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Dermatopathology > Stains > Flashcards

Stains Flashcards

1
Q

Verhoeff-van Gieson stains

A

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

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2
Q

Masson trichrome stains

A

collagen fibers blue or green, smooth muscle red

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3
Q

masson trichrome can be used in what condition

A

stains inclusions red in infantile digital fibromatosis

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4
Q

Movat’s pentachrome stains

A

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

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5
Q

Phosphotungistic acid hematoxylin (PTAH) stains

A

collagen red, smooth muscle and fibrin blue

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6
Q

lipid stains include

A

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

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7
Q

Hemosiderin/iron is stained with

A

Perls/prussian blue (blue)

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8
Q

Von Kossa stains

A

calcium (salts) brown black

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9
Q

Alizarin red stains

A

Calcium (red-orange)

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10
Q

alcian blue pH 0.5 stains

A

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

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11
Q

Alcian blue pH 2.5 stains

A

nonsulfated acid MPS (hyaluronic acid) blue

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12
Q

Colloidal iron stains

A

Acid MPS (sulfated and nonsulfated) blue

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13
Q

mucicarcmine stains

A

epithelial mucin pink red

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14
Q

PAS stains

A

Neutral MPS (basement membrane, fungi, glycogen pink

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15
Q

Calcium stains include

A

Von Kossa and Alizarin red

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16
Q

Iron stains include

A

Perls/Prussian Blue

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17
Q

Mucicarcmine stains

A

epithelial mucin pink-red/ cryptococcus

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18
Q

Toluidine blue stains

A

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

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19
Q

congo red stains

A

amyloid pink-red with apple green birefringence when polarized

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20
Q

Thioflavin T stains

A

amyloid (fluorescence microscopy) yellow green

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21
Q

Cresyl violet stains

A

amyloid red

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22
Q

Amyloid stains include

A

congo red, thioflavin T, cresyl violet

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23
Q

Melanin stains include

A

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

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24
Q

Smooth muscle stains include

A

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

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25
Q

Does Perls/Prussion blue work for talon noir?

A

not very well – does not stain iron in intact RBCs

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26
Q

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

A

T

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27
Q

In normal skin, most mucin is what forM?

A

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

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28
Q

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

A

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

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29
Q

Mucicarmine is used primarily for which conditions

A

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

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30
Q

Mast cell stains include

A

Leder, Tryptase, Giemsa, Toluidine blue

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31
Q

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

A

Leder and c-KIT (CD117)

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32
Q

how to biopsy mastocytosis

A

lido without epi

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33
Q

Leder stains

A

mast cell cytoplasm and granules

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34
Q

Tryptase stains

A

mast cells (immunostain) - brown or black

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35
Q

Giemsa stains

A

mast cell granules purple-blue (metachromatic)

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36
Q

toluidine blue stains

A

mast cell granules (purple - metachromatic)

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37
Q

PAS stains

A

fungi, neutral MPS (basement membrane) and GLYCOGEN pink

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38
Q

PAS is useful for which tumors

A

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

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39
Q

PAS-D stains

A

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

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40
Q

GMS stains

A

fungi black (stains fungal wall)

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41
Q

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

A

bacteria; gram negative bacteria not well visualized in skin biopsies

42
Q

Fite stains

A

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
Q

Ziehl-Neelsen stains

A

acid-fast bacteria red

44
Q

Auramine-rhodamine stains

A

acid-fast bacteria yellow fluorescence on fluorescence microscopy

45
Q

Warthin-Starry (silver stain) stains

A

spirochetes syphilis, borrelia black

46
Q

Steiner (silver stain) stains

A

spirochetes black

47
Q

Giemsa stains

A

Leishmanisis, histoplasma, rickettsia purple-blue

48
Q

Leishmaniasis stains with

49
Q

histoplasma and rickettsia stain with

50
Q

M. leprae, nocardia and atypical mycobacteria stain with

51
Q

Nerve axons stain with

A

bodian (black)

52
Q

bodian stain is positive in

A

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

53
Q

methyl green pyronin stains

A

RNA and DNA in frozen tissue

54
Q

Feulgen stains

A

DNA red purple

55
Q

B lymphocytes stain with

A

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

56
Q

CD20 is

A

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

57
Q

PAX5 is

A

mroe sensitive and specific marker for B cells than CD20

58
Q

CD79a stains

A

B cells and plasma cells

59
Q

CD19 stains

A

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

60
Q

CD45 stains

A

all hematopoietic cells except platelets and RBCs

61
Q

T lymphocytes stain with

A

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
Q

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

A

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
Q

Endothelial cells stain with

A

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
Q

Fibroblasts stain with

A

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

65
Q

Histiocytes/macrophages stain with

A

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
Q

keratinocytes stain with

A

cytokeratin and p63

67
Q

Langerhans cells stain with

A

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

68
Q

Lymphatics stain with

A

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

69
Q

c-KIT (CD117) and tryptase stain what?

A

mast cells

70
Q

Melanocytes stain with

A

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
Q

Merkel cells stain with

A

CK20 perinuclear dot pattern, neurofilament and NSE

72
Q

Myofibroblasts stain with

A

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

73
Q

natural killer cells stain with

A

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

74
Q

nerves stain with

A

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

75
Q

Neutrophils stain with

A

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

76
Q

Plasma cells stain with

A

CD138, CD79a and CD45

77
Q

Plasmacytoid dendritic cells stain with

A

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

78
Q

sebaceous glands stain with

A

EMA, adiopphilin, androgen receptor and cytokeratin

79
Q

Smooth muscle stains with

A

SMA (diffuse pattern) and desmin

80
Q

Sweat glands stain with

A

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

81
Q

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

82
Q

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

83
Q

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

84
Q

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

A

CAM5.2 stains CK8/18

85
Q

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?

A

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

86
Q

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

A

EMA (epithelial membrane antigen)

87
Q

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

88
Q

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

89
Q

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

A

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

90
Q

What stains would you order for spindle cell neoplasms?

A

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

91
Q

What stains would you order in neoplasms with pagetoid scatter?

A 
Bowen's - CK
Paget's/EMPD - CK, CEA
MF- LCA
Melanoma - S100
sebaceous carcinoma - CK, CEA
92
Q

What are the stains for epithelial carcinomas?

A

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

93
Q

Mib-1 is what?

A

Ki-67 stain for proliferation

94
Q

pHH3 does what?

A

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

95
Q

AE1/AE3 stains

A

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

96
Q

CAM5.2 stains what

A

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

97
Q

CK7 IDs

A

Non-GI adenocarcinoma

Including Paget’s and extramammary Paget’s

98
Q

CK20 positive in what and negative in what

A

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

99
Q

CK7 positive and CK20 positive

A

Bladder and pancreatic

100
Q

CK 7 positive CK 20 negative

Dermatopathology (6 decks)

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