Special stains

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PRESENTATION

Thanks to my PG Trainee for the preparation of this presentation Dr. Babar Yasin PGR II Histopathology FMH

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

CONGO RED

- - +++ - -

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

.

Podocytes forming 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 –

red3) 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 complete

ly surround

ed the deposits.

Stage IV, GBM is

thickened.

Deposits are

disappearing

BRAIN STORMING

Arteriolar

Hyalinosis

Capsular

Drops

Micro-Aneuris

ms

TRICHROME STAINING IN AYMLOIDOSIS:

TUBULO-INTERSTITIAL DISEASE:

CONCLUSION: