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Flashcards in Stains Deck (100):
1

Verhoeff-van Gieson stains

elastic fibers black, collagen red, rest of connective tissue yellow

2

Masson trichrome stains

collagen fibers blue or green, smooth muscle red

3

masson trichrome can be used in what condition

stains inclusions red in infantile digital fibromatosis

4

Movat's pentachrome stains

elastic fibers black, collagen yellow, smooth muscle and fibrin red

5

Phosphotungistic acid hematoxylin (PTAH) stains

collagen red, smooth muscle and fibrin blue

6

lipid stains include

Oil-red-O stains lipids red, sudan black B stains lipids black, Scarlet red stains lipids red-brown

7

Hemosiderin/iron is stained with

Perls/prussian blue (blue)

8

Von Kossa stains

calcium (salts) brown black

9

Alizarin red stains

Calcium (red-orange)

10

alcian blue pH 0.5 stains

sulfated acid MPS (heparin, chondroitin, and ermatan sulfates) blue

11

Alcian blue pH 2.5 stains

nonsulfated acid MPS (hyaluronic acid) blue

12

Colloidal iron stains

Acid MPS (sulfated and nonsulfated) blue

13

mucicarcmine stains

epithelial mucin pink red

14

PAS stains

Neutral MPS (basement membrane, fungi, glycogen pink

15

Calcium stains include

Von Kossa and Alizarin red

16

Iron stains include

Perls/Prussian Blue

17

Mucicarcmine stains

epithelial mucin pink-red/ cryptococcus

18

Toluidine blue stains

Acid MPS red-purple "metachromatic staining" - more commonly used as a mast cell stain

19

congo red stains

amyloid pink-red with apple green birefringence when polarized

20

Thioflavin T stains

amyloid (fluorescence microscopy) yellow green

21

Cresyl violet stains

amyloid red

22

Amyloid stains include

congo red, thioflavin T, cresyl violet

23

Melanin stains include

Fontana-Masson (silver stain) and Silver nitrate - both black

24

Smooth muscle stains include

masson trichrome, movat's pentachrome (both red) and phosphotungistic acid hematoxylin (PTAH) (blue)

25

Does Perls/Prussion blue work for talon noir?

not very well -- does not stain iron in intact RBCs

26

T/F: von kossa stains calcium anions rather than calcium itself

T

27

In normal skin, most mucin is what forM?

sulfated acid MPS -- stains with alcian blue pH 0.5 or 2.5

28

In diseases with increased mucin (lupus, GA, folliciular mucinosis), most mucin is which form

hyaluronic acid - stains with alcian blue at pH 2.5 only! HIGH-luronic acid stains with alcian blue at HIGH pH

29

Mucicarmine is used primarily for which conditions

adenocarcinoma, Paget's, Cryptococcus, sialomucin. not very good for dermal mucins

30

Mast cell stains include

Leder, Tryptase, Giemsa, Toluidine blue

31

Which mast cell stains can be used in degranulated skin after using lido with epi?

Leder and c-KIT (CD117)

32

how to biopsy mastocytosis

lido without epi

33

Leder stains

mast cell cytoplasm and granules

34

Tryptase stains

mast cells (immunostain) - brown or black

35

Giemsa stains

mast cell granules purple-blue (metachromatic)

36

toluidine blue stains

mast cell granules (purple - metachromatic)

37

PAS stains

fungi, neutral MPS (basement membrane) and GLYCOGEN pink

38

PAS is useful for which tumors

clear cell acanthoma and trichilemmoma as a result of increased glycogen. these become negative if you add diastase (PAS-D)

39

PAS-D stains

fungi and neutral MPS (basement membrane) - helpful for demonstrating BMZ thickening (lupus, DM) and thickened vessel walls of porphyria

40

GMS stains

fungi black (stains fungal wall)

41

gram stain (brown-Hopps and brown-brenn) stains

bacteria; gram negative bacteria not well visualized in skin biopsies

42

Fite stains

M. leprae, Nocardia and atypical mycobacteria red; stain of choice for partially acid-fast organisms like M. leprae and nocardia as well as atypical mycobacteria

43

Ziehl-Neelsen stains

acid-fast bacteria red

44

Auramine-rhodamine stains

acid-fast bacteria yellow fluorescence on fluorescence microscopy

45

Warthin-Starry (silver stain) stains

spirochetes syphilis, borrelia black

46

Steiner (silver stain) stains

spirochetes black

47

Giemsa stains

Leishmanisis, histoplasma, rickettsia purple-blue

48

Leishmaniasis stains with

Giemsa

49

histoplasma and rickettsia stain with

giemsa

50

M. leprae, nocardia and atypical mycobacteria stain with

fite

51

Nerve axons stain with

bodian (black)

52

bodian stain is positive in

neurofibromas, traumatic neuromas, and PEN; negative in schwannoma which lacks axons

53

methyl green pyronin stains

RNA and DNA in frozen tissue

54

Feulgen stains

DNA red purple

55

B lymphocytes stain with

CD20, PAX-5, CD79a, CD19, CD45 and IgG light chains

56

CD20 is

most common B cell marker, absent in plasma cells, target for rituximab

57

PAX5 is

mroe sensitive and specific marker for B cells than CD20

58

CD79a stains

B cells and plasma cells

59

CD19 stains

B cells, useful for monitoring rituximab therapy as CD20-negative B cells can arise following therapy

60

CD45 stains

all hematopoietic cells except platelets and RBCs

61

T lymphocytes stain with

CD2, CD3 (most specific), CD4, CD5, CD7, CD8, CD45, CD45Ra (naive T cells), CD45Ro (memory t cells, positive in MF), and FOX-P3 (T regulatory cells)

62

Dermal dendritic cells have two populations, what do they stain with?

type I: Factor 13a found in DF; type II: CD34+ resident in reticular dermis, LOST in scleroderma/morphea, increased in NSF, scleromyxedema; Tumors positive for CD34 include DFSP, spindle cell lipoma/pleommorphic lipoma, Kaposi sarcoma (endothelial cells), neurofibroma, fibrofolliculoma/trichodiscoma, trichilemmoma, solitary fibrous tumor, leukemia cutis, kaposiform hemangioendothelioma, sclerotic fibroma, pleomorphic fibroma, superficial angiomyxoma, superficial acranl fibromyxoma, cellular angiofibroma and ischemic fasciitis

63

Endothelial cells stain with

CD31 (previous gold standard, recently superceded by ERG and FLI-1), CD34 (less specific), ERG (very sensitive and specific), FLI-1 (nuclear stain, not as good as ERG), factor 7 antigen, Ulex europaeus agglutinin 1, vimentin

64

Fibroblasts stain with

vimentin, procollagen I (also seen in DFSP, AFX, NSF, scleromyxedema)

65

Histiocytes/macrophages stain with

CD68, CD163 (more specific), lysozyme, alpha-1 antitrypsin, HAM-56 (esp JXG and xanthogranulomas), CD11b, CD14b, factor 7 a, MAC-387 (true macrophages), and vimentin

66

keratinocytes stain with

cytokeratin and p63

67

Langerhans cells stain with

S100, CD1a, Langerin (CD207; stains birbeck granules -->extremely specific), peanut agglutinin, vimentin

68

Lymphatics stain with

D2-40 (podoplanin), LYVE-1 (negative in blood vessel endothelium) and vimentin

69

c-KIT (CD117) and tryptase stain what?

mast cells

70

Melanocytes stain with

S100, HMB-45 (negative in desmoplastic melanoma), MART-1/melan-A (less sensitive but more specific, typically negative in desmoplastic melanoma), MITF (nuclear stain, positive in only 30% of desmoplastic melanomas), p16 (positive in Spitz nevi, often lost or diminished in spitzoid melanoma), p75/NGFR (useful in desmoplastic melanoma, esp when S100 is negative), Sox10 (nuclear stain, positive in desmoplastic melanoma), tyrosinase, vimentin

71

Merkel cells stain with

CK20 perinuclear dot pattern, neurofilament and NSE

72

Myofibroblasts stain with

Smooth muscle actin (SMA) "tram track" pattern; do not stain with desmin (vs smooth muscle cells which do)

73

natural killer cells stain with

CD56 (most commonly used), CD57, granzyme A/B, and TIA-1

74

nerves stain with

Axons: neurofilament and NSE; Schwann cells stain with S100, GFAP, and MBP

75

Neutrophils stain with

MPO (myeloperoxidase, esp useful in histiocytoid Sweet's)

76

Plasma cells stain with

CD138, CD79a and CD45

77

Plasmacytoid dendritic cells stain with

CD123; plasmacytoid dendritic cells are increased in lupus but not DM and increased in GA

78

sebaceous glands stain with

EMA, adiopphilin, androgen receptor and cytokeratin

79

Smooth muscle stains with

SMA (diffuse pattern) and desmin

80

Sweat glands stain with

CEA, EMA, GCDFP-15 (apocrine > eccrine), and cytokeratin

81

Which immunostain helps confirm diagnosis of SCC and adnexal carcinomas but often fails to stain sarcomatoid SCC?

AE1/AE3

82

Which immunostain has better sensitivity than AE1/AE3 and stains all epitheliial tissue, helpful for differentiating sarcomatoid SCC (positive) from AFX (negative)

MNF116

83

What immunostain stains the lower level of the epidermis and also primary cutaneous adnexal carcinoma and SCC but not metastatic adenocarcinoma or AFX

CK5/6

84

What immunostain stains Paget's, EMPD , eccrine glands/neoplasms and glandular epithelium?

CAM5.2 stains CK8/18

85

What immunostain stainds glandular epithelium, is positive in Paget's and EMPD; can be used in conjunction with CK20 to determine origins of metastatic adenocarcinoma?

CK7
CK7 positive in malignancy above the diaphragm (breast, lung), CK20 positive in malignancy below diaphragm (stomach, colon)

86

What immunostain stains adnexae, Paget's, EMPD, adnexal neoplasms, most SCCs and epithelioid sarcoma

EMA (epithelial membrane antigen)

87

What immunostain stains normal sweat glands and is positive in sweat gland neoplasms as well as Paget's and EMPD?

CEA

88

What immuostain stains nonkeratinizing epithelial cells (positive in BCC)?

Ber-EP4

89

what homolog of p53 is positive in normal epidermis, adnexal epithelium?

p63 - use to ID primary cutaneous adnexal carcinomas (positive) from metastatic adenocarcinomas (negative) and high-grad/sarcomatoid SCC (positive) from AFX (negative)

90

What stains would you order for spindle cell neoplasms?

SCC - CK
leiomyosarcoma - vimentin and SMA
AFX - vimentin only
melanoma - vimentin and S100

91

What stains would you order in neoplasms with pagetoid scatter?

Bowen's - CK
Paget's/EMPD - CK, CEA
MF- LCA
Melanoma - S100
sebaceous carcinoma - CK, CEA

92

What are the stains for epithelial carcinomas?

SCC - EMA
BCC - Ber-EP4
sebaceous carcinoma - EMA, adiopophilin and androgen receptor

93

Mib-1 is what?

Ki-67 stain for proliferation

94

pHH3 does what?

Stains M phase cells, ID mitos es va apoptosis or hyperchromic nuclei

95

AE1/AE3 stains

Epithelial market cocktail of cytoketatin antibodies expressed in epdermis and adnexal
Stains SCC and adnexal
Also stains epithelium sarcoma, synovial sarcoma and mesothelioma

96

CAM5.2 stains what

Low molecular weight cutokeratins in most glandular neoplasms without staining epidermis or stratified squamous
Stains Pagets and EMPD

97

CK7 IDs

Non-GI adenocarcinoma
Including Paget's and extramammary Paget's

98

CK20 positive in what and negative in what

Positive in Merkel and negative in metastatic oat cell
Marker of GI carcinomas
In desmoplastic trichoep stains sparse merkel cells

99

CK7 positive and CK20 positive

Bladder and pancreatic

100

CK 7 positive CK 20 negative

Colon