Histopathology with Reflex Custom IHC Test: Booking, Price, and Results
About Histopathology with Reflex Custom IHC Test: Booking, Price, and Results
| Find | Value |
|---|---|
| Also Known As | Histopathology with reflex IHC, Tissue biopsy with IHC panel, Immunohistochemistry with Histopathology |
| Sample Type | Tissue biopsy specimen preserved in 10% formalin |
| Fasting Required | No |
| Report Time | 6 days (may extend for complex cases requiring additional IHC markers) |
| Recommended For | All genders and ages; primarily patients with suspected or confirmed tumours requiring classification |
| Price | Starting at ₹4,900 |
What is a Histopathology with Reflex Custom IHC Test?
The histopathology with reflex custom IHC test is a specialised laboratory examination that studies tissue samples under a microscope to detect disease, injury, or abnormal cell growth. A doctor prescribes this test when a tissue biopsy is needed to confirm cancer, infection, or inflammation.
The test combines two techniques. Standard histopathology examines the physical structure and appearance of tissue cells. Immunohistochemistry (IHC) is then added automatically — or "reflexively" — when findings suggest the need for deeper analysis. This combined approach is also known as Histopathology with Reflex IHC or Tissue Biopsy with IHC Panel.
What Does a Histopathology with Reflex Custom IHC Test Measure?
This test looks for certain proteins in a small sample of tissue using special stains. The selection of tests is determined by the initial biopsy report and clinical findings.
| Parameter | What It Measures |
|---|---|
| Oestrogen receptor (ER) and Progesterone receptor (PR) | Indicates whether a tumour is hormone-sensitive (oestrogen and progesterone) |
| HER2/neu | identifies eligibility for certain targeted therapies in breast and gastric cancers |
| Ki-67 | measures how rapidly cells are dividing, indicating tumour aggressiveness |
| TTF-1 and p40 | used for subtyping lung cancers |
| Cytokeratins | proteins that help identify the tissue of origin |
| Other tumour-specific markers were chosen based on clinical and pathological findings |
Why is a Histopathology with Reflex Custom IHC Test Done?
Doctors request this test when a patient's symptoms, imaging results, or earlier test findings point to the possibility of a tumour, infection, or chronic tissue condition requiring a definitive tissue diagnosis.
Common Symptoms That May Require This Test
The following symptoms often prompt a doctor to request a tissue biopsy for histopathology with reflex custom IHC analysis:
- An unexplained lump or mass in any part of the body
- A wound, ulcer, or skin lesion that does not heal over time
- Abnormal findings on imaging scans such as CT, MRI, or ultrasound
- Unexplained or unintentional weight loss
- Suspected return of a previously treated cancer
- Abnormal results from a screening test require confirmation
- Persistent inflammation of unknown cause
Conditions This Test Can Help Detect
The histopathology with reflex IHC examination can help identify a range of conditions, including:
- Breast, lung, prostate, colorectal, ovarian, and lymph node cancers
- Metastatic cancer where the site of the original tumour is unknown
- Lynch Syndrome, a hereditary condition linked to colorectal cancer, is identified through abnormal IHC patterns
- Autoimmune diseases such as lupus and vasculitis
- Chronic infectious conditions such as tuberculosis or fungal infections
How to Prepare and What to Expect
The tissue sample for this test is collected by a surgeon or specialist during a biopsy or surgical procedure. The steps below cover what to expect before, during, and after sample collection.
Do You Need to Fast?
No fasting is required. This test is performed on a tissue specimen already collected during a biopsy, so eating and drinking habits do not affect the results.
Practical Tips Before Your Test
Preparation for the histopathology with reflex custom IHC test procedure focuses on providing accurate clinical details and coordinating the sample correctly:
- Bring a detailed clinical history, including your symptoms, previous test results, and family history, as this is required for the test
- Carry your doctor's referral letter specifying the biopsy site and clinical details
- Bring any relevant radiology reports, such as CT, MRI, PET scan, ultrasound, or X-ray results
- If a paraffin block is being submitted, include the original histopathology report
- Tell your doctor about all medications, allergies, and any known bleeding disorders before the biopsy
- Arrange for a family member or friend to accompany you if the biopsy requires anaesthesia
Step-by-Step Procedure
The histopathology with reflex custom IHC test procedure involves several stages from tissue collection to report generation:
- A qualified surgeon collects the tissue sample via needle biopsy, endoscopic biopsy, or surgical excision under appropriate anaesthesia.
- The collected tissue is immediately placed in a wide-mouth container with 10% formalin to preserve its structure.
- In the laboratory, the tissue is embedded in wax, cut into very thin slices, and mounted on glass slides.
- Special stains, including haematoxylin and eosin (H&E), are applied to highlight cellular structures for microscopic review.
- A pathologist (a doctor who specialises in examining tissue) studies the slides and records observations about cell structure and any abnormalities.
- If the findings suggest malignancy or require further classification, custom IHC markers are applied reflexively, and a detailed diagnostic report is prepared.
Factors That Can Affect Accuracy
Several pre-analytical and procedural factors can influence the reliability of results:
- Delay between tissue removal and placement in formalin, which can degrade proteins in the sample
- Incorrect fixation time, fixative formula, or inadequate tissue-to-fixative ratio
- Insufficient tissue volume collected during the biopsy
- Incomplete or missing clinical and radiological history
- Previous chemotherapy or radiotherapy, which can alter tissue appearance and marker expression
Understanding Your Histopathology with Reflex Custom IHC Test Results
Results from this test are descriptive and interpretive rather than numerical. Your pathologist will issue a written report covering tissue morphology, any IHC marker findings, tumour grade, and stage, where applicable.
| Parameter | Reference/Interpretation |
|---|---|
| Tissue Morphology | Normal, benign, pre-cancerous, or malignant (Descriptive report) |
| IHC Marker Expression | Positive/Negative or Score- Varies by marker (e.g., HER2: 0, 1+, 2+, 3+ indicates level of expression) |
| Tumour Grade | Grade I to III/IV- Low to high, indicating cell aggressiveness |
| Tumour Stage | Stage I to IV- indicating how far the disease has spread in the body |
Results During Special Conditions
Certain conditions can affect how accurately the results reflect the underlying disease:
- Prior chemotherapy or radiotherapy may alter the appearance of cells and affect the expression of IHC markers, making interpretation more challenging.
- Storage conditions and the age of archived tissue sections can affect protein stability, which may influence IHC staining intensity and reliability.
How to Maintain Healthy Levels
While there are no numerical levels to maintain with this test, the following habits support early detection and overall health:
- Attend regular health screenings as recommended by your doctor, particularly if you have a family history of cancer or autoimmune conditions.
- Report any new or persistent lumps, unexplained weight loss, or chronic symptoms to your doctor without delay.
- Follow a balanced diet and maintain regular physical activity to support your overall health and immune function
Lupin Diagnostics Histopathology with Reflex Custom IHC Test Price
The histopathology with reflex custom IHC test is available at Lupin Diagnostics starting at ₹4,900. This test requires a visit to a Lupin Diagnostics centre; home collection is not available as the tissue specimen must be collected in a clinical setting by a qualified surgeon.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 4900 |
| CHENNAI | 4900 |
| HYDERABAD | 4900 |
| KOLKATA | 4900 |
| NAVI MUMBAI | 4900 |
| PUNE | 4900 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book the histopathology with reflex custom IHC test online booking through Lupin Diagnostics:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection and submission.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
"Reflex" means the lab automatically does another test on the first biopsy when the doctor didn’t ask for it, but needs more information. The pathologist triggers it without needing a separate request from the doctor, ensuring that the tissue sample is fully characterised in a single workflow.
This test requires a tissue specimen, which can only be collected during a biopsy or surgical procedure in a clinical setting. A qualified surgeon must perform the collection under appropriate anaesthesia or local numbing medicine. This cannot be replicated in a home setting.
The standard report time is 6 days. For complex cases that need additional IHC markers or specialist review, this may extend beyond that.
Bring your doctor's referral letter specifying the biopsy site, a copy of any radiology reports (CT, MRI, PET scan, ultrasound, or X-ray), and, if a paraffin block is being submitted, the original histopathology report. A detailed clinical history is also required.
Most biopsies are performed under local anaesthesia, which numbs the area and minimises discomfort during the procedure. Some soreness, bruising, or mild swelling at the biopsy site is normal afterwards and usually settles within a few days.
Tumour characteristics can shift over time. If a cancer returns or spreads to a new site, repeat testing may be needed to check whether the marker profile has changed, as this can affect treatment decisions. Your doctor will advise whether repeat testing is necessary.
Histopathology with Reflex Custom IHC Test: Booking, Price, and Results
