> For the complete documentation index, see [llms.txt](https://www.parapathology.com/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://www.parapathology.com/stains/antibody-list.md).

# Comprehensive IHC Antibody Menu for a National Reference Pathology Laboratory

### Dako Omnis / Agilent-prioritized, international-standard clones — tiered per subspecialty

**Bottom line:** A comprehensive national reference IHC menu should run \~340–360 distinct antibodies (well within the \~300–500 range expected of such a center), split into \~110–120 Tier 1 "essential core" markers that carry daily diagnostic volume and \~220–240 Tier 2 "extended reference" markers. Where possible, clone selection below is anchored to NordiQC external-quality-assessment (EQA) performance and, for predictive markers, to FDA/EMA companion-diagnostic pairings and CAP/ASCO-CAP guidance. Because you run Dako Omnis, I flag Agilent/Dako FLEX RTU products that perform well **and** explicitly flag the several clones NordiQC shows underperform on Omnis (desmin D33, MLH1 ES05 RTU IS079, PAX8 MRQ-50), so you can pre-empt validation failures.

***

## How the tiering and clone recommendations were decided

* **Primary source for "recommended clone":** NordiQC (nordiqc.org) publishes per-clone pass/optimal rates across the three main platforms (Dako/Agilent Omnis, Roche/Ventana BenchMark, Leica Bond). I prefer clones rated sufficient/optimal and note where NordiQC data favors one clone or flags a poor performer.
* **Predictive/companion markers:** follow FDA/EMA assay–drug pairings and CAP/ASCO-CAP guidelines, not just diagnostic performance.
* **Tier 1 = essential core** every high-volume lab must have; **Tier 2 = specialized/esoteric** markers expected only of a national reference center.
* **Omnis-specific flags:** several clones underperform specifically on Omnis; for those, run the concentrate as an LDT with alkaline HIER (TRS High pH) + 3-step detection, or source the Ventana/Leica RTU.

## Quality/validation context for a reference lab

* **Validation (CAP/CLSI "20/10 rule"):** ≥20 positive + ≥20 negative cases for predictive markers (ER, PR, HER2, PD-L1, MMR); ≥10 positive + ≥10 negative for non-predictive markers. Revalidate on any protocol/retrieval/platform change.
* **EQA:** Enroll in NordiQC and/or UK NEQAS ICC & ISH for all predictive and high-impact markers (NordiQC modules: General, Breast, HER2 ISH, Companion).
* **Controls:** on-slide multi-tissue controls including a low-expressor tissue (tonsil+kidney for MMR/EMA, pancreas for CK7/CDX2, testis for NKX3.1/PRAME/OCT3-4).
* **Accreditation:** ISO 15189 is the operative standard; in Turkey, TÜRKAK accreditation to ISO 15189 and TİTCK device registration apply — but the menu itself is built to international standard.

***

## 1. Epithelial / carcinoma workup & cytokeratins

### Tier 1

| Marker          | Recommended clone(s)                                                                                 | Note                                |
| --------------- | ---------------------------------------------------------------------------------------------------- | ----------------------------------- |
| Pan-CK          | AE1/AE3 (Dako FLEX RTU)                                                                              | Broad epithelial screen             |
| CK (low MW)     | CAM5.2 (CK8/18)                                                                                      | Adenocarcinoma                      |
| CK7             | **OV-TL 12/30** — Dako FLEX RTU GA619 gave highest optimal rate (97%) in NordiQC                     | Upper-GI/pulmonary/gynae epithelium |
| CK20            | **Ks20.8** (Dako FLEX RTU); alt SP33 (Ventana)                                                       | Colorectal/urothelial/Merkel        |
| CK5/6           | D5/16B4 (Dako) — **NordiQC found D5/16 B4 less successful for CK5; RTU XM26 or SP27 performed best** | Squamous/mesothelial/myoepithelial  |
| 34βE12 / HMW-CK | 34βE12 (CK903)                                                                                       | Basal/squamous                      |
| p63             | DAK-p63 / 4A4                                                                                        | Squamous, myoepithelial, urothelial |
| EMA / MUC1      | **E29** (Dako FLEX RTU) — NordiQC most reliable; GP1.4 gave no sufficient results                    | Epithelial/perineurial/plasma cells |

### Tier 2

| Marker              | Clone(s)               | Note                      |
| ------------------- | ---------------------- | ------------------------- |
| CK8/18              | B22.1 & B23.1 / Zym5.2 | LMW CK                    |
| CK19                | RCK108 / b170          | Thyroid, HCC differential |
| CK17 / CK14         | E3 / LL002             | Squamous/basal subsets    |
| Cadherin-17 (CDH17) | EPR3312                | GI adeno, medullary CRC   |

***

## 2. Breast pathology

### Tier 1

| Marker     | Recommended clone(s)                                                                                          | Note                                            |
| ---------- | ------------------------------------------------------------------------------------------------------------- | ----------------------------------------------- |
| ER         | **EP1 (Dako FLEX RTU)** — strongest NordiQC performance on Omnis; alt SP1, 1D5                                | ASCO/CAP; tonsil sensitivity control            |
| PR         | **PgR636 / PgR 1294 (Dako)**; alt 1E2 (Ventana), clone 16                                                     | ASCO/CAP                                        |
| HER2 (IHC) | **HercepTest mAb clone DG44, GE001 for Dako Omnis** — 100% pass, 76–91% optimal in NordiQC; alt 4B5 (Ventana) | ASCO/CAP 2023; DG44 more sensitive for HER2-low |
| Ki-67      | MIB-1 (Dako FLEX RTU); alt 30-9, K2, SP6                                                                      | All NordiQC-recommendable                       |
| GATA3      | **L50-823** (Ventana RTU best in NordiQC); alt EP368, QR018                                                   | Breast/urothelial                               |
| E-cadherin | **NCH-38** — NordiQC optimal on all platforms; alt EP700                                                      | Ductal vs lobular                               |
| p63        | 4A4 / DAK-p63                                                                                                 | Myoepithelial                                   |

### Tier 2

| Marker            | Clone(s)                                 | Note                                       |
| ----------------- | ---------------------------------------- | ------------------------------------------ |
| GCDFP-15          | 23A3 / EP1582Y                           | Apocrine/mammary                           |
| Mammaglobin       | 304-1A5 / 31A5                           | Mammary                                    |
| SOX10             | SP267 (Ventana RTU; NordiQC 95% optimal) | Triple-negative/basal, metaplastic         |
| TRPS1 (TRPS2)     | EPR16171                                 | Highly sensitive breast lineage incl. TNBC |
| p120 catenin      | 6H11 / EP66                              | Lobular (cytoplasmic) vs ductal            |
| Calponin          | CALP                                     | Myoepithelial                              |
| SMM-HC            | SMMS-1                                   | Myoepithelial                              |
| Androgen receptor | AR441 / SP107                            | Molecular apocrine, TNBC subtyping         |

***

## 3. Gastrointestinal & pancreatobiliary

### Tier 1

| Marker      | Recommended clone(s)                                                                                     | Note                                      |
| ----------- | -------------------------------------------------------------------------------------------------------- | ----------------------------------------- |
| CDX2        | **EPR2764Y or DAK-CDX2** (Dako FLEX RTU); also EP25 — NordiQC 97% sufficient                             | Intestinal lineage                        |
| SATB2       | **EP281** (Ventana RTU most successful 89%; EP281 concentrate weak on Bond/Omnis — use 3-step detection) | Colorectal/appendiceal, osteoblastic      |
| Villin      | CWWB1 / ID2C3                                                                                            | Brush-border/GI                           |
| DOG1        | K9 / SP31                                                                                                | GIST                                      |
| CD117 (KIT) | **DAK-CD117 polyclonal (Dako FLEX RTU)** / YR145                                                         | GIST, mastocytosis                        |
| β-catenin   | β-catenin-1                                                                                              | Nuclear in desmoid, solid-pseudopapillary |
| SMAD4/DPC4  | EP618Y / B-8                                                                                             | Loss in pancreatic ductal adeno           |

### Tier 2

| Marker               | Clone(s)               | Note                                  |
| -------------------- | ---------------------- | ------------------------------------- |
| HepPar-1             | OCH1E5                 | Hepatocellular                        |
| Arginase-1           | EPR6672 / polyclonal   | More specific hepatocellular          |
| Glypican-3           | 1G12 / GC33            | HCC, yolk sac                         |
| Glutamine synthetase | EP164 / GS-6           | β-catenin-activated adenoma, HCC      |
| SDHB                 | 21A11AE7               | Loss in SDH-deficient GIST            |
| MUC2 / MUC5AC / MUC6 | Ccp58 / CLH2 / CLH5    | Mucinous subtyping                    |
| IMP3 (IGF2BP3)       | 69.1                   | Pancreatobiliary/high-grade dysplasia |
| Maspin               | EAW24                  | Pancreatic ductal adeno (nuclear)     |
| Mesothelin           | 5B2                    | Pancreatic/mesothelial                |
| Annexin A10          | 1-CET-9C10             | Pancreatobiliary, gastric foveolar    |
| Cadherin-17          | EPR3312                | GI lineage                            |
| Claudin-18.2         | 43-14A (see Companion) | zolbetuximab CDx                      |

***

## 4. MMR / Lynch & GI predictive

### Tier 1

| Marker     | Recommended clone(s)                                                                                                          | Note                                              |
| ---------- | ----------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------- |
| MLH1       | **ES05** (Dako FLEX RTU & Leica) — best NordiQC pass (94% on Bond); Omnis RTU IS079 dropped performance — calibrate carefully | Predictive/Lynch (20/10 validation)               |
| PMS2       | **EP51** (Dako/Agilent & Leica RTU 96–100%); **avoid Ventana A16-4 RTU — inferior 32% NordiQC**                               | Pairs with MLH1                                   |
| MSH2       | **G219-1129 / FE11** (Dako FLEX RTU GA085 93% optimal; Ventana 760-5093 95%)                                                  | Pairs with MSH6                                   |
| MSH6       | EP49 / SP93 (NordiQC 90% pass)                                                                                                | Detects isolated MSH6 loss                        |
| BRAF V600E | **VE1** (Ventana RTU)                                                                                                         | Reflex after MLH1 loss; also melanoma/thyroid/HCL |

### Tier 2

| Marker         | Clone(s)                                                                                           | Note                     |
| -------------- | -------------------------------------------------------------------------------------------------- | ------------------------ |
| HER2 (gastric) | 4B5 (Ventana) / HercepTest                                                                         | Gastric-specific scoring |
| Claudin-18.2   | 43-14A (Ventana RxDx)                                                                              | see Companion            |
| MMR note       | Always run all four; MLH1 M1 clone gives dot-like pattern pitfall (avoid false isolated PMS2 loss) | —                        |

***

## 5. Genitourinary

### Tier 1

| Marker                 | Recommended clone(s)                                                                                                       | Note                                                     |
| ---------------------- | -------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------- |
| PSA                    | ER-PR8 / polyclonal (Dako FLEX RTU)                                                                                        | Prostatic                                                |
| NKX3.1                 | **EP356** (NordiQC 94% pass, all platforms)                                                                                | More specific/sensitive than PSA for metastatic prostate |
| AMACR (P504S)          | **13H4 (Dako RTU 100%) or SP116 (Ventana RTU 100%)** — SP116 needs 3-step for optimal                                      | Prostate carcinoma                                       |
| PIN4 / triple cocktail | 4A4 (p63) + 34βE12 + P504S                                                                                                 | Basal cell + carcinoma                                   |
| GATA3                  | L50-823                                                                                                                    | Urothelial                                               |
| PAX8                   | **SP348 (Ventana RTU 100%; NordiQC-preferred)** or QR016; **avoid MRQ-50 — poor on Omnis/Ventana, cross-reacts with PAX5** | Renal/Müllerian/thyroid                                  |
| ERG                    | EPR3864                                                                                                                    | Prostate (fusion), vascular                              |

### Tier 2

| Marker                  | Clone(s)            | Note                           |
| ----------------------- | ------------------- | ------------------------------ |
| PSAP                    | PASE/4LJ            | Prostatic (poorly diff.)       |
| Uroplakin II            | BC21                | Highly specific urothelial     |
| Uroplakin III           | AU1 / SP73          | Urothelial                     |
| S100P                   | 16/f5               | Urothelial                     |
| Thrombomodulin          | 1009                | Urothelial                     |
| CD10                    | 56C6                | RCC, others                    |
| RCC marker              | 66.4.C2             | Renal                          |
| CAIX                    | EP161 / polyclonal  | Clear cell RCC (membranous)    |
| PAX2                    | EP235               | Renal/Müllerian                |
| TFE3                    | MRQ-37              | Xp11 translocation RCC         |
| TFEB                    | MRQ-52 / polyclonal | t(6;11) RCC                    |
| Fumarate hydratase (FH) | J-13                | Loss in HLRCC/FH-deficient RCC |
| 2SC                     | polyclonal          | Surrogate for FH deficiency    |
| Cathepsin K             | 3F9                 | TFE/TFEB RCC, PEComa           |
| ALK                     | D5F3 / 5A4          | ALK-rearranged RCC             |
| INI1/SMARCB1            | MRQ-27              | Medullary RCC loss             |

***

## 6. Gynecologic

### Tier 1

| Marker    | Recommended clone(s)                                                                                                                       | Note                                   |
| --------- | ------------------------------------------------------------------------------------------------------------------------------------------ | -------------------------------------- |
| PAX8      | SP348 (Ventana RTU) / QR016                                                                                                                | Müllerian/renal/thyroid                |
| WT1       | **6F-H2** (Dako FLEX RTU)                                                                                                                  | Serous (diffuse nuclear)               |
| p53       | **DO-7** (Dako FLEX RTU) — interpret by mutation pattern (wild-type vs aberrant/null); NordiQC pass rates low (\~65%), calibrate carefully | Serous/endometrial molecular surrogate |
| p16       | **E6H4 (CINtec, Ventana RTU 100% NordiQC)**; alt JC8 (Dako), 6H12 (Leica)                                                                  | HPV surrogate; block-type positivity   |
| ER / PR   | EP1 / PgR636                                                                                                                               | see Breast                             |
| Napsin A  | polyclonal / IP64                                                                                                                          | Clear cell carcinoma                   |
| MMR panel | see Section 4                                                                                                                              | Endometrial universal screen           |

### Tier 2

| Marker           | Clone(s)              | Note                                  |
| ---------------- | --------------------- | ------------------------------------- |
| HNF-1β           | EPR16897 / polyclonal | Clear cell                            |
| Vimentin         | V9                    | Endometrioid vs endocervical          |
| PTEN             | 6H2.1 / Y184          | Endometrioid loss                     |
| ARID1A (BAF250a) | EPR13501 / D2A8U      | Clear cell/endometrioid loss          |
| SALL4            | 6E3 / EP299           | Germ cell                             |
| p57 (CDKN1C)     | KP10 / 57P06          | Complete vs partial hydatidiform mole |
| hPL              | polyclonal            | Trophoblast                           |
| SF1 / inhibin    | N1665 / R1            | Sex-cord stromal                      |

***

## 7. Pulmonary / thoracic

### Tier 1

| Marker   | Recommended clone(s)                                                                                                                                                                                      | Note                              |
| -------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------- |
| TTF-1    | **SPT24 or SP141** — NordiQC: 8G7G3/1 alarmingly low pass (3%, run 46); SPT24 88%, SP141 94%. **Trade-off: SPT24/SP141 more sensitive but 8G7G3/1 more specific (less SqCC/mesothelioma cross-staining)** | Lung adeno/thyroid                |
| Napsin A | polyclonal / IP64                                                                                                                                                                                         | Lung adeno                        |
| p40      | **BC28** (Dako RTU DAK-p40 100%; NordiQC 94% pass) — avoid polyclonal p40                                                                                                                                 | Squamous (more specific than p63) |
| CK5/6    | D5/16B4 (see caveat) / SP27                                                                                                                                                                               | Squamous                          |
| PD-L1    | 22C3 (Dako GE006) — see Companion                                                                                                                                                                         | NSCLC CDx                         |

### Tier 2 (incl. mesothelioma panel)

| Marker             | Clone(s)                                                                                                                                                                                          | Note                                           |
| ------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------- |
| ALK                | **D5F3** (Ventana CDx)                                                                                                                                                                            | NSCLC fusion                                   |
| ROS1               | **D4D6** (screen) / SP384                                                                                                                                                                         | Confirm by FISH/NGS                            |
| pan-TRK            | EPR17341                                                                                                                                                                                          | NTRK fusion screen                             |
| Calretinin         | DAK-Calret1 / SP65                                                                                                                                                                                | Mesothelial                                    |
| WT1                | 6F-H2                                                                                                                                                                                             | Mesothelial                                    |
| D2-40 (podoplanin) | D2-40                                                                                                                                                                                             | Mesothelial/lymphatic                          |
| BAP1               | **C-4** (NordiQC dominant clone, \~65% pass concentrate — calibrate); loss = mesothelioma                                                                                                         | Nuclear loss                                   |
| MTAP               | EPR6893                                                                                                                                                                                           | Cytoplasmic loss = CDKN2A codeletion surrogate |
| Claudin-4          | **3E2C1 / polyclonal** — no main-vendor RTU; carcinoma+ / mesothelioma−                                                                                                                           | Highly specific carcinoma marker               |
| HEG1               | **SKM9-2** — per Churg et al., Histopathology 2023 (4-lab data): membrane staining in 393/434 (91%) epithelioid/biphasic mesotheliomas vs 1/360 (0.3%) NSCLC (sensitivity 91%, specificity 99.7%) | Mesothelial                                    |
| DLL3               | SP347 (Ventana)                                                                                                                                                                                   | SCLC; tarlatamab context                       |

***

## 8. Head & neck, salivary, thyroid, endocrine

### Tier 1

| Marker         | Recommended clone(s)                                           | Note                                   |
| -------------- | -------------------------------------------------------------- | -------------------------------------- |
| p16            | E6H4                                                           | HPV-associated OPSCC surrogate         |
| SOX10          | SP267                                                          | Salivary, melanocytic, S100 substitute |
| S100           | polyclonal (Dako FLEX RTU) / 4C4.9                             | Salivary/nerve                         |
| Thyroglobulin  | DAK-Tg6 / 2H11+6E1                                             | Thyroid follicular                     |
| TTF-1          | SPT24 / SP141 (see caveat); 8G7G3/1 for specificity            | Thyroid/lung                           |
| PAX8           | SP348                                                          | Thyroid/parathyroid                    |
| Calcitonin     | polyclonal / SP17                                              | Medullary thyroid                      |
| Chromogranin A | **LK2H10 (± PHE5), DAK-A3** — NordiQC: LK2H10 most robust      | Neuroendocrine                         |
| Synaptophysin  | **MRQ-40 or SNP88** (higher sensitivity than DAK-SYNAP/27G12)  | Neuroendocrine                         |
| INSM1          | **MRQ-70** (NordiQC 93% — superior to widely-cited A-8 at 55%) | Neuroendocrine transcription factor    |

### Tier 2

| Marker                            | Clone(s)           | Note                                    |
| --------------------------------- | ------------------ | --------------------------------------- |
| NUT                               | C52B1              | NUT carcinoma                           |
| PLAG1                             | polyclonal / 3B7   | Pleomorphic adenoma                     |
| HMGA2                             | polyclonal         | Pleomorphic adenoma/lipoma              |
| MYB                               | EP769Y             | Adenoid cystic carcinoma                |
| NR4A3                             | polyclonal / H-7   | Acinic cell carcinoma                   |
| pan-TRK                           | EPR17341           | Secretory carcinoma (MASC)              |
| Mammaglobin                       | 304-1A5            | Secretory carcinoma                     |
| Androgen receptor                 | AR441 / SP107      | Salivary duct carcinoma                 |
| DOG1                              | K9                 | Acinic cell                             |
| Monoclonal CEA                    | II-7 / COL-1       | Medullary thyroid, biliary              |
| PTH                               | polyclonal         | Parathyroid                             |
| Insulin / glucagon / somatostatin | polyclonal         | Islet/endocrine typing                  |
| SF1 (NR5A1)                       | N1665 / polyclonal | Adrenal cortical, pituitary gonadotroph |
| Inhibin-α                         | R1                 | Adrenal cortical, sex-cord              |
| Melan-A                           | A103               | Adrenal cortical, melanocytic           |
| SDHB                              | 21A11AE7           | Paraganglioma/pheo syndromic loss       |
| Parafibromin (CDC73)              | 2H1                | Loss in parathyroid carcinoma           |
| PIT1 / TPIT / SF1                 | —                  | Pituitary lineage typing                |

***

## 9. Hematopathology

### Tier 1

| Marker         | Recommended clone(s)                                                               | Note                                  |
| -------------- | ---------------------------------------------------------------------------------- | ------------------------------------- |
| CD3            | polyclonal A0452 / LN10 / F7.2.38 (Dako FLEX RTU) — HIER mandatory                 | T cells                               |
| CD20           | **L26** (Dako FLEX RTU; Leica/Ventana RTU 100% NordiQC)                            | B cells                               |
| CD79a          | JCB117                                                                             | B cells (incl. post-rituximab)        |
| PAX5           | **DAK-PAX5** (NordiQC most robust; avoid SP34 — aberrant staining)                 | B lineage                             |
| CD5            | 4C7                                                                                | T cells, CLL/MCL                      |
| CD10           | 56C6                                                                               | GC, FL, BL                            |
| BCL2           | 124 (Dako) / E17                                                                   | FL, DLBCL                             |
| BCL6           | **PG-B6p or LN22** (Dako Omnis RTU best; GI191E/A8 Ventana poorer signal-to-noise) | GC                                    |
| MYC            | Y69                                                                                | High-grade/double-hit                 |
| Cyclin D1      | EP12 / SP4 (NordiQC 95% pass)                                                      | MCL, HCL, myeloma                     |
| CD30           | Ber-H2                                                                             | HL, ALCL, embryonal                   |
| CD15           | Carb-3 / MMA                                                                       | HL                                    |
| Ki-67          | MIB-1                                                                              | Proliferation                         |
| Kappa / Lambda | polyclonal IHC + mRNA ISH                                                          | Plasma cell clonality (ISH preferred) |

### Tier 2

| Marker                        | Clone(s)                                         | Note                      |
| ----------------------------- | ------------------------------------------------ | ------------------------- |
| SOX11                         | MRQ-58                                           | Cyclin D1-neg MCL         |
| CD23                          | DAK-CD23 / SP23                                  | CLL, FDC                  |
| LEF1                          | EP310                                            | CLL                       |
| CD138                         | MI15                                             | Plasma cells              |
| MUM1/IRF4                     | **MUM1p** (Dako GA644 100%, 98% optimal NordiQC) | Plasma cell/ABC-DLBCL     |
| ALK1                          | ALK1 / D5F3                                      | ALCL                      |
| TdT                           | polyclonal / SEN28                               | Lymphoblastic             |
| CD34                          | QBEnd/10                                         | Blasts, vascular          |
| CD117                         | polyclonal / YR145                               | Mast cells, AML           |
| MPO                           | polyclonal                                       | Myeloid                   |
| CD68                          | PG-M1 / KP1                                      | Histiocytes               |
| CD163                         | MRQ-26 / 10D6                                    | Histiocytes               |
| Lysozyme                      | polyclonal                                       | Myelomonocytic            |
| CD21 / CD23                   | 1F8 / DAK-CD23                                   | FDC meshworks             |
| CD4 / CD8 / CD7 / CD2         | 4B12 / C8/144B / CBC.37 / AB75                   | T-subset                  |
| CD56                          | 123C3 / MRQ-42                                   | NK/T, plasma cell, NE     |
| TIA-1 / granzyme B / perforin | 2G9 / GrB-7 / 5B10                               | Cytotoxic                 |
| EBV LMP1 + EBER-ISH           | CS.1-4 + EBER ISH                                | EBER ISH is gold standard |
| HHV8/LANA                     | 13B10                                            | KS, PEL, Castleman        |
| PD-1                          | NAT105                                           | TFH, follicular           |
| PD-L1                         | 22C3 / 28-8                                      | cHL, therapy              |
| CD25                          | 4C9                                              | HCL, ATLL                 |
| CD123                         | 6H6 / polyclonal                                 | pDC, BPDCN, HCL           |
| TCL1                          | 27D6                                             | pDC, CLL                  |
| Annexin A1                    | EP75                                             | HCL                       |
| BRAF VE1                      | VE1                                              | HCL                       |
| Langerin/CD207                | 12D6                                             | LCH                       |
| CD1a                          | O10 / EP3622                                     | LCH, cortical thymocytes  |
| S100                          | polyclonal                                       | LCH, RDD, histiocytoses   |
| IgG4 / IgG                    | polyclonal                                       | IgG4-RD ratio             |
| Tryptase                      | AA1                                              | Mast cells/mastocytosis   |
| ERG                           | EPR3864                                          | Vascular/endothelial      |

***

## 10. Soft tissue & bone

### Tier 1

| Marker      | Recommended clone(s)                                                                                                | Note                             |
| ----------- | ------------------------------------------------------------------------------------------------------------------- | -------------------------------- |
| SMA         | 1A4                                                                                                                 | Myoid                            |
| Desmin      | **D33 (Dako FLEX RTU) — NOT recommended on Dako Omnis per NordiQC; use DE-R-11 with HIER (not enzymatic) on Omnis** | Myogenic                         |
| h-caldesmon | h-CD / E89                                                                                                          | Smooth muscle vs myofibroblast   |
| Myogenin    | F5D                                                                                                                 | Rhabdomyosarcoma                 |
| MyoD1       | EP212 / 5.8A                                                                                                        | Rhabdomyosarcoma                 |
| S100        | polyclonal / 4C4.9                                                                                                  | Nerve sheath, cartilage          |
| SOX10       | SP267 (NordiQC 92% pass)                                                                                            | Nerve sheath, melanocytic        |
| CD34        | QBEnd/10                                                                                                            | SFT, DFSP, vascular              |
| STAT6       | YE361 / EP325                                                                                                       | Solitary fibrous tumor (nuclear) |
| Ki-67       | MIB-1                                                                                                               | Grading                          |
| β-catenin   | β-catenin-1                                                                                                         | Desmoid (nuclear)                |

### Tier 2

| Marker           | Clone(s)            | Note                                                   |
| ---------------- | ------------------- | ------------------------------------------------------ |
| MUC4             | 8G7                 | Synovial sarcoma, LGFMS                                |
| TLE1             | EPR9060 / 1F5       | Synovial sarcoma                                       |
| INI1/SMARCB1     | MRQ-27 / 25         | Loss: epithelioid sarcoma, rhabdoid                    |
| BRG1/SMARCA4     | EPNCIR111A          | Loss: SMARCA4-deficient tumors                         |
| ALK              | D5F3 / 5A4          | IMT                                                    |
| ROS1             | D4D6                | IMT subset                                             |
| pan-TRK          | EPR17341            | NTRK sarcoma, LFN tumor                                |
| CD99             | 12E7 / O13          | Ewing (membranous)                                     |
| NKX2.2           | EP336               | Ewing                                                  |
| FLI1             | MRQ-1               | Ewing, vascular                                        |
| ERG              | EPR3864             | Vascular, Ewing subset                                 |
| CAMTA1           | polyclonal          | Epithelioid hemangioendothelioma                       |
| TFE3             | MRQ-37              | ASPS, PEComa                                           |
| WT1 (C-terminus) | 6F-H2               | DSRCT                                                  |
| H3K27me3         | polyclonal / C36B11 | MPNST loss                                             |
| H3G34W           | RM263               | Giant cell tumor of bone                               |
| H3K36M           | RM193               | Chondroblastoma                                        |
| SATB2            | EP281               | Osteosarcoma, osteoblastic                             |
| Brachyury (TBXT) | EPR18113            | Chordoma                                               |
| MDM2             | IF2 / SMP14         | WD/DD liposarcoma — **confirm by FISH; IHC imperfect** |
| CDK4             | DCS-31              | WD/DD liposarcoma (with MDM2)                          |
| Rb1              | 13A10 / G3-245      | Spindle cell/pleomorphic lipoma loss                   |
| PAX7             | EPR20353            | Rhabdomyosarcoma, Ewing                                |
| DOG1             | K9                  | GIST                                                   |
| HHV8/LANA        | 13B10               | Kaposi                                                 |
| GLUT1            | polyclonal / SPM498 | Perineurioma, hemangioma                               |
| EMA / claudin-1  | E29 / polyclonal    | Perineurioma                                           |

***

## 11. Neuropathology

### Tier 1

| Marker        | Recommended clone(s)                                            | Note                                |
| ------------- | --------------------------------------------------------------- | ----------------------------------- |
| GFAP          | GA5 / polyclonal (Dako FLEX RTU)                                | Glial                               |
| OLIG2         | EPR2673 / 211F1.1                                               | Glial lineage                       |
| IDH1 R132H    | **H09** (Dianova; field standard); alt MRQ-67 (less background) | Diffuse glioma; WHO CNS5 first step |
| ATRX          | polyclonal / BSB-108                                            | Loss in astrocytoma                 |
| p53           | DO-7                                                            | Astrocytoma pattern                 |
| Ki-67         | MIB-1                                                           | Grading                             |
| Synaptophysin | MRQ-40 / SNP88                                                  | Neuronal/neurocytic                 |

### Tier 2

| Marker                                           | Clone(s)           | Note                                   |
| ------------------------------------------------ | ------------------ | -------------------------------------- |
| H3 K27M                                          | RM192 / polyclonal | Diffuse midline glioma                 |
| H3K27me3                                         | C36B11             | Loss in DMG, MPNST                     |
| BRAF VE1                                         | VE1                | PXA, ganglioglioma, PA                 |
| EMA                                              | E29                | Meningioma, ependymoma (dot)           |
| SSTR2A                                           | UMB-1              | Meningioma, NET                        |
| Progesterone receptor                            | PgR636             | Meningioma                             |
| STAT6                                            | YE361              | Solitary fibrous tumor/HPC             |
| NeuN                                             | A60                | Neuronal                               |
| Chromogranin A                                   | LK2H10             | Neuroendocrine                         |
| INI1/SMARCB1                                     | MRQ-27             | AT/RT loss                             |
| L1CAM                                            | UJ127              | Ependymoma (ZFTA/RELA)                 |
| LIN28A                                           | polyclonal         | ETMR                                   |
| β-catenin                                        | β-catenin-1        | WNT medulloblastoma, craniopharyngioma |
| Transthyretin                                    | polyclonal         | Choroid plexus                         |
| PIT1 / TPIT / SF1                                | —                  | Pituitary lineage                      |
| Pituitary hormones (GH, PRL, ACTH, TSH, FSH, LH) | —                  | Adenoma typing                         |
| Neurofilament                                    | 2F11               | Axonal preservation                    |
| Phospho-tau (AT8)                                | AT8                | Neurodegeneration/autopsy              |
| β-amyloid                                        | 6F/3D              | Alzheimer/CAA                          |
| α-synuclein                                      | KM51 / 5G4         | Lewy body                              |
| TDP-43 (phospho)                                 | 1D3 / polyclonal   | FTLD/ALS                               |

***

## 12. Dermatopathology & melanocytic

### Tier 1

| Marker  | Recommended clone(s)                                      | Note                              |
| ------- | --------------------------------------------------------- | --------------------------------- |
| S100    | polyclonal / 4C4.9                                        | Melanocytic screen                |
| SOX10   | SP267                                                     | Melanocytic/nerve                 |
| Melan-A | A103                                                      | Melanocytic                       |
| HMB-45  | HMB-45                                                    | Melanocytic (junctional gradient) |
| PRAME   | **EPR20330** (NordiQC 80% pass, optimal on all platforms) | Malignant melanocytic (nuclear)   |
| Ki-67   | MIB-1                                                     | Proliferation                     |
| BerEP4  | Ber-EP4                                                   | BCC                               |
| p16     | E6H4                                                      | Spitzoid/melanoma context         |

### Tier 2

| Marker            | Clone(s)            | Note                                              |
| ----------------- | ------------------- | ------------------------------------------------- |
| Tyrosinase        | T311                | Melanocytic                                       |
| MITF              | D5 / C5             | Melanocytic (nuclear)                             |
| BAP1              | C-4                 | BAP1-inactivated melanocytic tumor loss           |
| β-catenin / LEF1  | β-catenin-1 / EP310 | Deep penetrating nevus                            |
| EMA               | E29                 | Paget, sebaceous, epithelioid                     |
| CEA               | polyclonal / II-7   | Paget/EMPD                                        |
| CK7               | OV-TL 12/30         | Paget/EMPD                                        |
| GCDFP-15          | 23A3                | Mammary Paget                                     |
| Adipophilin       | polyclonal          | Sebaceous                                         |
| Androgen receptor | AR441 / SP107       | Sebaceous                                         |
| CD34              | QBEnd/10            | DFSP (vs DF)                                      |
| Factor XIIIa      | AC-1A1 / EP3372     | Dermatofibroma                                    |
| ERG / CD31        | EPR3864 / JC70A     | Angiosarcoma                                      |
| MYC               | Y69                 | Post-radiation/secondary angiosarcoma (amplified) |
| CD123             | 6H6                 | Lupus (pDC clusters)                              |

***

## 13. Renal medical / nephropathology & transplant

### Tier 1

| Marker               | Recommended clone(s)                      | Note                                                  |
| -------------------- | ----------------------------------------- | ----------------------------------------------------- |
| IgA / IgG / IgM      | polyclonal (Dako)                         | Immune-complex GN panel                               |
| C3 / C1q             | polyclonal                                | Complement deposition                                 |
| C4d                  | **SP91 (Cell Marque rmAb)** or polyclonal | Antibody-mediated rejection (peritubular capillaries) |
| Kappa / Lambda       | polyclonal                                | Light-chain restriction (myeloma cast, MIDD)          |
| Albumin / Fibrinogen | polyclonal                                | Panel completeness                                    |
| SV40 large T         | **MRQ-4** or PAb416                       | BK polyomavirus nephropathy (nuclear)                 |

### Tier 2

| Marker | Clone(s)                              | Note                                               |
| ------ | ------------------------------------- | -------------------------------------------------- |
| PLA2R  | polyclonal (Sigma HPA012657)          | Primary membranous nephropathy (granular GBM)      |
| THSD7A | polyclonal (Sigma HPA000923)          | PLA2R-negative membranous                          |
| DNAJB9 | rabbit polyclonal (Thermo/Invitrogen) | Fibrillary GN (sensitive/specific; can replace EM) |

***

## 14. Infectious disease IHC

### Tier 1

| Marker              | Recommended clone(s)                 | Note                  |
| ------------------- | ------------------------------------ | --------------------- |
| CMV                 | **DDG9 + CCH2** cocktail (Dako)      | Inclusions            |
| HSV1/2              | polyclonal (Dako)                    | Herpetic              |
| Helicobacter pylori | polyclonal (Cell Marque/Dako) or BC7 | Gastric               |
| EBV (EBER-ISH)      | EBER ISH probe                       | Gold standard for EBV |

### Tier 2

| Marker                 | Clone(s)                 | Note                          |
| ---------------------- | ------------------------ | ----------------------------- |
| Adenovirus             | 2/6 + 20/11 cocktail     | Enteric/pulmonary             |
| SV40/BK                | MRQ-4 / PAb416           | Polyomavirus                  |
| Treponema pallidum     | polyclonal               | Syphilis (superior to silver) |
| Spirochetes / Borrelia | polyclonal               | —                             |
| Mycobacteria           | polyclonal (BCG)         | Adjunct to AFB                |
| Fungal                 | anti-Aspergillus/Candida | Adjunct to GMS/PAS            |
| Toxoplasma gondii      | polyclonal               | Tachyzoites/bradyzoites       |
| HHV8/LANA              | 13B10                    | KS                            |
| Parvovirus B19         | R92F6                    | Aplastic/hydrops              |
| SARS-CoV-2 (N protein) | polyclonal / 1A9         | Research/autopsy              |

***

## 15. Neuroendocrine & paraganglioma across sites

* **Confirm NE differentiation:** synaptophysin (MRQ-40/SNP88), chromogranin A (LK2H10), INSM1 (MRQ-70).
* **Site of origin:** CDX2 (midgut), TTF-1 (lung/thyroid — clone caveat), Islet-1 (pancreatic/duodenal), SATB2 (rectal/appendiceal).
* **SSTR2A (UMB-1):** theranostic (SSA/PRRT) + diagnostic.
* **Ki-67 (MIB-1):** mandatory for WHO grading — per WHO 2019 GEP-NEN classification: well-differentiated NET **G1 Ki-67 <3%** (<2 mitoses/2 mm²), **G2 3–20%**, **G3 >20%**, distinct from poorly-differentiated NEC.
* **SDHB (21A11AE7):** loss flags SDH-deficient paraganglioma/pheochromocytoma syndromes.
* **GATA3 (L50-823):** head/neck parasympathetic paraganglioma (with tyrosine hydroxylase, keratin-negativity).

## 16. Cancer of unknown primary (CUP) — algorithmic core

First tier: pan-CK, CK7/CK20, TTF-1, CDX2, GATA3, PAX8, p40, ER, S100/SOX10, synaptophysin/chromogranin. Second tier by pattern: NKX3.1 (prostate), napsin A (lung/clear cell), WT1 (serous/mesothelial), SATB2 (colorectal), arginase-1/HepPar-1 (hepatocellular), GCDFP-15/mammaglobin/TRPS1 (breast), SALL4/OCT3-4 (germ cell), melan-A/inhibin/SF1 (adrenal). **GATA3 + PAX8 + TTF-1 + CDX2** resolves the majority of epithelial CUPs.

## 17. Germ cell tumors

| Marker     | Clone(s)               | Note                                |
| ---------- | ---------------------- | ----------------------------------- |
| SALL4      | 6E3 / EP299            | Pan-germ cell (most sensitive)      |
| OCT3/4     | C-10 (NordiQC optimal) | Seminoma/embryonal (nuclear)        |
| CD30       | Ber-H2                 | Embryonal carcinoma                 |
| Glypican-3 | 1G12                   | Yolk sac, choriocarcinoma           |
| AFP        | polyclonal             | Yolk sac                            |
| hCG (β)    | polyclonal             | Choriocarcinoma/syncytiotrophoblast |
| CD117      | polyclonal             | Seminoma/dysgerminoma               |
| D2-40      | D2-40                  | Seminoma                            |
| SOX2       | SP76                   | Embryonal (vs seminoma)             |
| SOX17      | polyclonal             | Seminoma/yolk sac                   |
| PLAP       | 8A9                    | Classic germ cell                   |

## 18. Pediatric small round blue cell tumors

WT1 (6F-H2; C-terminus for DSRCT), desmin (dot-like in DSRCT/RMS), myogenin/MyoD1 (RMS), CD99 (12E7) + NKX2.2 (EP336) + FLI1 (Ewing), PHOX2B (neuroblastoma — highly specific), INI1/SMARCB1 (rhabdoid loss), LIN28A (ETMR/germ cell), glypican-3 + β-catenin (hepatoblastoma), SALL4.

## 19. Mesothelial / serosal & body-cavity cytology

* **Carcinoma:** MOC31, claudin-4, BerEP4.
* **Mesothelial:** calretinin, WT1, D2-40, HEG1 (SKM9-2), CK5/6.
* **Malignancy within mesothelial proliferation:** BAP1 loss + MTAP loss (CDKN2A surrogate).
* **Efficient two-stain approach:** HEG1+/claudin-4− = mesothelioma; claudin-4+/HEG1− = carcinoma (caution when high-grade serous carcinoma is in the differential — mesothelial markers can stain it).

***

## 20. Predictive / companion & theranostic markers (consolidated)

### PD-L1 (assay–drug pairing; each assay tied to its own platform + scoring)

| Assay / clone                                                                      | Platform   | Drug / indication                                               | Scoring                  |
| ---------------------------------------------------------------------------------- | ---------- | --------------------------------------------------------------- | ------------------------ |
| **22C3 pharmDx (GE006, Dako/Agilent)** — NordiQC strongest (98% pass, 92% optimal) | Dako ASL48 | Pembrolizumab; NSCLC, gastric, cervical, H\&N, esophageal, TNBC | TPS (lung), CPS (others) |
| 28-8 pharmDx (Dako)                                                                | Dako       | Nivolumab (complementary)                                       | TC/TPS                   |
| SP263 (Ventana)                                                                    | BenchMark  | Durvalumab/atezolizumab; NSCLC, urothelial                      | TPS/CPS                  |
| SP142 (Ventana) — lowest sensitivity, non-interchangeable                          | BenchMark  | Atezolizumab; TNBC (IC), NSCLC                                  | IC% (TNBC), TC/IC        |

Blueprint project: 22C3/28-8/SP263 are concordant on tumor-cell staining; SP142 stains consistently fewer cells. **Do not interchange assay + scoring algorithm.**

### HER2

* **Breast:** HercepTest mAb DG44 (GE001, Dako Omnis) or 4B5 (Ventana); ASCO/CAP 2023. **HER2-low** — per Modi et al., NEJM 2022 (DESTINY-Breast04): \~60% of HER2-negative metastatic breast cancers express low HER2, defined as **IHC 1+, or IHC 2+ with negative ISH**; the trial used the VENTANA HER2/neu (4B5) assay (response rate 52.3% with trastuzumab deruxtecan). Reproducibility of 1+ vs 0 is the weak point (NordiQC flags decreased HER2-low concordance).
* **Gastric:** 4B5/HercepTest with gastric-specific scoring.

### ER / PR

EP1 (ER) / PgR636 (PR); ASCO/CAP 2020 — ≥1% positive is positive; tonsil sensitivity control; report % and intensity.

### MMR

MLH1 ES05, PMS2 EP51, MSH2 FE11/G219-1129, MSH6 EP49 — four-antibody panel; dMMR → immunotherapy eligibility + Lynch screen.

### Other established CDx / theranostic

| Marker                 | Clone / assay                         | Context & scoring                                                                                                                                                                   |
| ---------------------- | ------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| ALK                    | **D5F3 (VENTANA ALK CDx)**            | NSCLC — crizotinib/alectinib; dichotomous                                                                                                                                           |
| ROS1                   | D4D6 (screen) / SP384                 | Confirm fusion by FISH/NGS                                                                                                                                                          |
| pan-TRK                | EPR17341 (Ventana)                    | NTRK fusion screen; confirm by NGS                                                                                                                                                  |
| BRAF V600E             | VE1                                   | Melanoma, thyroid, CRC, HCL, LCH                                                                                                                                                    |
| IDH1 R132H             | H09                                   | Glioma                                                                                                                                                                              |
| Claudin-18.2           | **43-14A (VENTANA CLDN18 RxDx)**      | Gastric/GEJ — zolbetuximab; positive = **≥75% of tumor cells with moderate-to-strong (2+/3+) membranous staining** (SPOTLIGHT/GLOW; \~38.4% of screened patients positive)          |
| FOLR1 (FRα)            | **FOLR1-2.1 (VENTANA FOLR1 RxDx)**    | Ovarian — mirvetuximab soravtansine; high FRα by PS2+ = **≥75% of viable tumor cells at 2+/3+ intensity** (MIRASOL, NEJM 2023)                                                      |
| c-MET                  | **SP44 (VENTANA MET RxDx)**           | NSCLC — telisotuzumab vedotin (Emrelis, FDA accelerated approval May 14 2025); MET-high = **≥50% of tumor cells with strong (3+) staining** (intermediate = 25–<50% 3+; LUMINOSITY) |
| TROP2                  | EPR20043 (Ventana)                    | Sacituzumab govitecan — IHC **not yet a validated selector**                                                                                                                        |
| DLL3                   | SP347 (Ventana)                       | SCLC — tarlatamab context; emerging/RUO, not a required CDx                                                                                                                         |
| HER3 (ERBB3)           | RTJ.2 / DAK-H3-IC                     | Investigational (patritumab deruxtecan)                                                                                                                                             |
| NECTIN-4               | no validated clone                    | Enfortumab vedotin given without IHC selection                                                                                                                                      |
| EGFR mutation-specific | L858R (43B2), E746-A750del (6B6/D6B6) | Adjunct only — limited/variable sensitivity; molecular is gold standard                                                                                                             |

### Relevant ISH (adjuncts)

HER2 DISH/FISH (Ventana dominant), EBER-ISH (EBV gold standard), kappa/lambda mRNA ISH (plasma-cell clonality, superior to IHC), albumin mRNA ISH (hepatocellular), high-risk HPV RNA ISH (OPSCC/cervix — more specific than p16 alone).

***

## 21. Approximate antibody count summary

| Subspecialty                         | Tier 1 | Tier 2 | Subtotal                          |
| ------------------------------------ | ------ | ------ | --------------------------------- |
| Cytokeratins/epithelial              | 8      | 4      | 12                                |
| Breast                               | 7      | 8      | 15                                |
| GI & pancreatobiliary                | 7      | 12     | 19                                |
| MMR & GI predictive                  | 5      | 3      | 8                                 |
| Genitourinary                        | 7      | 17     | 24                                |
| Gynecologic                          | 7      | 8      | 15                                |
| Pulmonary/thoracic                   | 5      | 12     | 17                                |
| H\&N/salivary/thyroid/endocrine      | 11     | 20     | 31                                |
| Hematopathology                      | 14     | 33     | 47                                |
| Soft tissue & bone                   | 11     | 27     | 38                                |
| Neuropathology                       | 7      | 22     | 29                                |
| Dermatopathology                     | 8      | 16     | 24                                |
| Nephropathology                      | 6      | 3      | 9                                 |
| Infectious disease                   | 4      | 11     | 15                                |
| Germ cell                            | —      | 11     | 11                                |
| Pediatric SRBCT (new)                | —      | \~6    | 6                                 |
| Companion/theranostic (unique)       | \~8    | \~10   | 18                                |
| **Approximate total (deduplicated)** |        |        | **\~340–360 distinct antibodies** |

This places the menu squarely in the \~300–500 range expected of a comprehensive national reference laboratory. Roughly **110–120 Tier 1 antibodies** carry the vast majority of daily diagnostic volume; the **\~220–240 Tier 2** additions provide reference-center breadth.

***

## Recommendations (staged, with change thresholds)

1. **Phase 1 — core (\~120 Tier 1):** Stand up all Tier 1 panels first; prioritize predictive markers (ER/PR/HER2/MMR/PD-L1 22C3) with full 20/10 validation and NordiQC enrollment **before** clinical sign-out. Benchmark: NordiQC "sufficient" (ideally "optimal") on each before go-live.
2. **Phase 2 — reference breadth:** Add Tier 2 by expected referral volume. Highest reference-center value: hematopathology, soft tissue, and neuropathology panels (largest esoteric-marker counts and the markers other labs most often refer out).
3. **Omnis-specific validation (do this proactively):** For clones NordiQC flags as weak on Omnis — **desmin D33, MLH1 ES05 RTU (IS079), PAX8 MRQ-50** — either validate the concentrate as an LDT with alkaline HIER (TRS High pH) + 3-step detection, or source the Ventana/Leica RTU. Similarly plan 3-step detection for SATB2 (EP281), AMACR (SP116), and BCL6.
4. **Theranostic governance:** Tie each PD-L1 clone to its drug + scoring algorithm; never substitute. Onboard CDx assays (claudin-18.2 43-14A, FOLR1-2.1, MET SP44) as the corresponding drugs gain local (TİTCK) approval. Treat TROP2/DLL3/HER3/NECTIN-4 as investigational until validated selection assays exist.
5. **Revalidation triggers (thresholds that change the plan):** any NordiQC "insufficient" result, a platform or antibody-lot change, a new WHO classification edition, or a new companion-drug approval → revalidate the affected assay.

## Caveats

* NordiQC pass rates are platform- and protocol-dependent; a "recommended clone" still requires local calibration. Several clones (SATB2 EP281, AMACR SP116, BCL6, several MMR RTUs) need a 3-step detection system for optimal results.
* Several clones underperform **specifically on Dako Omnis** despite being field standards elsewhere (desmin D33, MLH1 ES05 RTU IS079) — this is the single biggest platform-specific risk for your lab.
* **p53 and PAX8** have persistently low NordiQC pass rates; invest in calibration and interpret p53 by mutation-pattern (wild-type / overexpressed / null), not simple positive-negative.
* **MDM2/CDK4 IHC is imperfect** — confirm liposarcoma by MDM2 FISH. Likewise ALK/ROS1/pan-TRK IHC are screens; confirm fusions molecularly.
* Emerging theranostic markers (TROP2, DLL3, HER3, NECTIN-4) **lack validated FDA companion-diagnostic IHC assays** — treat as investigational and do not use for treatment selection outside trials.
* Polyclonal antibodies remain field standard where no monoclonal RTU exists (PLA2R, THSD7A, DNAJB9, claudin-4, several infectious-disease markers) but require careful specificity validation.
* Clone vendor-sourcing shifts over time (e.g., HHV8 13B10 moved Leica→Cell Marque; C4d available as both SP91 mAb and polyclonal) — verify current availability and validate the specific lot/product locally.

## In this section

* [Supplement: Orphan-Disease, Rare-Tumor & Cutting-Edge IHC](/stains/antibody-list/ihc-supplement-orphan-rare-cutting-edge.md)