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Test ID P504S P504S 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

Characterization of renal cell carcinoma and the identification of high-grade prostatic intraepithelial neoplasia and prostate carcinoma

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

P504S IHC, Tech Only

Specimen Type


Specimen Stability Information

Specimen Type Temperature Time Special Container
TECHONLY Ambient (preferred)

Clinical Information

Alpha-methylacyl coenzyme A racemase (AMACR), also known as p504S, is a peroxisomal and mitochondrial enzyme that exhibits a granular expression in the cytoplasm (detected by the chromogen Fast Red). P504S expression is useful in the differentiation between benign prostate glands and prostatic adenocarcinoma as well as in characterizing primary and metastatic renal cell carcinomas.


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. Contact 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. Strojan Flezar M, Gutnik H, Jeruc J, Kirbis IS: Typing of renal tumors by morphological and immunocytochemical evaluation of fine needle aspirates. Virchows Arch. 2011;459(6):607-614

2. Molinie V, Balaton a, Rotman S, et al: Alpha-methyl CoA racemase expression in renal cell carcinomas. Hum Pathol. 2006 Jun;37(6):698-703

3. Lin F, Brown RE, Shen T, et al: Immunohistochemical detection of P504S in primary and metastatic renal cell carcinomas. Appl Immunohistochem Mol Morphol. 2004 Jun;12(2):153-159

4. Jiang Z, Fanger GR, Woda BA, et al: Expression of alpha-methylacyl-CoA racemase (P504s) in various malignant neoplasms and normal tissues: a study of 761 cases. Hum Pathol. 2003 Aug;34(8):792-796

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
610459 P504S IHC, Tech Only No LOINC Needed
Mayo Clinic Laboratories | IHC Catalog Additional Information: