PRESENTATION ROLE OF SPECIAL STAINS IN RENAL PATHOLOGY Thanks to my resident Dr. Babar Yasin PGR II Histopathology FMH
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: