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Stains (view source)

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[[Image:Corpora amylacea high mag.jpg|thumb|300px|Hematoxylin and eosin stain of benign [[prostate gland]].]]
[[Image:Corpora amylacea high mag.jpg|thumb|300px|[[Hematoxylin and eosin stain]] of benign [[prostate gland]].]]
This article deals with '''stains'''. H&E isn't the only stain out there.
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'''''.
Non-H&E stains are often referred to as '''''special stains'''''.  


=Where to start...=
=Where to start...=
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==Haematoxylin and eosin stain==
==Haematoxylin and eosin stain==
===General===
*Abbreviated ''H&E''.
*Abbreviated ''H&E''.
*Standard bearer in most pathology departments.
{{Main|Hematoxylin and eosin stain}}
 
===Intepretation===
*Blue (haematoxylin) = nucleus.
*Pink (eosin) = cytoplasm.
 
====Images====
<gallery>
Image:Cecal adenocarcinoma.jpg | Cecal adenocarcinoma. H&E stain. (WC)
Image:Basal cell carcinoma - high mag.jpg | [[Basal cell carcinoma]]. H&E stain. (WC)
</gallery>


==Haematoxylin phyloxin saffron stain==
==Haematoxylin phyloxin saffron stain==
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<gallery>  
<gallery>  
Image:Metanephric_adenoma_high_mag.jpg | Metanephric adenoma - PAS (WC)
Image:Metanephric_adenoma_high_mag.jpg | Metanephric adenoma - PAS (WC)
File:Liver biopsy of glycogen storage disorder PAS positive.jpg | Liver biopsy with glycogen storage disease - PAS (WC)
File:Esophageal candidiasis (2) PAS stain.jpg | Esophageal candidiasis - PAS (WC)
</gallery>
</gallery>


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Note:
Note:
*Thick sections (~10 micrometers) are considered a requirement for the stain to work properly.<ref>URL: [http://www.ihcworld.com/_protocols/special_stains/congo_red_bennhold.htm http://www.ihcworld.com/_protocols/special_stains/congo_red_bennhold.htm]. Accessed on: 26 January 2012.</ref>
*[[Cutting|Thick sections]] (~10 micrometers) are considered a requirement for the stain to work properly.<ref>URL: [http://www.ihcworld.com/_protocols/special_stains/congo_red_bennhold.htm http://www.ihcworld.com/_protocols/special_stains/congo_red_bennhold.htm]. Accessed on: 26 January 2012.</ref>
**If the section is too thin... it doesn't work.
**If the section is too thin... it doesn't work.


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Image:Cerebral_amyloid_angiopathy_-_very_high_mag.jpg | Congo red staining in [[cerebral amyloid angiopathy]]. (WC)
Image:Cerebral_amyloid_angiopathy_-_very_high_mag.jpg | Congo red staining in [[cerebral amyloid angiopathy]]. (WC)
</gallery>
</gallery>
==Thioflavin T stain==
==Thioflavin T stain==
===Use===
===Use===
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<gallery>
<gallery>
Image:Globus_pallidus_and_putamen_-_very_low_mag.jpg | Globus pallidus and putamen - H&E-LFB. (WC)
Image:Globus_pallidus_and_putamen_-_very_low_mag.jpg | Globus pallidus and putamen - H&E-LFB. (WC)
File:LFB_CNS_cortex_supratentorial.jpg | Normal cortex - LFB only. (WC/jensflorian)
File:LFB_CNS_cortex_grey-white_matter_junction.jpg | White-grey matter junction - LFB. (WC/jensflorian)
</gallery>
</gallery>
==Giemsa stain==
==Giemsa stain==
===Use===
===Use===
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===Interpretation===
===Interpretation===
*Tissue is light blue/green.
*Tissue is light blue/green.
*Goblet cells are purple.<ref>URL: [http://www.kennedy.ox.ac.uk/facilities/histology/histology-information http://www.kennedy.ox.ac.uk/facilities/histology/histology-information]. Accessed on: 17 August 2015.</ref>
Image:
*[http://path.upmc.edu/cases/case196/images/figure12.jpg Giemsa - colon (amser.org)].<ref>URL: [http://amser.org/index.php?P=AMSER--ResourceFrame&resourceId=6018 http://amser.org/index.php?P=AMSER--ResourceFrame&resourceId=6018]. Accessed on: 17 August 2015.</ref>


==Reticulin stain==
==Reticulin stain==
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**Sarcomas have reticulin around ''each'' cell.
**Sarcomas have reticulin around ''each'' cell.
**Carcinomas have reticulin around clusters of cells.
**Carcinomas have reticulin around clusters of cells.
*Commonly used in neuropathology.
** In adenoma, reticulin highlights the lost acinar structure of normal pituitary gland.
** Paraganglioma (Zellballen architecture)
** Separating schwannoma (basement membrane around each cell) from meingioma in cerebellopontine angle.
** Separating desmoplastic medulloblastoma from classic/anaplastic forms.


===Interpretation===
===Interpretation===
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Image:Liver_reticulin.jpg | [[Liver]]. Reticulin stain. (WC)
Image:Liver_reticulin.jpg | [[Liver]]. Reticulin stain. (WC)
Image:Hepatic_adenoma_high_mag_reticulin.jpg | [[Hepatic adenoma]]. Reticulin stain. (WC)
Image:Hepatic_adenoma_high_mag_reticulin.jpg | [[Hepatic adenoma]]. Reticulin stain. (WC)
File:Zellballen paraganglioma.jpg | Reticulin stain highlighting the "Zellballen" architecture of paraganglioma. (WC/jensflorian)
File:Desmoplastic medulloblastoma reticulin stain pale island.jpg | Reticulin staina round the "pale islands" of a desmoplastic medulloblastoma. (WC/jensflorian)
</gallery>
</gallery>


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<gallery>
<gallery>
Image:Hemosiderosis_high_mag.jpg | Liver [[hemosiderosis]]. Prussian blue stain. (WC/Nephron)
Image:Hemosiderosis_high_mag.jpg | Liver [[hemosiderosis]]. Prussian blue stain. (WC/Nephron)
File:Siderophage iron stain CSF.jpg | CSF Siderophages in subarachnoid hemorrhage. (WC/jensflorian)
</gallery>
</gallery>


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*Useful for differentiating brown pigments (melanin, lipofuscin, tattoo pigment, hemosiderin).
*Useful for differentiating brown pigments (melanin, lipofuscin, tattoo pigment, hemosiderin).
**Stains lipofuscin.
**Stains lipofuscin.
*Useful to detect demyelinating lesions in the CNS.


Notes:
Notes:
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*Described well by ''vetmed.vt.edu''.<ref>Kluver-Barrera stain. URL:[http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exkluvbarr.htm http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exkluvbarr.htm]. Accessed on: 5 May 2010.</ref>
*Described well by ''vetmed.vt.edu''.<ref>Kluver-Barrera stain. URL:[http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exkluvbarr.htm http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exkluvbarr.htm]. Accessed on: 5 May 2010.</ref>
*DDx of brown pigment: Fontana-Masson (melanin), Prussian blue stain (hemosiderin).
*DDx of brown pigment: Fontana-Masson (melanin), Prussian blue stain (hemosiderin).
<gallery>
File:MS Demyelinisation KB 10x.jpg | Encephalomyelitis disseminata (Klüver-Barrera)
</gallery>


==Oil red O stain==
==Oil red O stain==
===Use===
===Use===
*Stains adipose tissue.
*Stains adipose tissue.
*Corroborate diagnosis of [[lipoid pneumonia]].<ref name=pmid25374742>{{Cite journal  | last1 = Yampara Guarachi | first1 = GI. | last2 = Barbosa Moreira | first2 = V. | last3 = Santos Ferreira | first3 = A. | last4 = Sias | first4 = SM. | last5 = Rodrigues | first5 = CC. | last6 = Teixeira | first6 = GH. | title = Lipoid pneumonia in a gas station attendant. | journal = Case Rep Pulmonol | volume = 2014 | issue =  | pages = 358761 | month =  | year = 2014 | doi = 10.1155/2014/358761 | PMID = 25374742 }}</ref>
*Screen for [[GERD]] - positive staining seen in macrophages from [[BAL]] specimens.<ref name=pmid20466562>{{Cite journal  | last1 = Hopkins | first1 = PM. | last2 = Kermeen | first2 = F. | last3 = Duhig | first3 = E. | last4 = Fletcher | first4 = L. | last5 = Gradwell | first5 = J. | last6 = Whitfield | first6 = L. | last7 = Godinez | first7 = C. | last8 = Musk | first8 = M. | last9 = Chambers | first9 = D. | title = Oil red O stain of alveolar macrophages is an effective screening test for gastroesophageal reflux disease in lung transplant recipients. | journal = J Heart Lung Transplant | volume = 29 | issue = 8 | pages = 859-64 | month = Aug | year = 2010 | doi = 10.1016/j.healun.2010.03.015 | PMID = 20466562 }}</ref>
*Uncommon.
*Uncommon.


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==Sodium sulphate-alcian blue stain==
==Sodium sulphate-alcian blue stain==
:''Sulfated alcian blue'' redirects here.
:''Sulfated alcian blue'' (abbreviated '''SAB'') redirects here.
===Use===
===Use===
*Identify [[amyloid]].<ref name=pmid55419>{{Cite journal  | last1 = Pomerance | first1 = A. | last2 = Slavin | first2 = G. | last3 = McWatt | first3 = J. | title = Experience with the sodium sulphate-Alcian Blue stain for amyloid in cardiac pathology. | journal = J Clin Pathol | volume = 29 | issue = 1 | pages = 22-6 | month = Jan | year = 1976 | doi =  | PMID = 55419 }}</ref><ref>URL: [http://www.polyrnd.com/products/reagent-assembly-kits/conventional/amyloid-stain---sulfated-alcian-blue-(sab).aspx http://www.polyrnd.com/products/reagent-assembly-kits/conventional/amyloid-stain---sulfated-alcian-blue-(sab).aspx]. Accessed on: October 15, 2014.</ref>
*Identify [[amyloid]].<ref name=pmid55419>{{Cite journal  | last1 = Pomerance | first1 = A. | last2 = Slavin | first2 = G. | last3 = McWatt | first3 = J. | title = Experience with the sodium sulphate-Alcian Blue stain for amyloid in cardiac pathology. | journal = J Clin Pathol | volume = 29 | issue = 1 | pages = 22-6 | month = Jan | year = 1976 | doi =  | PMID = 55419 }}</ref><ref>URL: [http://www.polyrnd.com/products/reagent-assembly-kits/conventional/amyloid-stain---sulfated-alcian-blue-(sab).aspx http://www.polyrnd.com/products/reagent-assembly-kits/conventional/amyloid-stain---sulfated-alcian-blue-(sab).aspx]. Accessed on: October 15, 2014.</ref>
*Less specific than [[congo red stain|congo red]].
*Less [[specificity|specific]] than [[congo red stain|congo red]] but equally [[sensitivity|sensitive]].
*Does not require polarized light.
*Does not require polarized light.


===Interpretation===
===Interpretation===
*Green = amyloid.<ref name=pmid55419/>
*Green = amyloid.<ref name=pmid55419/>
**Other things that are green: [[mast cell]]s, mucoid degeneration, basophilic myofibre degeneration, califications.
*Yellow = background.
*Yellow = background.


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==Hale's colloidal iron stain==
==Hale's colloidal iron stain==
===Use===
*[[Chromophobe renal cell carcinoma]] vs. [[renal oncocytoma]] - chromophobe [[renal cell carcinoma]] +ve.<ref name=pmid9537468>{{cite journal |author=Tickoo SK, Amin MB, Zarbo RJ |title=Colloidal iron staining in renal epithelial neoplasms, including chromophobe renal cell carcinoma: emphasis on technique and patterns of staining |journal=Am. J. Surg. Pathol. |volume=22 |issue=4 |pages=419–24 |year=1998 |month=April |pmid=9537468 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0147-5185&volume=22&issue=4&spage=419}}</ref>


Notes:
{{:Hale's colloidal iron stain}}


===Interpretation===
==von Kossa stain==
*Blue (granular cytoplasmic) staining is positive.<ref name=Ref_WMSP682>{{Ref WMSP|682}}</ref>
===General===
 
*Type of silver stain.<ref name=pmid8360080>{{Cite journal  | last1 = Rungby | first1 = J. | last2 = Kassem | first2 = M. | last3 = Eriksen | first3 = EF. | last4 = Danscher | first4 = G. | title = The von Kossa reaction for calcium deposits: silver lactate staining increases sensitivity and reduces background. | journal = Histochem J | volume = 25 | issue = 6 | pages = 446-51 | month = Jun | year = 1993 | doi = | PMID = 8360080 }}</ref>
Images:
*[http://www.diagnosticpathology.org/content/4/1/21/figure/f1?highres=n ChRCC Hale's colloidal iron (diagnosticpathology.org)].
 
Notes:
*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 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==
===Use===
===Use===
*Look for calcium.
*Look for calcium.
*Actually stains phosphates and carbonates as a surrogate for calcium.


===Interpretation===
===Interpretation===
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*[[Cytopathology]].
*[[Cytopathology]].
*[[Helicobacter gastritis]] - organisms are dark blue against a light blue background.<ref>URL: [http://www.ihcworld.com/_protocols/special_stains/diff_quick_ellis.htm http://www.ihcworld.com/_protocols/special_stains/diff_quick_ellis.htm]. Accessed on: 30 August 2012.</ref>
*[[Helicobacter gastritis]] - organisms are dark blue against a light blue background.<ref>URL: [http://www.ihcworld.com/_protocols/special_stains/diff_quick_ellis.htm http://www.ihcworld.com/_protocols/special_stains/diff_quick_ellis.htm]. Accessed on: 30 August 2012.</ref>
====Images====
<gallery>
Image: Lung adenocarcinoma - Diff-Quik -- high mag.jpg | [[Pulmonary_cytopathology#Adenocarcinoma|Lung adenocarcinoma]] - DQ - high mag. (WC)
Image: Lung adenocarcinoma - Diff-Quik -- very high mag.jpg | Lung adenocarcinoma - DQ - very high mag. (WC)
Image: Lung small cell carcinoma - Diff-Quik -- very high mag.jpg | Lung SmCC - DQ - very high mag. (WC)
Image: Lung small cell carcinoma - Diff-Quik -- extremely high mag.jpg | Lung SmCC - DQ - extremely high mag. (WC)
</gallery>


===Wright stain===
===Wright stain===
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==Papanicolaou stain==
==Papanicolaou stain==
*Abbreviated ''Pap stain''.
*Abbreviated ''Pap stain''.
*Can be thought of as the [[H&E stain|H&E]] of [[cytopathology]].
{{Main|Papanicolaou stain}}
**It is a modified [[H&E stain]].
*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====
<gallery>
Image:Urine_citology_urothelial_carcinoma_2.jpg | Pap stain - [[urine cytology]] (WC)
</gallery>


==Fontana-Masson stain==  
==Fontana-Masson stain==  
*[[AKA]] ''Masson-Fontana stain'',<ref name=pmid16081962>{{Cite journal  | last1 = Gaitanis | first1 = G. | last2 = Chasapi | first2 = V. | last3 = Velegraki | first3 = A. | title = Novel application of the masson-fontana stain for demonstrating Malassezia species melanin-like pigment production in vitro and in clinical specimens. | journal = J Clin Microbiol | volume = 43 | issue = 8 | pages = 4147-51 | month = Aug | year = 2005 | doi = 10.1128/JCM.43.8.4147-4151.2005 | PMID = 16081962 }}</ref> ''Fontana-Masson stain for melanin'', ''melanin stain''.
*[[AKA]] ''Masson-Fontana stain'',<ref name=pmid16081962>{{Cite journal  | last1 = Gaitanis | first1 = G. | last2 = Chasapi | first2 = V. | last3 = Velegraki | first3 = A. | title = Novel application of the masson-fontana stain for demonstrating Malassezia species melanin-like pigment production in vitro and in clinical specimens. | journal = J Clin Microbiol | volume = 43 | issue = 8 | pages = 4147-51 | month = Aug | year = 2005 | doi = 10.1128/JCM.43.8.4147-4151.2005 | PMID = 16081962 }}</ref> ''Fontana-Masson stain for melanin'', ''melanin stain''.
*A type of silver stain.
{{Main|Fontana-Masson stain}}
 
Stains:
#Melanin.
#"Argentaffin granules" of the digestive tract.
#Pigment deposition due to minocycline treatment.<ref name=pmid15605966>{{Cite journal  | last1 = Patterson | first1 = JW. | last2 = Wilson | first2 = B. | last3 = Wick | first3 = MR. | last4 = Heath | first4 = C. | title = Hyperpigmented scar due to minocycline therapy. | journal = Cutis | volume = 74 | issue = 5 | pages = 293-8 | month = Nov | year = 2004 | doi =  | PMID = 15605966 }}</ref>
 
===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).<ref>URL: [http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exfontana.htm http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exfontana.htm]. Accessed on: 5 May 2010.</ref>
**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.<ref name=pmid19595269>{{cite journal |author=Geria AN, Tajirian AL, Kihiczak G, Schwartz RA |title=Minocycline-induced skin pigmentation: an update |journal=Acta Dermatovenerol Croat |volume=17 |issue=2 |pages=123–6 |year=2009 |pmid=19595269 |doi= |url=}}</ref>
**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:
*[http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exfontana.htm Fontana-Masson stain (vetmed.vt.edu)].


==Schmorl's stain==
==Schmorl's stain==
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*Collagen = bright red.
*Collagen = bright red.
*Muscle = dull red.
*Muscle = dull red.
<gallery>
File:Cerebral aneurysm EVG stain.jpg |EVG stain of a cerebral aneurysm. (WC/jensflorian)
</gallery>


==Copper stain==
==Copper stain==
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===General===
===General===
*Used in [[medical liver disease|medical liver]] biopsies - used to find copper.  
*Used in [[medical liver disease|medical liver]] biopsies - stains sulfhydrl groups and identifies:
**Copper-associated protein.
**Elastin.
**[[Hepatitis B]] surface antigen.<ref name=pmid7822848>{{Cite journal  | last1 = Ghosh | first1 = AK. | last2 = Dasgupta | first2 = A. | last3 = Raha | first3 = K. | last4 = Jana | first4 = A. | last5 = Majumdar | first5 = DN. | title = Hepatic histology in chronic liver disease in hepatitis B surface antigen positive cases. | journal = J Indian Med Assoc | volume = 92 | issue = 10 | pages = 333-5 | month = Oct | year = 1994 | doi =  | PMID = 7822848 }}</ref>


===Interpretation===
===Interpretation===
Features:<ref>URL: [http://www.nottingham.ac.uk/pathology/protocols/shikata.html http://www.nottingham.ac.uk/pathology/protocols/shikata.html]. Accessed on: 24 January 2011.</ref>
Features:<ref>URL: [http://www.nottingham.ac.uk/pathology/protocols/shikata.html http://www.nottingham.ac.uk/pathology/protocols/shikata.html]. Accessed on: 24 January 2011.</ref>
*Purple/brown = elastin fibres.
*Dark purple/brown = elastin fibres, HBsAg and copper-associated protein
*Light purple = background
*Red = nuclei (only if counter-stain used)
 
==Gömöri Trichrome stain==
*Named after George Gömöri<ref>GOMORI, G. - A rapid one-step trichrome stain. Am. J. Clin. Path. 20: 661-664, 1950.</ref>
 
===General===
*Used in [[muscle biopsies]] - used to find abnormal mitochondrial deposits.
 
===Interpretation===
*Dark green = muscle fibers.
*Red = nuclei.
*Red = nuclei.
*Light purple = background
*Bright red = mitochondria, red blood cells.
*??? = Copper associated protein.
 
Images:
<gallery>
File:Ragged red fibers in MELAS.jpg | Ragged red fibers in MELAS, a mitochondrial disease. (WC)
File:Dilated peri-tubular capillaries filled with sickled RBCs, original Gomori's trichrome stain.jpg | Sickle cell nephropathy. (WC)
</gallery>
 
==Miller stain==
===General===
*Stains elastin.
*Used to identify blood vessels and [[pleural invasion]] in [[lung cancer]].
 
===Interpretation===
Staining:<ref>URL: [https://www.ihcworld.com/_protocols/special_stains/miller's_elastic_ellis.htm https://www.ihcworld.com/_protocols/special_stains/miller's_elastic_ellis.htm]. Accessed on: 28 August 2015.</ref>
*Black = elastin fibres, granules in mast cells.
*Red = collagen.
*Yellow = muscle, fibrin, [[erythrocytes]].
*Green/brown = nuclei.
 
====Images====
<gallery>
Image: Normal visceral pleura of lung - Miller -- high mag.jpg | Miller stain showing lung tissue. (WC)
</gallery>


=See also=
=See also=
Michael
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