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HelpTest Code IHCFH Fumarate Hydratase Immunostain, Technical Component Only
Ordering Guidance
Shipping Instructions
Attach the green "Attention Pathology" address label (T498) and the pink Immunostain Technical Only label included in the kit to the outside of the transport container.
Specimen Required
Specimen Type: Tissue
Supplies: Immunostain Technical Only Envelope (T693)
Container/Tube: Immunostain Technical Only Envelope
Preferred: 2 unstained positively charged glass slide (25- x 75- x 1-mm) per test ordered; sections 4-microns thick
Acceptable: Formalin-fixed, paraffin-embedded tissue block
Useful For
Identifying fumarate hydratase-deficient neoplasms
Supporting the diagnosis of an atypical smooth muscle tumor over leiomyosarcoma
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IHTOI | IHC Initial, Tech Only | No | No |
| IHTOA | IHC Additional, Tech Only | No | No |
Method Name
Immunohistochemistry (IHC)
Reporting Name
FH IHC, Tech OnlySpecimen Type
TECHONLYSpecimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| TECHONLY | Ambient (preferred) | ||
| Refrigerated | |||
Reject Due To
| Wet/frozen tissue Cytology smears Non-formalin fixed tissue Nonparaffin embedded tissue Noncharged slides ProbeOn slides |
Reject |
Clinical Information
A ubiquitously expressed mitochondrial enzyme fumarate hydratase (FH) catalyzes the reversible hydration of fumaric acid to yield I-malic acid during the Krebs cycle. Germline alterations in the FH gene cause a predisposition to renal defects like hereditary leiomyomatosis and renal cell carcinoma (HLRCC). While morphologic features are characteristic enough that they can be suspected, FH deficiency or germline DNA testing are necessary for its diagnosis. HLRCC can be associated with multiple cutaneous leiomyomas, uterine leiomyomas, and an aggressive variant of renal cell carcinoma that occurs frequently in young patients.
Interpretation
This test does not include pathologist interpretation, only technical performance of the stain. If interpretation is required, order PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case.
The positive and negative controls are verified as showing appropriate immunoreactivity. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request; call 855-516-8404.
Interpretation of this test should be performed in the context of the patient's clinical history and other diagnostic tests by a qualified pathologist.
Cautions
Age of a cut paraffin section can affect immunoreactivity. Stability thresholds vary widely among published literature and are antigen dependent. Best practice is for paraffin sections to be cut within 6 weeks.
Method Description
Immunohistochemistry on sections of paraffin-embedded tissue.(Unpublished Mayo method)
Day(s) Performed
Monday through Friday
Report Available
1 to 3 daysSpecimen Retention Time
Until staining is completePerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
88342-TC, primary
88341-TC, if additional IHC
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| IHCFH | FH IHC, Tech Only | Order only;no result |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 606335 | FH IHC, Tech Only | Bill only; no result |
Testing Algorithm
For the initial technical component only immunohistochemical (IHC) stain performed, the appropriate bill-only test ID will be reflexed and charged (IHTOI). For each additional technical component only IHC stain performed, an additional bill-only test ID will be reflexed and charged (IHTOA).
Forms
If not ordering electronically, complete, print, and send a Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request (T763) with the specimen.