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Reminder: The MLH1 M1 clone may show a granular dot-like staining artifact that can be misinterpreted as “intact” expression with isolated PMS2 loss. The MLH1 ES05 clone does not show this artifact. (Pics - same case, M1 vs. ES05) #gynpath #gynepath #MMRIHC #pathtwitter #PathX

This granular "dot-like" staining pattern is an artifact that can occur with the M1 clone in cases of MLH1 loss. Recognizing this artifactual pattern will prevent you from misinterpreting this case as isolated PMS2 loss. Here we should report both MLH1 and PMS2 as lost.
#pathx
MSH IHC - retained or lost? What is your diagnosis? #GIpath #MMRihc #Lynch #mismatchrepair protein aberration #IHC

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