Immunohistochemistry and molecular diagnostics have been developing in parallel for some time. Because IHC is more readily accessible and its interpretation is more akin to routine morphologic examination of tissues, it has become the favored method for fine-tuning diagnoses in surgical pathology. As demonstrated here, in many instances IHC serves as a surrogate for molecular (i.e., nucleic acid) testing. In others, the molecular alteration leading to the disease process lends itself to precise, reproducible testing by PCR or FISH, whereas still other diseases either have an unknown molecular mechanism or are otherwise not amenable to molecular testing. For each specific disease, the advantages and limitations of these methods must be considered before ordering studies that can give misleading or conflicting results. By the thoughtful use of these tests in concert, a more precise classification of disease entities and a better understanding of their patho-genesis can be achieved.

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