Stains
| | | | | | | Table 8-1 Histologic Stains for Specific Tissue | | | Special Stain | | Target | | Color | | Collagen/Muscle | | | Masson trichrome | | Collagen | | Blue or green | | | | Muscle, nerves, nuclei | | Dark red | | | Verhoeff-van Gieson | | Collagen | | Red | | | | Nuclei, muscles, and nerves | | Yellow | | | Aldehyde fuchsin (Gomori) | | Collagen | | Red | | | Mallory triple stain or trichrome stain
(aniline blue) | | Collagen | | Blue | | | | Muscle | | Red | | | PTAH
(phosphotungstic acid hematoxylin) | | Collagen | | Red | | | | Muscle/fibrin | | Blue | | | Movat’s pentachrome | | Collagen | | Yellow | | | | Muscle/fibrin | | Red | | Elastic tissue | | | Verhoeff-van Gieson | | Elastic fibers | | Black | | | Orcein-Giemsa (Pinkus acid orcein) | | Elastic fibers | | Black | | | Aldehyde fuchsin (Gomori) | | Elastic fibers | | Blue or purple | | | Movat’s pentachrome | | Elastic fibers | | Black | | Nerve | | | Bodian | | Nerve fibers | | Black | | Fat | | | Oil-red-O | | Lipid | | Red | | | Sudan black B | | Lipid | | Black | | | Scarlet red | | Lipid | | Red brown | | Melanin | | | Fontana-Masson | | Melanin | | Black | | | Orcein-Giemsa | | Melanin | | Brown-black | | | Silver nitrate | | Melanin | | Black | | Hemosiderin | | | Perls | | Hemosiderin/iron (not melanin) | | Bright blue | | | Prussian blue | | Iron/hemosiderin | | Blue | | | Turnbull’s blue | | Iron/hemosiderin | | Blue | | Calcium | | | Alizarin Red S | | Ca++ | | Reddish orange | | | Von Kossa | | Ca++ | | Brown black | | Mucin/Mucopolysaccharides | | Toluidine blue | | Acid MPS | | Purple | | Alcian blue | | Acid MPS (pH 2.5) | | Blue | | | Sulfated MPS (pH 0.5) | | | Aldehyde fuchsin (Gomori) | | Acid MPS, elastic tissue | | Blue | | Colloidal iron | | Acid MPS | | Blue | | Crystal violet | | Acid MPS | | Purple with blue background | | Mucicarmine | | “Epithelial” mucin | | Bright pink (Paget’s, cryptococcus capsule) | | Giemsa | | Acid MPS | | Metachromatically purple | | PAS | | Neutral MPS | | Pink | | Amyloid | | | Congo red | | Amyloid | | Pink-red, green birefringence with polarization | | | Crystal violet | | Amyloid | | Purple with blue background | | | Thioflavin T | | Amyloid | | Yellow fluorescence under fluorescent microscope | | | Scarlet red | | Amyloid | | Red | | | Orcein-Giemsa | | Amyloid | | Light blue | | Mast cells | | | Leder (chloroacetate esterase) | | Granules | | Red | | | Giemsa | | Granules | | Purple | | | Toluidine blue | | Granules | | Purple | | | Tryptase | | Granules | | Red to brown | | Bacteria | | | Gram stain | | Gram-positive | | Blue
{Brown-Brenn and Brown-Hopps – modified gram stain} | | | | Gram-negative | | Red
{Brown-Brenn and Brown-Hopps – modified gram stain} | | | Fite | | M. leprae, Nocardia | | Red
{Fite better than Ziehl–Neelsen for more delicate M. leprae bacilli} | | | Ziehl–Neelsen | | Acid fast bacteria | | Red
{Fite better than Ziehl–Neelsen for more delicate M. leprae bacilli} | | | Warthin–Starry | | Spirochetes | | Black | | | Steiner | | Spirochetes | | Black | | | Giemsa | | Leishmania, Histoplasma, Rickettsia | | Purple to blue | | DNA/RNA | | | Methyl green-pyronin | | RNA | | Pink-red | | | | DNA | | Blue-green | | | Feulgen | | DNA only | | Magenta | | Fungi | | | GMS (Gomori methenamine silver) | | Donovan bodies, fungi | | Black | | | PAS (Periodic acid-Schiff) | | Fungi, neutral MPS, glycogen | | Red | | | Grocott | | Fungi | | Fungus cell wall: black | | | | | | | |
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| | | | | | | Table 8-2 Immunohistochemical Stains | | Marker | | Normal Location in | | Positive in | | Epithelial markers | | | Cytokeratin (Keratin) | | Epithelial cells, ± sweat glands | | Epithelial tumors, some adnexal tumors | | | | | | | | | | | | | | | | | | | | Types of keratin:
AE1 (low molecular weight): basal epidermis, sweat glands
AE3 (high molecular weight): mid to superficial epidermis
CAM 5.2: Paget’s disease; CK 7: Paget’s disease; CK 20: Merkel cell carcinoma | | | | | | | | | | | | | | |
| | Melanocytic | | | S100 | | Melanocytes, neural cells, smooth/skeletal muscle cells, Langerhans cells, eccrine and apocrine glands, chondrocytes | | Langerhans cell histiocytosis, melanoma, granular cell tumor, eccrine neoplasms, neural tumors, liposarcoma | | | HMB-45 | | Melanocytes (less sensitive but more specific than S100) | | Melanoma, some normal nevi, Spitz nevus, angiomyolipoma, breast carcinoma | | | Of note, MART-1/Melan A and Mel-5 are comparable to HMB-45 | | Adnexal | | | CEA (Carcinoembryonic antigen) | | Eccrine glands | | Paget’s disease, extramammary Paget’s, epithelioid sarcoma (sometimes), sweat gland tumors, adenocarcinomas (gastric, lung, breast, etc.) | | | EMA (Epithelial membrane antigen) | | Eccrine glands, some epithelial malignancies | | Paget’s disease, merkel cell carcinoma, meningioma, epithelioid sarcoma, most epithelial tumors | | Muscle | | | Desmin | | Muscle cells
(skeletal and smooth muscle) | | Leiomyoma, leiomyosarcoma, glomus cell tumor (focally +), embryonal rhabdomyosarcoma | | | Vimentin | | Muscle cells, fibroblasts, endothelial cells, histiocytes, lymphocytes, Schwann cells, melanocytes | | Mesenchymal tumors (sarcomas, lymphomas, atypical fibroxanthoma, dermatofibrosarcoma protuberans), melanoma, glomus cell tumor | | | Smooth muscle actin | | Myofibroblasts, muscle cells | | Glomus tumors, smooth muscle tumors, some atypical fibroxanthomas | | Neural | | | Neuron-specific enolase (NSE) | | Nonspecific neuroendocrine marker | | Granular cell tumor, merkel cell carcinoma, other neuroendocrine tumors, some melanocytic tumors (melanoma), schwannoma | | | Glial fibrillary acidic protein (GFAP) | | Glial cells, astrocytes, Schwann cells | | Nerve sheath tumors | | | Chromogranin | | Neuroendocrine neoplasms | | Merkel cell carcinoma | | | Synaptophysin | | Neuroendocrine neoplasms | | Merkel cell carcinoma | | | Myelin basic protein
(MBP) | | Myelin sheath tissue, Schwann cells | | Neurofibroma, neuroma, granular cell tumor | | Endothelial | | | Factor VIII–related antigen (von Willebrand) | | Endothelial cells
(not as sensitive as CD31) | | Vascular tumors (both benign and malignant) | | | CD31 | | Monocytes, granulocytes, T/B cells, endothelial cells | | Vascular neoplasms (angiosarcoma) | | | Ulex europaeus agglutinin 1 (UEA) | | Endothelial cells, most eccrine glands, keratinocytes | | Vascular tumors | | | CD34 | | Endothelial cells, nerves, hematopoietic cells | | Vascular tumors (benign/malignant), dermatofibrosarcoma protuberans, vascular tumors (not as sensitive as ulex), neurofibroma, epithelioid sarcoma, spindle cell lipoma, fibrous papule | | Miscellaneous | | | Factor XIIIa | | Macrophages, dermal dendrocytes, platelets | | Dermatofibroma, xanthoma disseminatum, fibrous papule, AFX, xanthogranuloma | | | Bcl-2 | | Indicator of ↓ apoptosis, ↑ cell longevity | | Follicular center cell lymphoma | | | Gross Cystic Disease Fluid Protein 15 (GCDFP-15) | | Apocrine glands | | Apocrine tumors, breast carcinoma, salivary gland tumors | | | | | | | |
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