Related Experiment Video
Updated: Jun 3, 2026
Simple Elimination of Background Fluorescence in Formalin-Fixed Human Brain Tissue for Immunofluorescence Microscopy
Published on: September 3, 2017
Immunohistochemistry utilization in autopsy pathology: a Canadian experience
Amy B Bromley1, Martin J Trotter
1Department of Pathology and Laboratory Medicine, University of Calgary, Canada.
Insights
Immunohistochemistry (IHC) is widely used in autopsy pathology, especially for diagnosing malignancies and neurological conditions. This study provides a benchmark for IHC utilization in complex hospital cases.
Area of Science:
- Pathology
- Diagnostic techniques
Background:
- Immunohistochemistry (IHC) is crucial in surgical pathology but its role in autopsy pathology is not well-defined.
- Autopsy pathology provides critical insights into disease processes and patient outcomes.
Purpose of the Study:
- To quantify and analyze the utilization of immunohistochemistry (IHC) in non-medicolegal, hospital-based adult autopsies.
- To establish a reference point for IHC usage in autopsy pathology.
Main Methods:
- Retrospective analysis of 609 consecutive adult autopsies over three years.
- Detailed recording of IHC requests, including stain numbers, tissue blocks, antibodies, resident involvement, and pathologist variation.
- Review of final autopsy reports for cases with IHC requests.
Main Results:
- IHC was requested in 57% of autopsies, with an average of 13.5 stains per case (4612 total stains).
- Non-neurologic tissues primarily used IHC for malignancy diagnosis; neuropathologic examinations used it for neurodegenerative conditions and clinical correlation.
- Significant variation in IHC utilization was observed among individual pathologists, while resident involvement had minimal impact.
Conclusions:
- Immunohistochemistry is extensively utilized in Canadian non-medicolegal autopsy pathology, reflecting disease complexity in academic hospital settings.
- Neuropathology significantly influences IHC utilization in autopsies.
- This study offers a valuable reference for IHC application in autopsy pathology.
Abstract:
Immunohistochemistry (IHC) is an important part of the diagnostic work-up in surgical pathology, but the use of IHC in autopsy pathology is poorly defined. We measured IHC utilization by pathologists performing 609 consecutive non-medicolegal, hospital-based, adult autopsies over a three-year period. IHC requests on non-neurologic and neurologic material were analyzed separately. Total stains, number of tissue blocks, specific antibody requests, resident trainee involvement, and ordering pathologist were recorded. For all autopsies on which IHC was requested, the final autopsy report was reviewed. IHC was requested on 345 cases (57%), and a total of 4612 stains were performed (mean 13.5 per autopsy). For non-neurologic autopsy tissues, IHC was used most commonly for the accurate diagnosis of malignancy. For neuropathologic autopsy examinations, IHC was employed most commonly to exclude neurodegenerative conditions and correlate ante-mortem clinical neurologic findings. Resident involvement did not significantly impact utilization. Individual pathologists demonstrated a wide variation in IHC utilization. We conclude that IHC is used extensively in Canadian non-medicolegal autopsy pathology reflecting the complexity, extent, and severity of disease in patients dying in a tertiary-care, academic hospital setting. Utilization is strongly influenced by the neuropathology component of these autopsies. The results provide a point of reference for IHC utilization in autopsy pathology.
