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Morphology with stains and any other tests performed at the discretion of the pathologists (flow cytometry, cytogenetics, FISH, molecular) as deemed medically necessary and a summary / comprehensive report once all tests are completed.
Used to identify amyloid in tissue sections to demonstrate amyloidosis, a rare disease characterized by the deposition of insoluble misfolded proteins in various tissues and organs. The stain uses polarized light microscopy, and in cases with positive staining, immunohistochemical stains for amyloid A, amyloid P, and immunoglobulin light chains are available for further evaluation.
Expert pathology review
Detects the cell cycle regulator cyclin D1, overexpressed in most mantle cell lymphomas. Hairy cell leukemia and plasmacytomas may show weaker expression.
Detects cells infected with cytomegalovirus. Shows no cross-reactivity with other herpes viruses or adenoviruses.
This antibody reacts with an intermediate filament protein found in smooth, skeletal, and cardiac muscle cells. It is useful for identifying tumors of myogenic origin, such as leiomyosarcomas and rhabdomyosarcomas, and may also stain reactive mesothelium and angiomatoid fibrous histiocytoma.
Identifies a cell surface protein selectively expressed in gastrointestinal stromal tumors (GIST) and complements other markers such as c-Kit (CD117). It detects most c-Kit–negative and PDGFRA-mutated GISTs that may still respond to imatinib therapy. DOG1 shows fewer cross-reactions with mesenchymal, epithelial tumors, and melanomas, improving GIST diagnostic accuracy.
BCL6 BREAKAPART | MYC BREAKAPART | IGH::BCL2 T(14:18)
Detects Epstein-Barr virus–encoded RNA within infected cells, identifying all latent EBV-infected cells, including EBV-positive lymphoblastoid cell lines and B-cell immunoblasts in infectious mononucleosis. It is also positive in EBV-associated undifferentiated nasopharyngeal carcinomas and Reed-Sternberg cells in nearly all EBV-associated Hodgkin lymphoma cases.
Identifies EBV latent membrane protein-1, a cell surface-associated protein encoded by the EBV genome and expressed by a subset of EBV-infected B-cells. It shows strong reactivity in EBV-positive lymphoblastoid cell lines, EBV-infected immunoblasts in infectious mononucleosis, and certain EBV-associated neoplasms such as Hodgkin lymphoma. LMP-1 is a less sensitive marker compared to EBER for detecting EBV infection.
Identifies a transmembrane cell-cell adhesion protein that is expressed in epithelial cells. It stains positively in glandular epithelium and in adenocarcinomas of the lung, gastrointestinal tract, and ovary. E-cadherin is useful in distinguishing adenocarcinoma from mesothelioma, and in differentiating lobular carcinoma (which shows loss or marked reduction of expression) from ductal carcinoma of the breast.
Identifies epidermal growth factor receptor, a transmembrane protein overexpressed in various tumors including lung, breast, prostate, ovarian, brain, and especially squamous cell carcinomas. EGFR serves as a therapeutic target for agents such as gefitinib, erlotinib, and cetuximab. Its expression is linked to poor prognosis and shorter disease-free survival, with most colon carcinomas showing positivity in over 1% of tumor cells.
Identifies the epidermal growth factor receptor (EGFR) protein, a transmembrane receptor tyrosine kinase involved in cell growth and differentiation. The 43B2 clone specifically detects the wild-type EGFR protein and is expressed in various epithelial tissues and tumors, including lung, breast, colorectal, and squamous cell carcinomas. EGFR overexpression is often associated with tumor aggressiveness and poor prognosis and may guide targeted therapy decisions using EGFR inhibitors.
Detects deletions or mutations in exon 19 of the EGFR gene, which are common activating mutations in non-small cell lung carcinoma (NSCLC). These mutations predict sensitivity to EGFR tyrosine kinase inhibitors such as gefitinib, erlotinib, and afatinib, aiding in targeted therapy selection and prognosis assessment.
Identifies epithelial membrane antigen (EMA), a transmembrane glycoprotein encoded by the MUC1 gene. This marker stains normal and neoplastic epithelial cells, including those from mammary epithelium
This antibody cocktail is used to distinguish luminal (ER-positive) from basal-like (CK5-positive) breast carcinomas. Estrogen receptor (ER) identifies hormone-responsive luminal epithelial cells, while cytokeratin 5 (CK5) highlights basal/myoepithelial cells. The combined stain aids in subtyping breast cancers for prognosis and treatment planning, as well as differentiating benign proliferations from malignant lesions.
ERG is a member of the ETS transcription factor gene family and is strongly overexpressed in endothelial cells and is a highly specific and sensitive marker of vascular neoplasms, and expression has been shown to be a highly specific marker for prostate cancer. ERG expression is lacking in a wide variety of normal epithelial tissues and tumors, therefore detection of ERG by IHC is a useful tool for diagnosing prostate cancer or determining prostatic origin.
Identifies a cell surface glycoprotein expressed on epithelial cells and most epithelial-derived tumors. ESA is useful for detecting carcinomas, distinguishing epithelial neoplasms from non-epithelial tumors, and aiding in the identification of metastatic carcinoma.
Detects the estrogen receptor, a nuclear hormone receptor expressed in approximately 85% of invasive breast cancers. It serves as a strong predictive marker for response to endocrine therapies such as tamoxifen and aromatase inhibitors and is used to guide hormonal treatment decisions. Even moderate to strong staining in as little as 1% of tumor cells correlates with improved disease-free survival.
A nuclear transcription factor that is reportedly the first nuclear marker of endothelial differentiation. It labels hemangiomas, angiosarcomas, Kaposis sarcoma, and Ewings and Merkel cell carcinoma. It is also expressed in normal endothelial cells, megakaryocytes, and normal breast epithelia.
A nuclear transcription factor that regulates gene expression in epithelial tissues, including the prostate, breast, and liver. FOXA1 is involved in hormone receptor signaling and differentiation, and its expression is useful in the classification of hormone-driven cancers, such as breast and prostate carcinomas, as well as in research on tumor biology and transcriptional regulation.
A nuclear transcription factor expressed primarily in ovarian granulosa cells. FOXL2 is a key regulator of ovarian development and function and is useful in identifying sex cord-stromal tumors of the ovary, particularly adult granulosa cell tumors. It helps differentiate these tumors from other ovarian neoplasms.
A nuclear transcription factor of the FOX family involved in gene regulation during development. FOXR1 expression has been reported in certain neoplasms, including neuroectodermal and embryonal tumors, and can be used as a diagnostic or research marker to help classify specific tumor subtypes.
A pituitary hormone produced by gonadotrophs that regulates reproductive function. In females, FSH promotes ovarian follicle maturation and estrogen production; in males, it stimulates spermatogenesis and testosterone secretion. Immunohistochemical detection is useful for identifying FSH in pituitary adenomas and differentiating primary from secondary ovarian failure.
Identifies von Willebrand factor, a protein synthesized by endothelial cells and stored in Weibel-Palade bodies. It is also present in platelets and megakaryocytes. Immunohistochemical detection is useful for identifying endothelial cells, diagnosing vascular neoplasms, and detecting vascular invasion by tumors.
Marks dermal dendrocytes and is used for histiocytic phenotyping. Factor XIIIa also stains capillary hemangiomas and certain central nervous system tumors. In combination with CD34, it helps differentiate dermatofibroma (Factor XIIIa positive) from dermatofibrosarcoma protuberans (CD34 positive).
A highly conserved actin-bundling protein expressed mainly in dendritic cells. Fascin is negative in most lymphoid, myeloid, and plasma cells, but positive in Reed-Sternberg cells of Hodgkin lymphoma, helping to distinguish it from anaplastic large cell lymphoma. EBV infection may induce fascin expression in B-cells.
Detects a 15 kDa protein expressed in apocrine epithelia, lacrimal, ceruminous, and Moll’s glands, as well as serous cells of salivary, tracheal, and bronchial glands. GCDFP-15 is used to identify breast carcinoma, sweat gland carcinoma, and a subset of salivary gland carcinomas. It may also be expressed in about 10% of primary lung adenocarcinomas.
Glial Fibrillary Acidic Protein (GFAP), an intermediate filament protein expressed almost exclusively in glial cells and tumors of the central nervous system. Gliomas are the most common cerebral neoplasm in adults and include astrocytomas, oligodendrogliomas and glioblastomas. It can also be demonstrated in ependymal cells, ependymomas, subependyomas, glioblastomas, mixed central nervous system neoplasms, and gangliomas. It is detected in immature but not mature oligodendrocytes and neurons, and anti-GFAP antibodies do not cross-react with neurons, fibroblasts, or muscle cells. These antibodies are useful in differentiating primary gliomas from metastatic lesions in the brain and for documenting astrocytic differentiation in tumors outside the central nervous system. GFAP is also expressed in a restricted subset of epithelial tumors, including salivary gland pleomorphic adenomas.
A pituitary hormone produced by somatotroph cells, involved in growth regulation. Immunohistochemical detection of GH is used to classify pituitary tumors and evaluate pituitary disorders, including hypopituitarism and acromegaly.
Demonstrates fungal organisms in tissue sections.
A cytoplasmic adaptor protein involved in signal transduction from receptor tyrosine kinases, including MET and EGFR. Gab1 plays a role in cell growth, differentiation, and survival. Immunohistochemical detection of Gab1 can aid in studying tumors with dysregulated MET or EGFR signaling pathways, including certain carcinomas and sarcomas.
A lectin-family protein that localizes to the cytoplasm and nucleus. Galectin-3 is up regulated in thyroid carcinomas, particularly papillary thyroid carcinoma, and helps distinguish malignant thyroid tumors from benign adenomas. It is commonly used as part of a panel to differentiate benign from malignant thyroid neoplasms.
A polypeptide hormone produced by G cells in the gastric antrum and by a subset of pancreatic islet tumors (gastrinomas). Immunohistochemical detection of gastrin identifies gastrin-producing cells in tumors and G cell hyperplasia.
A zinc finger nuclear transcription factor of the GATA family, GATA3 is a sensitive marker for breast and bladder carcinomas. It regulates luminal cell differentiation in the mammary gland and is associated with ER expression in breast cancer. GATA3 also stains subsets of squamous cell carcinomas, skin adnexal tumors, mesotheliomas, and salivary gland tumors, but is negative in prostate and renal carcinomas.
Stians peripheral blood and bone marrow smears for study of blood cell morphology.
A pancreatic hormone produced by alpha cells of the islets of Langerhans. Immunohistochemical detection of glucagon is useful for identifying glucagon-producing tumors (glucagonomas) and evaluating disorders associated with hyperglucagonemia or glucagon-induced hypoglycemia.
A transmembrane protein that facilitates glucose transport in mammalian cells. GLUT1 is expressed in colon, lung, stomach, esophagus, and breast tissues. Overexpression is associated with aggressive behavior in cancers such as breast, renal, and bladder carcinoma, and it is useful in distinguishing malignant mesothelioma from reactive mesothelial proliferations.
A cytoplasmic enzyme that catalyzes the synthesis of glutamine from glutamate and ammonia. Glutamine synthetase is expressed in hepatocytes, particularly around the central veins, and is a useful marker for identifying hepatocellular lesions, including hepatocellular carcinoma, and for assessing liver zonation and metabolic patterns.
A transmembrane protein on the surface of human erythrocytes, Glycophorin A serves as a marker of erythroid differentiation. It is expressed throughout erythroid maturation and in blast cells of erythroleukemia, but does not react with acute lymphoblastic or myeloblastic leukemia. This antibody targets an extracellular epitope specific to glycophorin A without cross-reacting with glycophorin D.
A heparan sulfate proteoglycan highly expressed in hepatocellular carcinoma and yolk sac tumors. Glypican-3 is more sensitive and specific than AFP and HepPar1 for HCC, and it helps distinguish malignant liver lesions (positive) from benign liver conditions (negative).
A cytotoxic protein expressed in cytotoxic T-lymphocytes (CTLs) and natural killer (NK) cells. Granzyme B is useful for identifying tumors of CTL or NK-cell origin and for differentiating them from other hematolymphoid neoplasms. It is commonly used in the evaluation of anaplastic large cell lymphoma, large granular lymphocytic leukemia, hepatosplenic T-cell lymphoma, intestinal T-cell lymphoma, NK-like T-cell lymphoma, NK-cell lymphoma, nasal T/NK-cell lymphoma, and subcutaneous panniculitic T-cell lymphoma.
Identifies a nuclear protein involved in the modification of DNA by protein Histone H3 and this antibody is used to identify malignant peripheral nerve sheet tumors (MPNST), about half of which show complete loss of expression of this nuclear protein. This loss of expression is highly specific to MPNST and can help distinguish it from other sarcomas and spindle cell melanomas.
A monoclonal antibody that stains normal mesothelial cells and epithelial mesotheliomas, highlighting microvilli in a thick membrane pattern. It is also used in panels to help distinguish thyroid carcinomas from adenomas and may show cytoplasmic staining in some carcinomas.
Detects cells infected with hepatitis B virus. Core antigens localize to the nucleus, while surface antigens are present in the cytoplasm. Antibodies to core antigens appear in blood after several weeks, whereas surface antigen antibodies are detectable earlier in infection.
Detects cells infected with hepatitis B virus by identifying the surface antigen (HBsAg). Antibodies to the surface antigen appear early in the course of infection and can be used to monitor exposure and infection status. Identifies hepatitis B infected cells in the liver and other sites. The antibodies to surface antigens appear at an early stage of infection.
Identifies the hormone produced by trophoblasts and secreted in large quantities by the placenta and normally found in maternal circulation during early fetal development. This antibody is useful for the identification of cells manifesting trophoblastic differentiation, e.g., in germ cell tumors.
Identifies a cell-surface protein highly expressed in mesothelial cells and epithelioid mesotheliomas. Useful in distinguishing mesothelioma from adenocarcinomas and other non-mesothelial tumors.
A transmembrane tyrosine kinase receptor in the EGFR family, HER2 is overexpressed or amplified in various tumors, including breast and gastric cancers. HER2 status serves as both a prognostic and predictive marker and guides therapy with trastuzumab and other HER2-targeted agents.
Identifies a nuclear protein expressed by cells infected with Human Herpes Virus 8, which is expressed in both Kaposi's sarcoma and HHV8-associated lymphoproliferative disorders, including primary effusion lymphomas and multicentric Castleman's disease. HHV8 encodes a latent nuclear antigen (LANA) that is the product of the viral gene 73.
Detects gp100, a premelanosome-associated protein specific to melanocytic cells. HMB-45 is a highly sensitive and specific marker for melanoma, marking most malignant melanomas, nevus cells, clear cell sarcomas, and PEComas.
A nuclear transcription factor involved in the development and function of the kidney, pancreas, liver, and genitourinary tract. HNF1B is expressed in renal cell carcinomas, ovarian clear cell carcinomas, and some pancreatic tumors, and is useful in distinguishing these tumors from other neoplasms in diagnostic pathology.
A hormone produced by placental syncytiotrophoblasts, used as a tissue marker for gestational trophoblastic tumors and to assess placental function. It is clinically valuable in evaluating patients with suspected trophoblastic disease or pregnancy-related complications, including hypertensive disorders of pregnancy.
Detects cells infected with HSV-1 and HSV-2 by targeting major viral envelope glycoproteins and at least one core protein. Does not cross-react with CMV or EBV. Useful for identifying HSV in tissue biopsies, superficial lesions, and early-stage infected cell cultures.
Identifies cells infected with Herpes Simplex Virus Type I. This antibody specifically detects HSV-I without cross-reactivity to other herpesviruses or adenoviruses, making it useful for diagnosing HSV-I infections in tissue samples.
Detects cells infected with Herpes Simplex Virus Type II. This antibody specifically identifies HSV-II without cross-reactivity to other herpesviruses or adenoviruses, aiding in the diagnosis of HSV-II infections in tissue specimens.
Used to diagnose hairy cell leukemia and hairy cell leukemia-variant. Available as global only. This add-on panel is available to clarify findings on samples currently having flow cytometry analysis at Vitro Molecular Laboratories. Markers are CD11c, CD19, CD20, CD22, CD25, CD45, CD103, kappa, and lambda (9 markers).
Detects Helicobacter pylori organisms in gastric mucosa, including on the surface and within epithelial cells. Useful for diagnosing chronic active gastritis and assessing the role of H. pylori in peptic ulcer disease.
DNA & RNA next generation sequencing (NGS) assay for a comprehensive evaluation of all hematologic neoplasms. The test covers 302 DNA genes and more than 1600 RNA genes.
It is especially recommended for:
Other Features of Hematology Profile Plus:
DNA next generation sequencing (NGS) assay designed to analyze 302 genes associated with various hematologic cancers including:
Myelodysplastic syndrome(MDS)/Chronic myelomonocytic leukemia (CMML): It helps in determining prognosis and selecting therapy, also if the patient has reactive cytopenia and will distinguish between CHIP (Clonal Hematopoiesis of Indeterminate Potential) orCCUS (Clonal Cytopenia of Unknown Significance) and MDS.
VEXAS Syndrome: Recently VEXAS(vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is caused by mutations in the UBA1 gene.
Acute Myeloid Leukemia (AML): It helps in the diagnosis of AML and distinguishes between De Novo AML vs secondary AML. It also helps in determining eligibility for treatment with FLT3 and IDH1/2 inhibitors.
Myeloproliferative Neoplasms(MPN): This includes quantitative analysis of all exons of JAK2, CALR, and MPL.
Lymphoma: Analysis of mutations reported in various types of lymphoma, including follicular, DLBCL, CLL, and T-cell lymphoma.
Multiple Myeloma: It detects mutations in the coding sequence of genes frequently mutated.
Detects carbamoyl phosphate synthetase 1, a mitochondrial protein in hepatocytes and hepatocellular carcinoma. Shows granular cytoplasmic staining and helps distinguish hepatocellular carcinoma from cholangiocarcinoma and metastatic tumors. Also labels hepatoblastoma, hepatic adenoma, and some hepatoid carcinomas.
Identifies isocitrate dehydrogenase 1, an enzyme that participates in the citric acid cycle and is mutated in a high fraction of gliomas and oligodendrogliomas, particularly in grade II and grade III neoplasms. These mutations are frequent genetic alterations in low-grade diffuse gliomas and secondary glioblastoma (70%), and has been observed in fewer than 10% of primary glioblastoma cases. The antibody is a diagnostic tool in assessing the mutational status of codon 132 (R132H) and does not cross react with the native protein, helping differentiate GBM tumors from others. Because these mutations do not occur in reactive gliosis, these can often be separated from diffuse gliomas, which are usually positive for the mutation.
Identifies the gene product of the INI-1 gene, a tumor suppressor gene, and inactivation through mutation or other mechanism characterizes a unique subset of tumors that includes renal and extrarenal rhabdoid tumors, atypical teratoid/rhabdoid tumors of the central nervous system, distal and proximal variants of epithelioid sarcoma, as well as a subset of mesenchymal chondrosarcomas, epithelioid malignant peripheral nerve sheath tumors, and soft tissue myoepitheliomas. A lack of nuclear expression of INI1 is characteristic of malignant rhabdoid tumors and epithelioid sarcomas.
Identifies a transcription factor that is a sensitive and specific marker for neuroendocrine tumors. As a nuclear stain, it is as good as or better than synaptophysin and is superior to chromogranin. It is rarely expressed on adenocarcinoma or squamous cell carcinomas without neuroendocrine differentiation.
This antibody reacts with immunoglobulin Ig alpha chains to identify IgA-positive plasma cells and plasma cell neoplasms, as well as leukemias, plasmacytomas, and B-cell lymphomas.
This antibody reacts with immunoglobulin Ig delta chains, cytoplasmic proteins strongly expressed by naive/mantle zone B-cells and a small subset of plasma cells, and weakly expressed by germinal center B cells. This antibody is useful in identifying leukemias, plasmacytomas, and B-cell lineage lymphomas, as well as a subset of B-cell non-Hodgkin lymphomas and normal mantle zone B-lymphocytes.
Detects IgE-expressing plasma cells and B-cells. Useful in evaluating IgE-related plasma cell neoplasms, leukemias, and B-cell lymphomas.
This antibody reacts with immunoglobulin Ig gamma chains to identify plasma cell neoplasms and B-cell lineage lymphomas. It is also used in conjunction with IgG4 staining to asses for IgG4 associated disease.
Detects IgG4-positive plasma cells, commonly found in autoimmune pancreatitis. Useful for distinguishing autoimmune pancreatitis from pancreatic ductal adenocarcinoma and chronic alcoholic pancreatitis, as IgG4-positive cells are typically absent or rare in these conditions.
Detects IgM-positive plasma cells and plasma cell neoplasms by targeting Ig mu chains. Useful for identifying leukemias, plasmacytomas, and B-cell lineage lymphomas.
Detects Inhibin-α, a peptide hormone that inhibits pituitary FSH secretion. Expressed in granulosa cells, sex cord-stromal tumors, and adrenal cortical cells/tumors. Useful for distinguishing adrenocortical tumors from renal cell carcinoma.
Detects insulin in pancreatic islet cells. Useful for identifying insulin-producing tumors (insulinomas) or islet cell hyperplasia, and for evaluating insulin production in hypoglycemia or diabetes. Cannot distinguish endogenous insulin from exogenous insulin administration.
Identifies the neuronal intermediate filament protein Internexin, used to detect neuronal differentiation in tumors such as neuroblastoma, ganglioglioma, and other CNS neoplasms.
Used to detect ferric (Fe3+) iron in tissue preparations, blood smears, or bone marrow smears, minute amounts of which are commonly found in bone marrow and in the spleen.
Identifies Kappa and lambda immunoglobulin light chains, which are expressed by plasma cells and plasmacytoid lymphocytes, and less reliably detected on B cells with small amounts of cytoplasm. This antibody is useful in the identification of leukemias, plasmacytomas, and certain non-Hodgkin lymphomas. Demonstration of monotypism in lymphoid infiltrates is a surrogate for clonality, and therefore malignancy.
Detects kappa light chain mRNA in plasma cells and plasmacytoid B cells. Used to evaluate clonality and distinguish neoplastic from reactive lymphoid proliferations, including multiple myeloma, plasmacytoma, and plasmacytoid or immunoblastic lymphomas.
Identifies a high–molecular-weight acidic cytokeratin found in stratified epithelia. It is useful in detecting squamous cell carcinomas and distinguishing stratified epithelial cells from simple epithelial cells. It has also been studied as a prognostic marker in breast cancer.
Identifies a subset of epithelia and carcinomas and distinguishes myoepithelial cells from luminal epithelium of various glands (mammary, sweat, salivary, bronchial, tracheal, laryngeal, esophageal) and benign from malignant forms of tumors. Expression can also help identify primary carcinomas of the pancreatobiliary tract, distinguishing them from ovarian mucinous adenocarcinomas and carcinnomas of the stomach, among others. Predominant expression of CK17 is the characteristic feature of basal cell carcinomas.