MEDizzy - An autopsy is performed on a 64-year-old man who died of

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General Pathology (I)

An autopsy is performed on a 64-year-old man who died of congestive heart failure. Sections of the liver reveal yellow-brown granules in the cytoplasm of most of the hepatocytes. Which of the following stains would be most useful to demonstrate with positive staining that these yellow-brown cytoplasmic granules are in fact composed of hemosiderin (iron)?

ExplanationThe differential for brown (or yellow-brown) granules in hepatocytes as seen with routine hematoxylin and eosin (H&E) stain includes hemosiderin, bile, and lipofuscin. The special histologic stain for hemosiderin, which contains iron, is the Prussian blue stain. Hemosiderin stains blue with a Prussian blue stain. Causes of excess iron deposition in the liver include hemosiderosis, which can result from excessive blood transfusions, and familial hemochromatosis, which results from excessive iron absorption from the gut. In contrast, excess bile in the liver can be seen with jaundice, while lipofuscin deposition is seen with aging, cachexia, and severe malnutrition. In contrast to the Prussian blue stain, the oil red O stain and the Sudan black B stain are both used to demonstrate neutral lipids in tissue sections, while the PAS (periodic acid–Schiff) stain is used to demonstrate carbohydrates. For example, glycogen is PAS-positive, and this staining characteristically is diastase-sensitive.