PRESENTATIONROLE OF SPECIAL STAINS

IN RENAL PATHOLOGY

Thanks to my residentDr. Babar YasinPGR IIHistopathologyFMH

SPECIAL STAINS

Histopathology involves detailed

microscopic study of diseased tissue after

use of special techniques for

preparation of the specimen.

For us every specimen is a patient, which we have to make talk and tell about itself.

Routine (H&E) staining

Corner stone of tissue-based diagnosis.

Haematoxylin dye stains cell nuclei blue.

Eosin dye stains other structures pink or red.

This technique provides exceptional detail of tissue structure and the makeup of the cells.

Special stains use a variety of dyes and techniques to stain particular tissues, structures or pathogens to assist pathologists with tissue-based diagnosis.

MORPHOLOGIC DD OF HOMOGENOUS ACELLUAR GLOMERULAR MATERIAL:

STAIN HYALINOSIS SCLEROSIS AMYLOID FIBROSIS FIBRIN THROMBUS

H&E +++ +++ ++ ++ +++

PAS +++ +++ + ++ +

MS - +++ - + -

TRICHROME

RED/BLUE BLUE BLUE BLUE DARK RED

CONGORED

- - +++ - -

PAS (Periodic Acid-Schiff)

Stains basement membrane (normal and in tumors), glycogen, some mucins and mucopolysaccharides.

Kidney: recommended for routine evaluation of renal biopsies due to basement membrane staining; also useful to diagnose renal cell carcinoma.

PAS STAINING OF A NORMAL GLOMERULOUS.

PAS highlights basement membranes of glomerular

capillaries and tubular epithelium.

Thin capillary loops with

endothelial cells.

Normal size mesangium.

Podocytesforming viseral

epithelium

Bowman space along with

Parietal epithelial cells.

PAS STAINING IN MEMBRANOUS GN:

PAS STAINING IN FSGS

PAS STAINING IN NODULAR GLOMERULOSCLEROSIS.

Kimmelstiel-Wilson Nodules highlight with PAS stain

PAS STAINING IN LIGHT CHAIN DISEASE DISEASE:

AMYLOIDOSIS:

MPGN: GLOBAL CRESENTS

THROMBOTIC MICROANGIOPATHY:

SILVER STAIN:

Special stain for detecting fungi.

Stains Basement membranes.

There are several silver stains, including:

1) Grocott's methenamine silver stain, used widely as a screen for fungal organisms.

2) Jones' stain, a methenamine silver-Periodic acid-Schiff that stains for basement membrane.

SILVER STAINING IN MEMBRANOUS GN:

Highlights the membrane in black. The spikes of basement membrane are easily seen.

Black material completely surrounds the immune deposits forming rings.

SILVER STAINING IN MPGN:

Double contour or the “tram tracking” of the membranes because of reduplication.

SILVER STAINING IN DIABETIC GLOMERULOPATHY

CRESENT FPRMATION:

COLLASPING GLOMERULOPATHY

TRICHROME STAINING:

Trichrome is a three colour staining protocol used in histology.

The following staining is achieved:

1) Nuclei - blue/black.

2) Muscle, erythrocytes, cytoplasm – red

3) Connective tissue, in particular collagen -blue/green.

TRICHROME STAINING IN FSGS:

Demonstrate blue collagen deposition

TRICHROME STAINING IN MEMBRANOUS GN:

The immune deposits with a characteristic red color.

In stage 1, deposits are

not accompanied

by spikes.

In stage II, the reaction

in outer GBM

produces spikes.

In stage III, the GBM

has completely surrounded

the deposits.

Stage IV, GBM is

thickened.Deposits are disappearing

BRAIN STORMING

Arteriolar Hyalinosis

Capsular Drops

Micro-Aneurisms

TRICHROME STAINING IN AYMLOIDOSIS:

TUBULO-INTERSTITIAL DISEASE:

CONCLUSION: