Identification of high levels of aberrant S-(2-succino)-cysteine (2SC), secondary to pathogenic alterations of the fumarate hydratase (FH) gene
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
IHTOI | IHC Initial, Tech Only | No | No |
IHTOA | IHC Additional, Tech Only | No | No |
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).
Immunohistochemistry (IHC)
IS2SCIHCTO
2SC
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).
TECHONLY
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.
Attach the green pathology address label and the pink Immunostain Technical Only label included in the kit to the outside of the transport container.
Supplies: Immunostain Technical Only Envelope (T693)
Specimen Type: Tissue
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 (FFPE) tissue block
1. Information on accessing digital images of immunohistochemical (IHC) stains and the manual requisition form can be accessed through this website: https://news.mayocliniclabs.com/ihc-stains/
2. Clients ordering stains using a manual requisition form will not have access to digital images.
3. Clients wishing to access digital images must place the order for IHC stains electronically. Information regarding digital imaging can be accessed through this website: https://news.mayocliniclabs.com/ihc-stains/#FAQ
If not ordering electronically, complete, print, and send an Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request (T763) with the specimen.
See Specimen Required
Wet/frozen tissue Cytology smears Nonformalin fixed tissue Nonparaffin embedded tissue Noncharged slides ProbeOn slides | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
TECHONLY | Ambient (preferred) | ||
Refrigerated |
Identification of high levels of aberrant S-(2-succino)-cysteine (2SC), secondary to pathogenic alterations of the fumarate hydratase (FH) gene
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).
A subset of aggressive renal tumors have pathogenic alterations of fumarate hydratase (FH) that do not result in the loss of FH expression. Typically FH alterations are associated with aberrantly high levels of S-(2-succino)-cysteine (2SC) expression observed in the nucleus. FH and 2SC immunohistochemistry assays may be used in combination to identify these pathogenic conditions. This is useful in the diagnosis of renal cell carcinomas, and cutaneous and uterine leiomyomas that occur secondary to somatic or germline (hereditary leiomyomatosis and renal cell cancer) alterations of the FH gene.
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 and documentation is retained at Mayo Clinic Rochester. 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.
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.
1. Gupta S, Swanson AA, Chen YB, et al. Incidence of succinate dehydrogenase and fumarate hydratase-deficient renal cell carcinoma based on immunohistochemical screening with SDHA/SDHB and FH/2SC. Hum Pathol. 2019;91:114-122. doi:10.1016/j.humpath.2019.07.004
2. Andrici J, Gill AJ, Hornick JL. Next generation immunohistochemistry: Emerging substitutes to genetic testing? Semin Diagn Pathol. 2018;35(3):161-169. doi:10.1053/j.semdp.2017.05.004
3. Muller M, Guillaud-Bataille M, Salleron J, et al. Pattern multiplicity and fumarate hydratase (FH)/S-(2-succino)-cysteine (2SC) staining but not eosinophilic nucleoli with perinucleolar halos differentiate hereditary leiomyomatosis and renal cell carcinoma-associated renal cell carcinomas from kidney tumors without FH gene alteration. Mod Pathol. 2018;31(6):974-983. doi:10.1038/s41379-018-0017-7
4. Buelow B, Cohen J, Nagymanyoki Z, et al. Immunohistochemistry for 2-succinocystine (2SC) and fumarate hydratase (FH) in cutaneous leiomyomas may aid in identification of patients with HLRCC (hereditary leiomyomatosis and renal cell carcinoma syndrome). Am J Surg Pathol. 2016;40(7):982-988. doi:10.1097/PAS.0000000000000626
5. Trpkov K, Hes O, Agaimy A, et al. Fumarate hydratase-deficient renal cell carcinoma is strongly correlated with fumarate hydratase mutation and hereditary leiomyomatosis and renal cell carcinoma syndrome. Am J Surg Pathol. 2016;40(7):865-875. doi:10.1097/PAS.0000000000000617
6. Magaki S, Hojat SA, Wei B, So A, Yong WH. An introduction to the performance of immunohistochemistry. Methods Mol Biol. 2019;1897:289-298. doi:10.1007/978-1-4939-8935-5_25
Immunohistochemistry on sections of paraffin-embedded tissue.(Unpublished Mayo method)
Monday through Friday
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.
88342-TC, primary
88341-TC, if additional IHC
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
2SC | 2SC IHC, Tech Only | No LOINC Needed |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
610032 | 2SC IHC, Tech Only | No LOINC Needed |
Change Type | Effective Date |
---|---|
Test Status - Test Resumed | 2023-11-07 |
Test Status - Test Down | 2023-10-25 |