special stains to know

Question 1

verhoff-van geison (VVG)

Answer 1

target: elastic fibers, collagen, other connective tissue
color: black, red, yellow
helps with perforating disease(s)

Question 2

masson trichome

Answer 2

target: smooth muscle, collagen
color: blue, green, red
* infantile digital fibromatosis

Question 3

Movat’s pentachrome

Answer 3

target: smooth muscle, collagen
color: black, yellow, red
* infantile digital fibromatosis

Question 4

phosphotungistic acid hematoxylin (PTAH)

Answer 4

target: smooth muscle, collagen
color: red, blue
* infantile digital fibromatosis

Question 5

oil-red-O

Answer 5

target: lipids
color: red
* not commonly use, must be performed on frozen tissue for LIPIDS

Question 6

Sudan black B

Answer 6

target: lipids
color: black
* not commonly use, must be performed on frozen tissue for LIPIDS

Question 7

scarlet red

Answer 7

target: lipids
color: red-brown
* not commonly use, must be performed on frozen tissue for LIPIDS

Question 8

perls/prussian blue

Answer 8

target: iron/hemosiderin
color: blue
often used with fontana-masson to differentiate melanin vs. hemosiderin

Question 9

von kossa

Answer 9

target: calcium
color: brown-black
stains anions rather than calcium

Question 10

alizarin red

Answer 10

target: calcium
color: red-orange
* more specific for calcium

Question 11

alcian blue ph 0.5

Answer 11

target: mucin
color: blue

Question 12

alcian blue ph 2.5

Answer 12

target: mucin
color: blue
* ***stains hyaluronic acid

Question 13

colloidal iron

Answer 13

target: mucin
color: blue

Question 14

mucicarmine

Answer 14

target: mucin
color: pink-red
* not good for dermal mucin, only epithelial

Question 15

periodic acid schiff (PAS)

+

periodic acid schiff (PAS-D) with diastase

Answer 15

target: mucin + fungi
color: pink
* PAS-D primarily used to highlight BMZ (think DM/lupus, porphyria). PAS positive in clear cell acanthoma and trichilemmoma

Question 16

toluidine blue

Answer 16

target: mucin
color: red-purple
* more often used as mast cell stain

Question 17

congo red

Answer 17

target: amyloid
color: pink-red (apple-green biofringence)

Question 18

thioflavin T

Answer 18

target: amyloid
color: yellow-green

Question 19

Cresyl violet

Answer 19

target: amyloid
color: red

Question 20

Fontana Masson (silver stain)

Answer 20

target: melanin
color: black
* also, used in conjunction with Perls/Prussian blue to distinguish hemosiderin vs. melanin

Question 21

Silver nitrate

Answer 21

target: melanin
color: black

Question 22

leder (chloracetate esterase)

Answer 22

target: mast cells
color: red
* only c-KIT and leder stain are reliable in degranulated skin b/c they DO NOT rely on mast cell granules. Must use lido WITHOUT epi for topical anesthesia to avoid mast cell degranulation

Question 23

tryptase

Answer 23

target: mast cells
color: red or brown

Question 24

giemsa

Answer 24

target: mast cells**, leishmania, histoplasma, and rickettsia
color: purple-blue

Question 25

toluidine blue

Answer 25

target: mast cells color: purple *but also mucin

Question 26

gomori methenamine (GMS silver stain)

Answer 26

target: fungi color: black

Question 27

gram stain (brown-hopps and brown-brenn)

Answer 27

target: gram + bacteria > gram - bacteria color: blue and red respectively

Question 28

fite

Answer 28

target: m. leprae, nocardia, atypical mycobacterium color: red * better than ziehl-neelsen *best for lepromatous leprosy

Question 29

ziehl-neelsen

Answer 29

target: acid fast bacteria color: red

Question 30

auramine-rhodamine

Answer 30

target: acid fast bacteria color: yellow fluorescence

Question 31

warthin-starry (silver stain)

Answer 31

target: spirochetes color: black * this is a dirty stain and has been replaced by spirochete immunostain

Question 32

Steiner (silver stain)

Answer 32

target: spirochetes color: black * same as warthin-starry

Question 33

bodian

Answer 33

target: nerve axons color: black * negative in schwannoma

Question 34

methyl green pyronin

Answer 34

target: DNA, RNA color: blue-green and pink respectively * requires frozen tissue

Question 35

feulgen

Answer 35

target: DNA color: red-purple