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. Author manuscript; available in PMC: 2015 Mar 16.
Published in final edited form as: Am J Surg Pathol. 2014 Nov;38(11):1501–1509. doi: 10.1097/PAS.0000000000000321

FIGURE 4.

FIGURE 4

Algorithm for testing of endometrial adenocarcinomas for MMR deficiency. A 2-antibody approach utilizing MSH6 and PMS2 as preliminary screening with subsequent MSH2 or MLH1 IHC for cases that show loss of MSH6 or PMS2 can also be performed.

*If strong clinical suspicion for LS, consider MLH1 promoter methylation analysis of non-neoplastic tissue/peripheral blood to evaluate for germline epigenetic MLH1 promoter methylation.

**If MSH2 and MSH6 unmutated, consider LS EPCAM, sequencing and deletion/duplication.