<p> 1 of 5</p><p>Anatomic Pathology’s Immunohistochemistry (IHC) on Paraffin-Embedded Tissues Accession Number: Ordering Physician: Block(s): Date of Request: Patient Name: Total Slides Sent: Patient DOB: Total Antibodies Ordered:</p><p>√ Antibody a-1 ACT a-1 AT Actin, Smooth Muscle Actin, Muscle Specific Adenovirus AFP ALK Protein Alpha B Crystallin Alpha Synuclein AMACR (P504S) Androgen Receptor Annexin A1 B72.3 BAP1 BCL-2 BCL-6 Ber-EP4 Beta Amyloid Beta Catenin Bob 1 Brachyury BRAFV BRST-2 C4d Calcitonin Caldesmon Calponin Calretinin CAM5.2 Carbonic Anhydrase IX Cat Scratch Fever CD1a CD2 CD3 2 of 5 √ Antibody CD3/CD20 CD3/SMA CD4 CD4/CD8 CD5 CD7 CD8 CD10 CD13 CD14 CD15 CD19 CD20 (L26) CD21 CD23 CD25 CD30 (Ber-H2) CD31 CD33 CD34 CD34 Heme CD43 (LEU22) CD45 (LCA) CD45RA (4KB5) CD45RO (UCHL-1) CD56 CD57 CD61 CD68 CD68/CD8 CD79a CD99 (MIC2) CD117 CD123 CD138 CD163 CD163/CD4 CD163/CD8 Cdk4 CDX-2 CEA mono CEA poly Chromogranin A Clusterin CMV C-Myc Collagen IV Cyclin D1 Cytokeratin 19 Cytokeratin 20 Cytokeratin 5/6 Cytokeratin 7 Cytokeratin AE1/AE3 3 of 5 √ Antibody Cytokeratin CAM5.2 Cytokeratin Cocktail (CAM5.2 & AE1/3) D2-40 DBA.44 Desmin DOG-1 EBER ISH EBER RNA E-Cadherin EGFR EMA ER ERG Factor 13A Factor VIIIRA Fascin FOXP1 Fumarate Hydratase Gastrin GATA-3 GFAP Glucagon GLUT1 Glutamine Synthetase Glycophorin A Glypican-3 Granzyme H. pylori HBME HCG Hemoglobin A Hep B Core Hep B Surface Hepatocyte Her2/neu (4B5) HHV8 HMB-45 HPL HPV ISH HSV I HSV II IDH1 IgA Heavy chain IgD Heavy chain IgG Heavy chain IgG4 IgM Heavy chain Inhibin INI-1 Insulin K903 Kappa (IHC) 4 of 5 √ Antibody Kappa probe (ISH) Ki-67 KI67/GFAP KI67/MART Lambda (IHC) Lambda probe (ISH) Lysozyme Mammaglobin Mast Cell Tryptase MDM2 Melan A Mismatch Repair Panel (MLH1, MSH2, MSH6, PMS2) MITF MNF116 MOC-31 MUC2 MUC5AC MUC6 Mucin 4 MUM1 Myelin Basic Protein Myeloperoxidase Myogenin Myoglobin Myosin, Fast Myosin, Slow Myosin, Smooth Muscle Napsin-A NeuN Neurofilament NGFR NKI/C3 NSE Oct-2 Oct-4 p16 p53 p57 p63 Parathyroid Hormone Parvovirus PAX-2 PAX-5 PAX-8 PD-1 PGP9.5 PHH3 PIN-4 Cocktail (AMACR & p63 & 34BE12) Pituitary Panel (ACTH, FSH, GH, LH, PRL, TSH) PLAP 5 of 5 √ Antibody PR PRAP Prealbumin Prostate cocktail (p63 & 34BE12) PROX-1 PSA PSMA PTH PU.1 Rb-1 RCC S100 S100A1 Sall4 Serotonin Somatostatin SOX-10 Spirochete SV40 Synaptophysin, AP Protocol Synaptophysin, NP Protocol Tau TCL1 TCR Beta F1 TDP-43 TdT TFE3 Thyroglobulin TIA1 TLE-1 Toxoplasma TRAP TTF1 Tyrosinase Ubiquitin Varicella Zoster Vimentin WT1 WT1/EMA Other</p>