Best practices recommendations for diagnostic IHC in lung ca
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This article published in the Journal of Thoracic Oncology provides answers and explanations for the key questions about the use of IHC in lung carcinoma diagnosis representing viewpoints of experts in thoracic pathology that should assist the community in the appropriate use of IHC in diagnostic pathology.

Since the 2015 WHO classification was introduced into clinical practice, the importance of immunohistochemistry (IHC) has figured prominently in lung cancer diagnosis. In addition to distinction of small versus non-small cell carcinoma (NSCC), patients’ treatment of choice is directly linked to histological subtypes of NSCC, which pertains to IHC results, particularly for poorly-differentiated tumors.

The use of IHC has improved diagnostic accuracy in the lung carcinoma classification, but the interpretation remains challenging in some instances.

Also, pathologists must be aware of many interpretation pitfalls, and the use of IHC should be efficient to spare the tissue for molecular testing. The IASLC Pathology Committee received questions on practical application and interpretation of IHC in lung cancer diagnosis. After discussions in several IASLC Pathology Committee meetings, the issues and caveats were summarized as eleven key questions, which cover common and important diagnostic situations in a daily clinical practice with some relevant challenging queries.

The questions included best IHC markers for distinguishing NSCLC subtypes, differences in TTF1 clones, utility of IHC in diagnosing uncommon subtypes of lung cancer and distinguishing primary from metastatic tumors.

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