Difference between revisions of "Stains"

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*Often described as a "fastidious" (difficult/demanding) stain.<ref>URL: [http://www.merriam-webster.com/dictionary/fastidious?show=0&t=1319550566 http://www.merriam-webster.com/dictionary/fastidious?show=0&t=1319550566]. Accessed on: 25 October 2011.</ref>
*Often described as a "fastidious" (difficult/demanding) stain.<ref>URL: [http://www.merriam-webster.com/dictionary/fastidious?show=0&t=1319550566 http://www.merriam-webster.com/dictionary/fastidious?show=0&t=1319550566]. Accessed on: 25 October 2011.</ref>
**A few staff think this is a totally useless stain.<ref>ALS. On several occasions in 2009.</ref>
**A few staff think this is a totally useless stain.<ref>ALS. On several occasions in 2009.</ref>
*A variant of exists known as the ''Muller and Mowry modification of Hale's colloidal iron stain'' (AKA ''Müller-Mowry stain''.<ref name=pmid16133362>{{Cite journal  | last1 = Mete | first1 = O. | last2 = Kilicaslan | first2 = I. | last3 = Gulluoglu | first3 = MG. | last4 = Uysal | first4 = V. | title = Can renal oncocytoma be differentiated from its renal mimics? The utility of anti-mitochondrial, caveolin 1, CD63 and cytokeratin 14 antibodies in the differential diagnosis. | journal = Virchows Arch | volume = 447 | issue = 6 | pages = 938-46 | month = Dec | year = 2005 | doi = 10.1007/s00428-005-0048-6 | PMID = 16133362 }}</ref>
*A variant exists known as the ''Muller and Mowry modification of Hale's colloidal iron stain'' (AKA ''Müller-Mowry stain''.<ref name=pmid16133362>{{Cite journal  | last1 = Mete | first1 = O. | last2 = Kilicaslan | first2 = I. | last3 = Gulluoglu | first3 = MG. | last4 = Uysal | first4 = V. | title = Can renal oncocytoma be differentiated from its renal mimics? The utility of anti-mitochondrial, caveolin 1, CD63 and cytokeratin 14 antibodies in the differential diagnosis. | journal = Virchows Arch | volume = 447 | issue = 6 | pages = 938-46 | month = Dec | year = 2005 | doi = 10.1007/s00428-005-0048-6 | PMID = 16133362 }}</ref>


==von Kossa stain==
==von Kossa stain==

Revision as of 14:19, 25 August 2014

Hematoxylin and eosin stain of benign prostate gland.

This article deals with stains. H&E isn't the only stain out there.

Non-H&E stains are often referred to as special stains.

Where to start...

Principles

When considering additional (i.e. special) stains one should (in order) do the following:[1]

  1. Make sure one has exhausted the clinical history; history is considered the best special stain.
  2. Special stains (below).
  3. Immunohistochemistry (dealt with in a separate article).
  4. Molecular testing, electron microscopy.

Common stains

  1. H&E stain.
  2. PAS stain.
  3. PAS-D stain.
  4. AFB stains, e.g. Ziehl-Neelsen stain.
  5. Congo red.
  6. GMS stain.
  7. Gram stain.

Immunohistochemistry

General

  • Abbreviated IHC.

Interpretation

Simple version:

  • Positive is (usually): brown.
  • Negative tissue is: light blue.

Important notes:

  • One has to know where the target (of the antibody) is supposed to be, i.e. cytoplasm vs. cell membrane.
  • The edge of the tissue may have light staining - edge effect.
  • If everything is brown... suspect that it didn't work.
  • In some situations you're blessed with an internal control, e.g. in renal tumours CD10 will stain RCC and the proximal tubule, in GISTs - CD117 the mast cells are positive.

Work-up of infection

It often not possible to be definitive by staining.[2]

Basic panel:

  • Gram stain - for bacteria.
  • GMS stain - fungal stain.
  • PAS (or PAS-D) - fungal stain.

Fungi

Fungi are a type of microorganisms. They are seen by pathologist every once in a while.

Specific stains

What follows is a big list... of stains.

Haematoxylin and eosin stain

General

  • Abbreviated H&E.
  • Standard bearer in most pathology departments.

Intepretation

  • Blue (haematoxylin) = nucleus.
  • Pink (eosin) = cytoplasm.

Images

Haematoxylin phyloxin saffron stain

General

  • Abbreviated HPS.
  • An alternative to the H&E stain - some pathol. departments use this as their standard.

Interpretation

  • Haematoxylin = blue -- stains nucleus.
  • Phyloxin = pink -- stains muscle and cytoplasm.
  • Saffron = yellow -- stains collagen.
  • An alternative to H&E stain.
    • Fibrosis is easier to see on HPS than H&E... as one can see the collagen.

Images

Periodic acid Schiff stain

  • Abbreviated PAS.

Primary application

  • Kidney biopsies, medical.
  • Liver biopsies, medical.
    • Positive in alpha-1 antitrypsin deficiency.

Utility

  • Stains - lipofuscin,[3] basement membranes, fungi, glycogen, (neutral) mucin.

Interpretation

  • Magenta = glycogen, mucin, fungi.
  • Blue = nuclei.

Ref.:[4]

Image

Periodic acid Schiff fungal stain

  • Abbreviated PASF.

Primary application

Interpretation

  • Light purple = fungi.
  • Light green = background.
  • Washed-out light purple = Gram positive bacilli.

Note:

  • This is much improved over the PAS in the context of skin, as the background is similar to the fungal organisms.

Periodic acid Schiff with diastase

  • Abbreviated: PAS-D and PASD.

General

  • Diastase digests the glycogen.
  • "PAS diastase resistant"[5] implies PASD +ve and PAS +ve.

Use

  • Stains mucin.
  • Used to identify glycogen (together with PAS stain).
    • Glycogen = clear (digested) on PAS-D.
    • Glycogen = magenta on PAS.

Notes: [6]

Interpretation

  • Light purple = fungi.
  • Light blue/pink = background. ???

Gomori methenamine-silver stain

  • Abbreviated GMS.

Note:

  • GMS is "Grocott's methenamine Silver" according to WMSP.[7]

Use

Image

Acid-fast bacilli stains

  • Abbreviated: AFB.

There are several AFB stains:

Ziehl-Neelsen stain

  • Most popular acid-fast bacilli stain.
  • Stains other mycobacteria -- not specific for tuberculosis.
    • Stains Nocardia.[9]

Image

Fite stain

Interpretation:

  • Red = AFB.
  • Blue = background.

Auramine-rhodamine stain

  • Fluorescent stain.

Image

Kinyoun stain

Congo red stain

Use

  • Used to look for amyloid.
    • Mnemonic: CRAP = congo red amyloid protein.
  • An alternate stain for amyloid is Thioflavin T.

Note:

  • Thick sections (~10 micrometers) are considered a requirement for the stain to work properly.[12]
    • If the section is too thin... it doesn't work.

Interpretation

  • Amyloid = pink/red.
  • Nuclei = blue.

Ref.:[13]

Image

Thioflavin T stain

Use

Interpretation

  • Amyloid = green.

Image: Amyloid (inano.au.dk).

Gram stain

Use

  • "It is useless for finding bacteria."[14]
    • If they are to be seen... they'll be visible on H&E.

Note:

  • Microbiology is better at finding organisms than pathology.
    • They have one significant advantage -- if a small amount of bugs are present... they grows into a large (obviously visible) colony.

DDx for common patterns

A short list of bacteria and their characteristics:[15]

Shape\Gram stain Positive Negative Variable or negative
Bacilli Clostridium difficile, Bacillus anthracis, Nocardia spp. Escherichia coli, Helicobacter pylori, Yersinia pestis, Hemophilus influenzae Mycobacterium tuberulosis, Legionella pneumophila[16]
Cocci Streptococcus pneumoniae, Staphylococcus aureus Neisseria meningitidis, Moraxella catarrhalis

Interpretation

  • Purple (or blue) = Gram positive organisms.
  • Red = Gram negative organisms, nuclei.[17]
  • Yellow = background.

Notes:

  • Many of the bacteria are quite small relative to lymphocytes; Escherichia coli is 1-2 micrometers long x 0.25 micrometers in diameter.[18]
  • Epithelial cell nuclei & stromal cell nuclei may stain red.
  • Memory device: purple = positive.

Images

Luxol fast blue stain

  • Abbreviated LFB.

Use

  • Neuropathology, myelin stain.

Intepretation

  • Blue = myelinated fibers (contain lipoproteins), lipofuscin.[19]
    • Lack of blue (where it ought to be) = demyelination.
  • Purple = nerve cell (e.g. neuron).
  • Neutrophils = pink.

Ref.:[20]

Image

Giemsa stain

Use

Interpretation

  • Tissue is light blue/green.

Reticulin stain

Use

  • Liver biopsy, medical.
    • Demonstrates the reticular fibers (in cirrhosis the fibers are disrupted).
  • Before IHC, reticulin was used to differentiate sarcomas from carcinomas:[22]
    • Sarcomas have reticulin around each cell.
    • Carcinomas have reticulin around clusters of cells.

Interpretation

  • Black = reticular fibers.
  • Red = nuclei.

Notes:[23]

Images

Cresyl violet stain

Use

  • Used at some places (e.g. SMH) to look for Helicobacter organisms.

Interpretation

  • Everything is shades of blue.
    • Helicobacter stains blue.

Prussian blue stain

  • AKA Perl's iron stain.

Use

  • Useful for iron and hemosiderin; useful for differentiating brown pigments (melanin, lipofuscin, tattoo pigment, hemosiderin).

Interpretation

  • Blue = iron.

Image:

Notes:

  • Described well by vetmed.vt.edu.[24]
  • DDx of brown pigment: Fontana-Masson (melanin), Kluver-Barrera stain (lipofuscin).

Images

Kluver-Barrera stain

Combination of:

  • Luxol Fast Blue,
  • Cresyl Violet,
  • Special component for lipofuscin.

Use

  • Useful for differentiating brown pigments (melanin, lipofuscin, tattoo pigment, hemosiderin).
    • Stains lipofuscin.

Notes:

  • PAS also stains lipofuscin and is more commonly available.

Interpretation

  • Blue pigmented granules = lipofuscin.

Notes:

  • Described well by vetmed.vt.edu.[25]
  • DDx of brown pigment: Fontana-Masson (melanin), Prussian blue stain (hemosiderin).

Oil red O stain

Use

  • Stains adipose tissue.
  • Uncommon.

Notes:

  • Must be done on fresh tissue, i.e. it cannot be fixed in formalin.

Interpretation

  • Red = fat.

Images

Warthin-Starry stain

Background:

  • Developed by a bunch of pathologists in Michigan to look for spirochetes.[26]

Use

  • Find spirochetes, e.g. syphilis (Treponema pallidum),[27] cat-scratch disease (Bartonella henselae).
  • Find Helicobacter spp., e.g. Helicobacter pylori -- Mount Sinai Hospital.[28]

Interpretation:[29]

  • Spirochetes - black.
  • Background - yellow.

Image

Notes:

  • Considered a "dirty" stain - picks-up junk in the background.[30]

Dieterle stain

Considered a variant of the Steiner stain.[31]

Use

  • Find spirochetes, e.g. syphilis (Treponema pallidum),[32] donovan bodies (leishmaniasis),[33] Helicobacter pylori and Bartonella henselae (Cat-scratch disease).[34]

Interpretation

  • Spirochetes - black.
  • Background - yellow.

Images

www:

Bielschowsky stain

Abbreviated: Biel stain.

Use

  • Stains glial tissue, i.e. brain.
    • Demonstrates neurofibrillary tangles, senile plaques (as in Alzheimer's disease).

Interpretation

  • Black = axons, tangles, plaques.
  • Brown/dark brown = plaque, vascular amyloid.
  • Yellow/brown = other.

Ref.: [35]

Image

Mucicarmine stain

  • Stains some mucins... uses the dye carmine.

Use

  • Identify mucin.
  • Malignant cells that produce mucin... carcinomas.[36]

Interpretation

  • Carmine with metanil yellow and Weigert's Hematoxylin:[37]
    • Blue/black = nucleus.
    • Yellow = background.
    • Red = mucin.[38]

Images

www:

Alcian blue stain

General

  • Stains acidic mucin (pH=2.5); Alcian blue = Acidic.
    • A variant uses pH=1.0.[7]

Note:

  • Alcian blue (not otherwise specified) usu. refers to the pH=2.5.[39]

Use

Note:

  • Esophageal submucosal glands - alcian blue positive.

Interpretation

  • Blue = acidic mucins.[40]

Notes:

Image

Movat's stain

Use

Components

  • Acid fuchsin, alcian blue, crocein scarlet, elastic hematoxylin, and saffron.[41][42]

Interpretation of Movat stain

  • Black = nuclei and elastic fibers.
  • Yellow = collagen and reticular fibers.
  • Blue = mucin, ground substance.
  • Red (intense) = fibrin.
  • Red = muscle.

Reference: [42]

How to remember? A.: Primary colours (red, blue, yellow) + black.

Images

Masson's trichrome stain

General

  • Collagen vs. muscle.

Interpretation

  • Black = nuclei.
  • Red = muscle (smooth muscle actin).
  • Baby blue = collagen.

Notes: [43]

Elastic trichrome stain

General:

  • "Elastic trichrome" is one important variant of Masson's trichrome.

Interpretation - as above in Masson's trichrome - plus:

  • Black = nuclei and elastin.

Mallory trichome stain

General

  • Collagen vs. muscle.
  • May be done with elastin.

Site

  • Kidney Bx (to assess for fibrosis).
  • Liver Bx (to assess for cirrhosis).
  • Cardiovascular/lung (to see differentiate the layers of the arteries, and arteries from veins).

Interpretation

  • Black = nuclei.
  • Red = muscle (smooth muscle actin).
  • Green = collagen.

Image

Haematoxylin orcein phyloxin saffron stain

  • Abbreviated HOPS.[44]
  • It should not be confused with the HPS stain.

Interpretation

  • Blue (haematoxylin) = nuclei.
  • Black (orcein) = elastin.
  • Red (phyloxin) = muscle.
  • Yellow (saffron) = collagen.

Jones stain

  • AKA PAS methenamine technique.[45]
  • AKA Methenamine PAS, abbreviated MPAS.

Use

  • Visualize basement membrane in kidney biopsies.

Interpretation

  • Black = basement membrane.
  • Blue = nuclei.
  • Pink = other structures/background.

Notes:[46]

Images

Hale's colloidal iron stain

Use

Notes:

Interpretation

  • Blue (granular cytoplasmic) staining is positive.[7]

Images:

Notes:

  • Often described as a "fastidious" (difficult/demanding) stain.[49]
    • A few staff think this is a totally useless stain.[50]
  • A variant exists known as the Muller and Mowry modification of Hale's colloidal iron stain (AKA Müller-Mowry stain.[51]

von Kossa stain

Use

  • Look for calcium.

Interpretation

  • Black = calcium.[7]

Toluidine blue stain

Use

Interpretation

  • Dark blue - nuclei, mast cell granules (darker than nuclei).
  • Light blue - cytoplasm.
  • Red/magneta - cartilage. (???)

Refs: looks a bit sketchy[54], [55]

Image

www:

Romanowsky stain

  • Occasionally spelled Romanowski.
  • Many variants of this stain exist.
  • Specimens are air-dried.

Interpretation:[56]

  • Red - RBCs, eosinophil granules.
  • Blue (basophilic) - lymphocyte cytoplasm.
  • Purple - nuclear chromatin, neutrophil granules, platelets.

Field stain

  • Variant of the Romanowsky stain for rapid processing.
  • Tends to "blow-up" cell, i.e. cells are larger vis-a-vis Pap stain.

Diff-Quik

Pronounced Diff-Quick.
  • Proprietary variant of Romanowsky stain.[57]

Uses:

Wright stain

  • A variant of the Romanowsky stain; popular in North American.

Use:

  • Blood films.

May-Grünwald-Giemsa stain

  • A variant of the Romanowsky stain; popular in Europe.
  • Abbreviated MGG.

Use:

  • Blood films.
  • Cytopathology.

Papanicolaou stain

  • Abbreviated Pap stain.
  • Can be thought of as the H&E of cytopathology.
  • Specimens are fixed in ethanol.
  • Good for seeing nuclear detail.
  • Out-of-focus cytoplasm is translucent; allows one to focus overlapped cells in different planes.

Use

  • Cytopathology.

Interpretation

  • Blue/purple = nucleus.
  • Green/pink = cytoplasm.
  • Orange = keratin.

Image

Fontana-Masson stain

  • AKA Masson-Fontana stain,[59] Fontana-Masson stain for melanin, melanin stain.
  • A type of silver stain.

Stains:

  1. Melanin.
  2. "Argentaffin granules" of the digestive tract.
  3. Pigment deposition due to minocycline treatment.[60]

Use

  • Stain for melanin.
    • Displays melanin - whether it be in melanocytes, keratinocytes or melanophages.
    • IHC stains, i.e. Melan A, SOX10 or MITF are preferable for displaying melanocytes.
    • Used to differentiate brown pigments (lipofuscin, hemosiderin, melanin).[61]
    • Used to document Minocycline type II drug induced pigment deposition
      • Minocycline pigment, Type II will stain with both the Fontana-Masson stain AND the Perls iron stain.[62]
    • Used in the differential diagnosis of hypomelanosis
      • Idiopathic hypomelanosis will demonstrate ONLY loss of melanin with the Fontana-Masson stain - melanocytes will not be absent with the Melan A stain.
      • Vitiligo will show loss of melanin AND loss of melanocytes with a Melan A stain.

Image:

Schmorl's stain

  • Stains melanin.
    • Similar to Fontana-Masson stain.

Notes:[63]

Martius scarlet blue stain

General

  • Stains connective tissue and fibrin.[64]
  • Abbreviated MSB.

Use:

Interpretation

  • Muscle and fibrin - red.
  • Nuclei = brown/black.
  • Collagen - blue.
  • Red blood cells - yellow.

Image:

Ref.:[65]

Picro-Mallory stain

General

  • Find fibrin.

Interpretation[66]

  • Fibrin = red.
  • Erythrocytes = yellow.
  • Connective tissue = blue.

Image:

Verhoeff-van Gieson stain

Verhoeff stain redirects here.
  • AKA Elastic van Gieson stain, abbreviated EVG.

General

  • Similar to Masson Trichrome & Verhoeff stain.[67]

Use:

  • Examine large blood vessels.[68]

Interpretation

  • Elastin = black.
  • Collagen = bright red.
  • Muscle = dull red.

Copper stain

General

Note:

  • Copper staining is a non-specific finding seen in many liver diseases; it is associated with impaired bile secretion.[69]

Interpretation

  • Copper = red granules.

Images:

Shikata stain

  • AKA Orcein stain for copper-protein.
  • AKA Shikata-Cu,[71]
  • AKA Shikata's orcein staining.[72]

General

Interpretation

Features:[73]

  • Purple/brown = elastin fibres.
  • Red = nuclei.
  • Light purple = background
  • ??? = Copper associated protein.

See also

References

  1. LAE. 13 July 2010.
  2. Woods GL, Walker DH (July 1996). "Detection of infection or infectious agents by use of cytologic and histologic stains". Clin. Microbiol. Rev. 9 (3): 382-404. PMC 172900. PMID 8809467. http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=8809467.
  3. Kovi J, Leifer C (July 1970). "Lipofuscin pigment accumulation in spontaneous mammary carcinoma of A/Jax mouse". J Natl Med Assoc 62 (4): 287–90. PMC 2611776. PMID 5463681. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2611776/pdf/jnma00512-0077.pdf.
  4. http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/PAS.PDF
  5. Qizilbash, A.; Young-Pong, O. (Jun 1983). "Alpha 1 antitrypsin liver disease differential diagnosis of PAS-positive, diastase-resistant globules in liver cells.". Am J Clin Pathol 79 (6): 697-702. PMID 6189389.
  6. http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/PASD.PDF
  7. 7.0 7.1 7.2 7.3 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 682. ISBN 978-0781765275.
  8. URL: http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/FITES.PDF. Accessed on: 19 May 2011.
  9. URL: http://library.med.utah.edu/WebPath/LUNGHTML/LUNG024.html. Accessed on: 19 May 2011.
  10. Kehl, KS.; Cicirello, H.; Havens, PL. (Feb 1995). "Comparison of four different methods for detection of Cryptosporidium species.". J Clin Microbiol 33 (2): 416-8. PMID 7536216.
  11. Ignatius, R.; Lehmann, M.; Miksits, K.; Regnath, T.; Arvand, M.; Engelmann, E.; Futh, U.; Hahn, H. et al. (Feb 1997). "A new acid-fast trichrome stain for simultaneous detection of Cryptosporidium parvum and microsporidial species in stool specimens.". J Clin Microbiol 35 (2): 446-9. PMID 9003613.
  12. URL: http://www.ihcworld.com/_protocols/special_stains/congo_red_bennhold.htm. Accessed on: 26 January 2012.
  13. URL: http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/CONGORED.PDF. Accessed on: 4 December 2010.
  14. St. Michael's Hospital - Stains Handout.
  15. URL: http://www.atsu.edu/faculty/chamberlain/Website/pnebact.htm. Accessed on: 7 May 2013.
  16. URL: http://meded.ucsd.edu/isp/1999/CAP/legion.html. Accessed on: 7 May 2013.
  17. URL: http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/GRAM.PDF. Accessed on: 7 May 2013.
  18. URL: http://www.lpi.usra.edu/publications/slidesets/marslife/slide_27.html.
  19. MUN. 26 November 2010.
  20. http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/LFB.PDF
  21. URL: http://library.med.utah.edu/WebPath/HISTHTML/STAINS/STAINS.html. Accessed on: April 6, 2009.
  22. MACKENZIE DH (March 1958). "Reticulin patterns in the diagnosis of carcinomas and sarcomas". Br. J. Cancer 12 (1): 14–9. PMC 2074006. PMID 13536209. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2074006/.
  23. http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/RETIC.PDF
  24. Prussian blue stain. URL:[http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exprussb.htm. Accessed on: 5 May 2010.
  25. Kluver-Barrera stain. URL:http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exkluvbarr.htm. Accessed on: 5 May 2010.
  26. URL: http://www.merriam-webster.com/medical/warthin. Accessed on: 17 August 2010.
  27. URL: http://library.med.utah.edu/WebPath/HISTHTML/STAINS/STAINS.html. Accessed on: April 6, 2009.
  28. http://www.dako.co.uk/index/prod_search/prod_products.htm?productareaid=41&baseprodidver=A224462007
  29. http://library.med.utah.edu/WebPath/HISTHTML/STAINS/STAIN029.html
  30. DB. 4 August 2010.
  31. URL: http://www.mayomedicallaboratories.com/test-catalog/Overview/80327. Accessed on: 8 August 2010.
  32. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 455. ISBN 978-0781765275.
  33. URL: http://www.mondofacto.com/facts/dictionary?Dieterle%27s+stain. Accessed on: 4 August 2010.
  34. URL: http://www.mayomedicallaboratories.com/test-catalog/Overview/80327. Accessed on: 8 August 2010.
  35. http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/BIELSCH.PDF
  36. Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 681 (Q25). ISBN 978-1416025887.
  37. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 678. ISBN 978-0781765275.
  38. http://www.medschool.lsuhsc.edu/pathology/pathist/SURGPATH/special%20stains/assets/mucicarmine3.jpg
  39. URL: http://www.pathologyoutlines.com/topic/stainsalcianblue.html. Accessed on: 11 October 2012.
  40. URL: http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/ALCIAN.PDF. Accessed on: 20 December 2011.
  41. [1]
  42. 42.0 42.1 Modified Movat's Pentachrome Stain. University Penn Medicine. URL: http://www.med.upenn.edu/mcrc/histology_core/movat.shtml. Accessed on: January 29, 2009.
  43. ULR: http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/MASSONS.PDF. Accessed on: 2 November 2011.
  44. Perry JR, Bilbao JM, Gray T (1992). "Fatal basilar vasculopathy complicating bacterial meningitis". Stroke 23 (8): 1175–8. PMID 1636194. Free Full Text.
  45. Jones, DB.. "Nephrotic glomerulonephritis.". Am J Pathol 33 (2): 313-29. PMC 1934622. PMID 13402889. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1934622/.
  46. URL: http://library.med.utah.edu/WebPath/HISTHTML/MANUALS/JONES.PDF. Accessed on: 19 May 2011.
  47. Tickoo SK, Amin MB, Zarbo RJ (April 1998). "Colloidal iron staining in renal epithelial neoplasms, including chromophobe renal cell carcinoma: emphasis on technique and patterns of staining". Am. J. Surg. Pathol. 22 (4): 419–24. PMID 9537468. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0147-5185&volume=22&issue=4&spage=419.
  48. URL: http://www.ultrapath.org/oldsite/cases99/sep99/cotm9-2.html. Accessed on: 9 October 2011.
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