Stains Flashcards
1
Q
Verhoeff-van Gieson stains
A
elastic fibers black, collagen red, rest of connective tissue yellow
2
Q
Masson trichrome stains
A
collagen fibers blue or green, smooth muscle red
3
Q
masson trichrome can be used in what condition
A
stains inclusions red in infantile digital fibromatosis
4
Q
Movat’s pentachrome stains
A
elastic fibers black, collagen yellow, smooth muscle and fibrin red
5
Q
Phosphotungistic acid hematoxylin (PTAH) stains
A
collagen red, smooth muscle and fibrin blue
6
Q
lipid stains include
A
Oil-red-O stains lipids red, sudan black B stains lipids black, Scarlet red stains lipids red-brown
7
Q
Hemosiderin/iron is stained with
A
Perls/prussian blue (blue)
8
Q
Von Kossa stains
A
calcium (salts) brown black
9
Q
Alizarin red stains
A
Calcium (red-orange)
10
Q
alcian blue pH 0.5 stains
A
sulfated acid MPS (heparin, chondroitin, and ermatan sulfates) blue
11
Q
Alcian blue pH 2.5 stains
A
nonsulfated acid MPS (hyaluronic acid) blue
12
Q
Colloidal iron stains
A
Acid MPS (sulfated and nonsulfated) blue
13
Q
mucicarcmine stains
A
epithelial mucin pink red
14
Q
PAS stains
A
Neutral MPS (basement membrane, fungi, glycogen pink
15
Q
Calcium stains include
A
Von Kossa and Alizarin red
16
Q
Iron stains include
A
Perls/Prussian Blue
17
Q
Mucicarcmine stains
A
epithelial mucin pink-red/ cryptococcus
18
Q
Toluidine blue stains
A
Acid MPS red-purple “metachromatic staining” - more commonly used as a mast cell stain
19
Q
congo red stains
A
amyloid pink-red with apple green birefringence when polarized
20
Q
Thioflavin T stains
A
amyloid (fluorescence microscopy) yellow green
21
Q
Cresyl violet stains
A
amyloid red
22
Q
Amyloid stains include
A
congo red, thioflavin T, cresyl violet
23
Q
Melanin stains include
A
Fontana-Masson (silver stain) and Silver nitrate - both black
24
Q
Smooth muscle stains include
A
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
