General references

Leong A S-Y, Cooper K and Leong FJ W-M. Manual of diagnostic antibodies for immunohistology. First edition published 1998, Oxford University Press, ISBN 1 900 151 316. Second edition published 2003, Greenwich Medical Media ISBN 1 84110 100 1. £65.

This is an excellent manual. The core of the book consists of sections devoted to each antigen/antibody, in alphabetical order. It gives some technical information as well as immunoreactivities and diagnostic usage. The book concludes with tables of differential diagnoses and the discriminating antibodies.

The text of the first edition is highly conserved in the second. In addition, the entries for each antibody have been expanded by a median of 12% (range 0-30%). There are also 30 new antibodies, not listed in the first edition, increasing the number listed by 17% to 180. This includes a couple of very important additions, namely CD117 and TTF-1. The combination of new entries and expanded entries gives an overall increase in the length of the text of about 30%. The number of tables in the appendices has also increased by 30%, bringing the total to 52. These tables list the antibodies which are informative in particular situations and differentials. A minor niggle, but there are some perversities in the ordering of antibodies, which, erratically, have been put in strictly alphabetical order, with CD103 falling between CD10 and CD11, cytokeratin 20 preceding cytokeratin 7. Yet CD117 is after CD99 and CDw75 is correctly positioned between CD74 and CD79a. An impressive number of the references are from 2002.


Diagnostic Immunohistochemistry edited by Professor D. J. Dabbs, Churchill Livingstone. ISBN 0 443 06566 7. Published 2001. This is the most substantial publication to date dedicated to immunohistochemistry. It is organised by organ-system. Each chapter is designed to be stand-alone, which has perhaps expedited publication, but has resulted in significant duplication. In defense of this, the editor points out that this renders each chapter more self-sufficient. The greatest drawback of such duplication without cross-referencing is that the reader may not realise that there is a more substantial discussion of a subject elsewhere in the book.


The differing choices which the two above publications have had to make, to organise the information by antigen and by organ system respectively illustrates the limitation of not using a hypermedium!


Immunomicroscopy: a diagnostic tool for the surgical pathologist edited by Clive R Taylor and Richard Cote is published by Saunders Elsevier in the Major Problems in Pathology series. In 2006, the third edition was published. ISBN 0721601820. The first quarter of the book gives an excellent presentation of technical issues. This is followed by a system-based presentation, with each antibody dealt with in the context of the organ system for which it may be informative. The book concludes with chapters on tumours of unknown origin, cytopathology and fine needle aspiration, and the detection of occult metastases.


I recommend a web site called Immunoquery. Its address is:

This is what Dr DM Frisman says about his site:

"Currently, no easy way exists to determine the best panel of immunostains that will aid in the differential diagnosis of tumors, especially with the commercial explosion of available antibody reagents. To meet this need, I have developed an immunohistochemistry database query system that will: 1) list the antibodies that can differentiate between tumors entered by the user (e.g., lung adenocarcinoma vs. breast carcinoma), 2) rank the antibodies in terms of their ability to differentiate between the tumors, and 3) provide instant references to journal articles describing the reactivity of these antibodies. The query system provides a meta-analysis of the literature by utilizing a database developed over several years containing 1835 peer-reviewed references and 257,825 immunostain reactivities. Only articles using immunoperoxidase methods on paraffin-embedded material are included. Articles using flow cytometry or immunoperoxidase on frozen sections are excluded. After entering one or two specific diagnoses, the user will obtain a ranked list of antibodies. The user can also enter a single immunostain to get a list of reactivities to tested diagnoses in the database. The diagnoses can be ranked by percent reactivity to the immunostain or alphabetically. The program reports the percentage reactivity to the tumors, the number of cases tested, the confidence interval (if possible), and the references from which the data is derived."

One limitation of this type of database is the need to dichotomise results as positive or negative, when many papers report varying strengths of staining and varying proportions of cells showing immunoreactivity. Nevertheless, this site is very useful in providing an overview of the immunoreactivity with a particular antibody applied to a particular tumour. This site is also a very efficient way of finding the most apposite references; it is certainly much faster than using Pubmed/Medline.

I hope that this vade mecum and Dr Frisman's site are complementary. I cannot (yet) compete with the comprehensiveness of his site. However, I hope that the free text of my programme can make available information not amenable to capture in a structured database.