Megan Troxell, MD, PhD
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
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
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
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
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
2. The resident will be observed closely while working
in the laboratory and at the microscope.
3. The presentations during the rotation will be