-Hodgkin Group Group Lymphoma Group  CD31  Ber-EP4  AFP  Chromogranin  BCL-2  CU-18  CD34  CDX2  A AT  BCL-6  1  Pancytokeratin  ER CD68  CEA  CD117  LMW Cytokeratin  NSE  Kappa light chain  PR (CAM 5.2)  CK 7  Desmin  Lambda light chain  Serotonin   HAM 56  CK 20  GCDFP-15 Factor VIII-related  CD3 antigen  Somatostatin Thyroid Group  CU-18  E-Cadherin  Factor XIIIa  CD4  Synaptophysin   LMW Cytokeratin Prostate Group  HHV-8 Thyroglobulin  CD5 (CAM 5.2) Germ Cell Tumor  Myoglobulin Group   Calcitonin CD7  HMW Cytokeratin  Cytokeratin 903  Muscle-specific Actin  AFP  CD 8  Pancytokeratin  PSA  S-100  CEA  β-hCG  CD10  E-Cadherin  Smooth-muscle Actin  PSAP  Chromogranin  CEA  CD20   EMA Vimentin  Racemase  Mesothelioma vs  TTF-1  Pancytokeratin CD23  NSE Carcinoma Group  CD43, MT1  P63 Hematopoietic  PLAP   OC125 Ber-EP4 Group  CD45, Leukocyte  PIN-3 Triple stain Infectious Disease  B72.3 common antigen (LCA)  PSA  CD1a Group Melanoma Group  Calretinin  CD45 RA  Helicobacter pylori  PSAP  CEA  CD117  CD45 RO, UCHL-1  HMB45  HSV I & II (Cocktail) (T cell)  P16  CK 5 & 6   Myeloperoxidase  CD74  Melan-A Hodgkin Disease ProEx C  Pancytokeratin Group  CD79a  Super Pancytokeratin  Mel-5  E-Cadherin  TdT  CD30 (AE1/AE3, CAM 5.2)  CD138  EMA  S-100  CD34  TTF-1  CD20  CD15  Cyclin D1  Vimentin  CD68  Villin  Vimentin  CD15  Ki67

Patient’s Name ______Surgical Pathology Case Number: ______Requesting Physician ______Telephone: ______For program options II and IV, please submit an H&E slide and complete the following information: Differential Diagnosis: ______Site of Specimen: ______Clinical Information: ______Alphabetical Index

A1AT (α1-antitrypsin) EMA (Epithelial membrane antigen) AFP (α-fetoprotein) ER (Estrogen receptor) B72.3 Factor VIII-related antigen BCL-2 Factor XIIIa BCL-6 GCDFP-15 Ber-EP4 HAM 56 β-hCG Helicobacter pylori Calcitonin HHV-8 Calretinin HMB45 CD1a HMW Cytokeratin (34ßE12) CD3 HSV I & II (cocktail) CD4 Kappa light chain CD5 Ki67 (MIB-1) CD7 Lambda light chain CD8 (T cell) LMW Cytokeratin (CAM 5.2) CD10 Mel-5 CD15 (LeuM1) Melan-A CD20 (B cell, L26) Muscle-specific Actin CD23 Myeloperoxidase CD30 (Ki-1 antigen/BerH2) Myoglobulin CD31 NSE (Neuron-specific enolase) CD34 OC125 (Celomic ovarian antigen) CD43, MT1 (T cell) P16 CD45 RA P63 CD45 RO, UCHL-1 (T cell) Pancytokeratin (AE1/AE3 & PCK26) CD45, Leukocyte common antigen (LCA) PIN-3 Triple stain (p504S/P63/HMW Cytokeratin) CD68 (KP-1) PLAP (Placental alkaline phosphatase) CD74, LN2 (B cell) PR (Progesterone receptor) CD79a (B cell) ProEx C CD117 PSA (Prostate-specific antigen) CD138 PSAP (Prostate-specific acid phosphatase) CDX2 Racemase (P504S) CEA (Carcinoembryonic antigen) S-100 Chromogranin Serotonin CK 5 & 6 Smooth-muscle Actin CK 7 Somatostatin CK 20 Super Pancytokeratin (AE1/AE3, CAM 5.2) CU-18 (Breast-related antigen) Synaptophysin Cyclin D1 TdT Cytokeratin 903 Thyroglobulin Desmin TTF-1 (Thyroid transcription factor-1) E-Cadherin Villin Vimentin

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