Special stains

1. Presentation RoLe of sPECIAL STAINS IN RENAL PATHOLOGY Thanks to my resident Dr. Babar Yasin PGR II Histopathology FMH

2. SPECIAL STAINS

3. Histopathology involves detailed microscopic study of diseased tissue after use of special techniques for preparation of the specimen.

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

5. 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.

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

7. 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 - - +++ - -

8. 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.

9. 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.

10. PAS STAINING IN MEMBRANOUS GN:

11. PAS STAINING IN FSGS

12. PAS STAINING IN NODULAR GLOMERULOSCLEROSIS .

13. Kimmelstiel -Wilson Nodules highlight with PAS stain

14. PAS STAINING IN LIGHT CHAIN DISEASE DISEASE:

15. AMYLOIDOSIS:

16. MPGN: GLOBAL CRESENTS

17. THROMBOTIC MICROANGIOPATHY:

18. SILVER STAIN: Special stain for detecting fungi. Stains Basement membranes. There are several silver stains, including: Grocott's methenamine silver stain, used widely as a screen for fungal organisms. Jones' stain, a methenamine silver-Periodic acid-Schiff that stains for basement membrane.

19. SILVER STAINING IN MEMBRANOUS GN: Highlights the membrane in black. The spikes of basement membrane are easily seen.

20. Black material completely surrounds the immune deposits forming rings.

21. SILVER STAINING IN MPGN: Double contour or the “tram tracking” of the membranes because of reduplication.

22. SILVER STAINING IN DIABETIC GLOMERULOPATHY

23. CRESENT FPRMATION:

24. COLLASPING GLOMERULOPATHY

25. TRICHROME STAINING: Trichrome  is a three colour  staining protocol used in histology.  The following staining is achieved: Nuclei - blue/black. Muscle, erythrocytes, cytoplasm – red Connective tissue, in particular collagen - blue/green.

26. TRICHROME STAINING IN FSGS: Demonstrate blue collagen deposition

27. TRICHROME STAINING IN MEMBRANOUS GN: The immune deposits with a characteristic red color.

28. 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

29. BRAIN STORMING

30. Arteriolar Hyalinosis Capsular Drops Micro-Aneurisms

31. TRICHROME STAINING IN AYMLOIDOSIS:

32. TUBULO-INTERSTITIAL DISEASE:

33. CONCLUSION :