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Test ID EXT2 Exostosin 2 (EXT2) Immunostain, Technical Component Only

Ordering Guidance

This test includes only technical performance of the stain (no pathologist interpretation is performed). If diagnostic consultation by a pathologist is required order PATHC / Pathology Consultation.

Shipping Instructions

Attach the green pathology address label and the pink Immunostain Technical Only label included in the kit to the outside of the transport container.

Specimen Required

Supplies: Immunostain Technical Only Envelope (T693)

Specimen Type: Tissue

Container/Tube: Immunostain Technical Only Envelope

Preferred: 2 unstained positively charged glass slide (25- x 75- x 1-mm) per test ordered; sections 4-microns thick.

Acceptable: Formalin-fixed, paraffin-embedded (FFPE) tissue block

Useful For

Identification of exostosin 2 associated membranous nephropathy

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IHTOI IHC Initial, Tech Only No No
IHTOA IHC Additional, Tech Only No No

Testing Algorithm

For the initial technical component only immunohistochemical (IHC) stain performed, the appropriate bill-only test ID will be reflexed and charged (IHTOI). For each additional technical component only IHC stain performed, an additional bill-only test ID will be reflexed and charged (IHTOA).

Method Name

Immunohistochemistry (IHC)

Reporting Name

EXT2 IHC, Tech Only

Specimen Type


Specimen Stability Information

Specimen Type Temperature Time Special Container
TECHONLY Ambient (preferred)

Clinical Information

Primary membranous nephropathy is an autoimmune disease of the kidney where antibodies target an antigen in the glomerular basement membrane resulting in kidney damage or failure. In up to 75% of primary membranous nephropathy cases phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A) are the target antigens. Exostosin 1 (EXT1) and exostosin 2 (EXT2), a recently identified set of novel proteins are associated with a subset of PLA2R and TSD7A double-negative MN. EXT1 and EXT2 may represent the target antigens or biomarker proteins of secondary (autoimmune) MN.


This test does not include pathologist interpretation only technical performance of the stain. If interpretation is required, order PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case.


The positive and negative controls are verified as showing appropriate immunoreactivity and documentation is retained at Mayo Clinic Rochester. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request; call 855-516-8404.


Interpretation of this test should be performed in the context of the patient's clinical history and other diagnostic tests by a qualified pathologist.

Clinical Reference

1. Bobart SA, Tehranian S, Sethi S, et al: A target antigen-based approach to the classification of membranous nephropathy. Mayo Clin Proc. 2021;96(3):577-591

2. Ravindran A, Moura MC, Fervenza FC, et al: In Patients with membranous lupus nephritis, exostosin-positivity and exostosin-negativity represent two different phenotypes. JASN. 2021;32(3):695-706

3. Sethi S, Madden BJ, Debiec H, et al: Exostosin1/exostosin 2-associated membranous nephropathy. JASN. 2019;30(6):1123-1136

Day(s) Performed

Monday through Friday

Report Available

1 to 3 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

88342-TC, primary

88341-TC, if additional IHC

LOINC Code Information

Result ID Test Result Name Result LOINC Value
614549 EXT2 IHC, Tech Only No LOINC Needed


If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Mayo Clinic Laboratories | IHC Catalog Additional Information: