IHC single marker with reporting CD56

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Tumor marker staining.

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IHC Single Marker with Reporting CD56 - Comprehensive Medical Test Guide

Section 1: Why is it done?
- Test Purpose: CD56 is an immunohistochemical (IHC) marker used to detect and identify neural cell adhesion molecule (NCAM) expression on tissue samples. This single marker test helps identify specific cell types and diagnoses various hematologic and solid malignancies.
- Primary Indications: Diagnosis of natural killer (NK) cell lymphomas; identification of NK/T-cell lymphomas; detection of neuroendocrine tumors; diagnosis of small cell carcinoma; identification of multiple myeloma; assessment of neural and neuroendocrine differentiation in malignant tumors; classification of lymphoid neoplasms.
- When Test is Performed: When tissue biopsy samples require cell lineage determination; during initial diagnosis of suspected lymphomas or neuroendocrine malignancies; as part of a comprehensive immunophenotyping panel; when precise tumor classification is needed for treatment planning; in cases of diagnostic uncertainty on standard histology.
Section 2: Normal Range
- Normal Result (Negative): No CD56 immunostaining (0% positive cells) or minimal background staining only; typically reported as 'Negative' or 'No CD56 expression detected'; indicates absence of CD56-expressing cells in the tissue sample.
- Positive Result (Abnormal): CD56 immunostaining present in ≥20% of cells (typically expressed as percentage); reported as 'Positive' with percentage of staining documented; may be classified as weak, moderate, or strong intensity based on staining characteristics.
- Interpretation Categories: Negative (0-5%): No clinically significant CD56 expression; Equivocal/Borderline (5-20%): May require clinical correlation or repeat testing; Positive (>20%): Significant CD56 expression; consistent with NK/T-cell neoplasms or neuroendocrine differentiation.
- Staining Pattern Descriptors: Membranous and cytoplasmic staining pattern typical; diffuse staining suggests strong expression; focal staining may indicate limited CD56-positive cell population.
Section 3: Interpretation
- CD56 Positive Results: Indicates presence of natural killer cells, NK cell lymphomas, or cells with neuroendocrine differentiation; specific interpretation depends on clinical context and additional immunophenotypic markers; may suggest NK/T-cell lymphomas, extranodal NK/T-cell lymphoma nasal type, or aggressive NK-cell leukemia when combined with other findings.
- CD56 Negative Results: Excludes NK-cell neoplasms; does not support neuroendocrine differentiation; aids in ruling out NK/T-cell lymphomas; indicates non-NK/T-cell origin of lymphoid proliferation; should be interpreted with other markers (CD3, CD20, CD8, etc.) for complete classification.
- Factors Affecting Results: Tissue fixation quality and duration; adequacy of tissue sample; antigen retrieval methodology; antibody concentration and quality; tissue processing variations; presence of reactive CD56+ cells in background; timing of fixation; presence of normal lymphoid tissue with intrinsic CD56+ cells.
- Clinical Significance of Patterns: Diffuse CD56 positivity: Suggests homogeneous population of NK cells or NK neoplasia; focal positivity: May indicate small clone or reactive NK population; combined with other markers: Strong CD56+ with CD3+, CD8+ may indicate NK/T-cell lymphoma; combined with neuroendocrine markers (chromogranin, synaptophysin): Suggests neuroendocrine differentiation.
Section 4: Associated Organs
- Primary Systems Involved: Lymphatic/immune system (primary); nervous system (in neuroendocrine tumors); hematopoietic system; endocrine system; respiratory system (in neuroendocrine malignancies); gastrointestinal system.
- Diseases Associated with CD56 Positivity: Extranodal NK/T-cell lymphoma, nasal type; aggressive NK-cell leukemia; NK-cell lymphoproliferative disorders; primary cutaneous NK/T-cell lymphoma; small cell carcinoma (lung, esophageal); neuroendocrine carcinomas; paraganglioma; pheochromocytoma; multiple myeloma; atypical NK-cell proliferations.
- Organs Commonly Affected: Nasal cavity and nasopharynx (NK/T-cell lymphomas); bone marrow (NK-cell leukemias); lymph nodes; liver and spleen; lungs (small cell carcinoma); skin; adrenal glands (pheochromocytoma); gastrointestinal tract; central nervous system.
- Clinical Consequences of Abnormal Results: May lead to diagnosis of aggressive hematologic malignancy; necessitates treatment planning including chemotherapy or targeted therapy; determines prognosis and staging; impacts clinical outcomes; influences survival rates; may require additional imaging or staging procedures; can affect quality of life through treatment side effects; potential for systemic complications if malignancy spreads.
Section 5: Follow-up Tests
- Recommended Follow-up Immunohistochemical Markers: CD3 (T-cell marker); CD20 (B-cell marker); CD8 (cytotoxic T-cells); CD4 (helper T-cells); TIA-1 (cytotoxic granule protein); granzyme B (cytolytic effector); perforin (cytolytic protein); Epstein-Barr virus (EBV) in situ hybridization (EBER); Ki-67 (proliferation index); CD30 (marker in T-cell lymphomas).
- Additional Laboratory Tests: Flow cytometry for immunophenotyping; T-cell receptor (TCR) gene clonality study; immunoglobulin (Ig) gene clonality study; cytogenetic analysis; FISH (fluorescence in situ hybridization) for specific translocations; molecular studies for clonal populations; complete blood count (CBC); lactate dehydrogenase (LDH); complete metabolic panel.
- Imaging Studies: CT scan (chest, abdomen, pelvis); PET-CT for lymphoma staging; MRI for CNS involvement; ultrasound for lymphadenopathy; X-ray as clinically indicated.
- Monitoring and Surveillance: Repeat biopsy if diagnosis unclear or disease progression suspected; periodic imaging based on treatment response; clinical examination every 3-6 months during and after treatment; laboratory monitoring during chemotherapy; long-term follow-up for recurrence detection.
- Neuroendocrine Marker Panel (if applicable): Chromogranin A; synaptophysin; neuron-specific enolase (NSE); somatostatin receptor analysis; hormone studies (serotonin, ACTH, VIP) depending on clinical context.
Section 6: Fasting Required?
- Fasting Requirement: NO - Fasting is not required for this test
- Reason: This is an immunohistochemical test performed on tissue biopsy samples, not a blood test. It analyzes fixed tissue obtained from biopsy, so fasting status is irrelevant.
- Patient Preparation for Tissue Biopsy: Fasting may be required depending on the biopsy type and location; follow specific instructions from your physician for the biopsy procedure; if sedation will be used, fasting typically required (usually 6-8 hours); if local anesthesia only, fasting may not be necessary.
- Medications: No medications need to be held specifically for the IHC test itself; however, anticoagulants (warfarin, aspirin, NSAIDs) may need to be held before biopsy procedure depending on location and bleeding risk; consult with your healthcare provider regarding your specific medications.
- Special Instructions: Inform healthcare provider of allergies, especially to anesthetics; wear comfortable, loose-fitting clothing; arrange for transportation if sedation will be used; plan for rest period post-biopsy depending on biopsy site; inform provider of bleeding disorders or current anticoagulation; bring insurance card and identification; arrive early for registration.
- Post-Biopsy Care: Follow specific post-biopsy instructions provided by your physician; keep biopsy site clean and dry; monitor for signs of infection; avoid strenuous activity as recommended; take pain medication if needed; report unusual bleeding or signs of infection to healthcare provider.

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