Loading

Review Article Open Access
Volume 5 | Issue 1 | DOI: https://doi.org/10.33696/pathology.5.053

Immunohistochemistry in Small Lung Biopsies: Diagnostic Pitfalls and Challenges with Limited Panels

  • 1Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80048, USA
+ Affiliations - Affiliations

Corresponding Author

Jian Jing, Jian.jing@caunschutz.edu

Received Date: October 03, 2024

Accepted Date: October 26, 2024

Abstract

With the increasing need for targeted therapies in non-small cell lung carcinoma (NSCLC), preserving sufficient biopsy material has become essential. As most lung cancer cases are advanced or inoperable at the time of diagnosis, small biopsies, including cytology specimens, often serve as the only source of diagnostic material. Accurate subclassification of adenocarcinoma and squamous cell carcinoma in NSCLC using a limited panel including TTF1 and p63/p40 immunohistochemical (IHC) staining, as well as confirming small cell carcinoma using essential IHC markers, is critical for precise diagnosis, cost-effective treatment, and optimal patient care. This review highlights common challenges in applying IHC to small lung biopsies, focusing on diagnostic pitfalls from real-world cases, including adenocarcinoma, squamous cell carcinoma, and the use of IHC markers to support neuroendocrine carcinoma diagnosis. Together, these entities account for over 94% of all lung cancers, according to 2024 cancer statistics. Relevant clinical information, epidemiology, and molecular mechanisms will also be discussed for comprehensive practice considerations. The goal is to raise awareness among practicing pathologists about the critical role of IHC applications in small lung biopsies, with the aim of improving patient care by minimizing unnecessary IHC use while ensuring accurate diagnoses.

Keywords

Lung biopsy, Adenocarcinoma, Epidemiology, Immunohistochemistry, Cell carcinoma

Author Information X