Test Code HISME Histone H3 Trimethyl K27 Immunostain, Technical Component Only
Ordering Guidance
This test includes only technical performance of the stain (no pathologist interpretation is performed). If diagnostic consultation by a pathologist is required order PATHC / Pathology Consultation.
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
Supplies: Immunostain Technical Only Envelope (T693)
Container/Tube: Immunostain Technical Only Envelope
Preferred:
-Formalin-fixed, paraffin-embedded tissue block
OR
-2 Unstained, positively charged glass slides (25- x 75- x 1-mm) per test ordered; sections 4-microns thick
Acceptable: None
Useful For
Diagnosis of malignant peripheral nerve sheath tumors and diffuse midline gliomas H3 K27M-mutant
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
Histone3 K27me3 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 Nonformalin fixed tissue Nonparaffin embedded tissue Noncharged slides ProbeOn slides Snowcoat slides |
Reject |
Clinical Information
Histone H3 trimethyl-K27 is a bivalent epigenetic regulator that silences or represses the gene. Evaluation of H3 trimethyl-K27 immunohistochemical expression is a helpful biomarker in the diagnosis of diffuse midline gliomas H3 K27M-mutant, which most frequently occur in children and with less frequency in adults. These tumors typically occur along the midline and include intrinsic pontine gliomas (DIPG), thalamic, and spinal cord diffuse gliomas. H3 K27M mutations lead to global reduction in H3 trimethyl-K27 and result in H3 trimethyl-K27 loss of expression.
Histologic mimics can be distinguishable from malignant peripheral nerve sheath tumors that show H3 trimethyl-K27 loss of expression.
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
The charge of glass slides can be affected by environmental factors and subsequently may alter slide staining. Sending unsuitable glass slides can result in inconsistent staining due to poor slide surface chemistry.
Best practices for storage of positively charged slides:
-Minimize time slides are stored after being unpackaged
-Limit exposure to high humidity and heat
-Minimize exposure to plastics
Day(s) Performed
Monday through Friday
Report Available
1 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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 |
---|---|---|
HISME | Histone3 K27me3 IHC, Tech Only | Order only;no result |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
72128 | Histone3 K27me3 IHC, Tech Only | Bill only; no result |
Forms
If not ordering electronically, complete, print, and send a Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request (T763) with the specimen.
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).