Ultrastructural immunolabeling: a general overview of techniques and applications.

Ultrastructural immunolabeling techniques combine the advantages of routine electron microscopy and detection of antigenic epitopes, the latter of which is customarily done by immunocytochemistry at the light microscopic level. In surgical pathology, immunocytochemistry has become routine to approach the differential diagnosis of difficult cases. Immunoelectron microscopy has been used primarily for research purposes or for addressing specific questions in diagnostic pathology. Ultrastructural immunolabeling is extremely useful in those instances in which the ultrastructural and immunocytochemical findings are not pathognomonic and are subject to interpretation. Preembedding and postembedding labeling techniques have been described in the literature. Preembedding techniques are not as applicable to diagnostic work, however. Their use remains rather limited to applications in which the antigen to be labeled cannot maintain its viability when exposed to fixatives. Even in such cases a new methodology--the LifeCell process--has emerged; this technique cryofixes tissues, thereby maintaining antigenic integrity. After cryofixation, a postembedding labeling technique can be utilized. Immunogold and peroxidase methods are used for labeling. Immunogold methods elegantly mark reaction sites with preservation of underlying morphology. Postembedding immunogold methods are used by most individuals working in the field. Ultrastructural labeling techniques are rapidly moving from classification as exclusively research tools to the diagnostic arena.