IMMUNOHISTOCHEMISTRY

Supervisor:

Megan Troxell, MD, PhD

Duration:

1 month

Location:

Surgical Pathology, OHSU

Goals & Objectives:

This rotation is designed primarily to train residents in the application and interpretation of immunohistochemical stains and in-situ hybridization studies, as used in routine surgical pathology, hematopathology, autopsy, neuropathology and muscle biopsy analysis. Specific goals and objectives are organized around the following core competencies.

1.    Patient Care

    Residents are expected to demonstrate a thorough understanding of how  immunohistochemistry can impact pathologic diagnosis and resulting patient care.

2.    Medical Knowledge

    Residents must demonstrate a basic understanding of the biochemistry of standard immunohistochemistry and in-situ hybridization. Residents should become familiar with common antibodies used in routine immunohistochemistry, including proper controls and interpretation.

3.    Practice-Based Learning And Improvement

    Residents are expected to make use of print and on-line information (both internet and local network) in learning about the proper use and interpretation of antibody stains. This includes gathering published references and relevant images, as well as preparing documentation and presentation materials. Residents will learn about the College of American Pathologists (CAP) sponsored testing program as a tool for monitoring the quality of the immunohistochemistry laboratory.

4.    Interpersonal And Communication Skills

    Residents are expected to be able to communicate results to clinicians and fellow pathologists by phone, email and written reports. Residents will give brief presentations to colleagues during the rotation.

5.    Professionalism

    Residents are expected to work closely with histotechnologists and other support personnel in a professional manner. Residents will assist other residents and students in consultations related to immunohistochemistry.

6.    Systems-Based Practice

    Residents must learn about cost-effective approaches to the application of immunohistochemistry. They are also expected to learn about the costs and other billing issues related to immunohistochemical tests.

Duties & Responsibilities:

1.    Learn about the standard methods used for routine immunohistochemistry, in-situ hybridization, and standard histochemistry through reading, lectures/discussions with the rotation director, and working with laboratory technicians.
2.    Review all immunohistochemical stains, including controls, with the laboratory lead worker and/or the rotation director each workday.

3. Learn about proper quality controls for titering and daily use, and requirements of CAP and other laboratory regulatory bodies.
4.    Assist the histotechnologists in the routine titering of one antibody new to the lab.
5.    Read key articles on the use of antibodies for diagnostic immunohistochemistry, as assigned by the rotation director. Present the findings of one or more recent publications on the use of a new antibody (or a new use for an established antibody) in routine immunohistochemistry at one of the daily surgical pathology conferences.

6. Present an around the microscope conference with examples of interesting/challenging cases and/or immunohistochemistry panels and pitfalls for fellow residents.
7.    Contribute to an image database that contains examples of proper and improper immunohistochemical staining results.
8.    Identify tissues that can be used for purposes of positive controls in immunohistochemistry.

Supervision & Evaluation:

1.    At the beginning of the rotation, the resident will be given a short test to assess their basic knowledge of immunohistochemistry. If the initial score is low (less than 70% correct answers), this test may be repeated at the end of the rotation to assess the resident's progress.
2.    The resident will be observed closely while working in the laboratory and at the microscope.
3.    The presentations during the rotation will be evaluated.