Histopathological Techniques
Tutorial for Exit Exam
Tissue marking
 Giving identification
(prevent loss of small
tissue)
 Cutting a notch
 Dye marking
( E.g. indian ink, Silver nitrate)
 Criteria for selection of
tissue marker
 Relatively insoluble
 Can’t cause reagent conta
 Remain on surface of
specimen
 Clearly identifiable
Samples for Histopathological Lab
Fixation
• Purpose is to preserve the
tissue structure
• First step in tissue preparation
• Aim:
 arrest autolysis
 Decomposition
 Coagulate the tissue ( make
tissue life-like state)
 Increase mechanical strength
• Fixatives can be classified
according to their;
1.Mechanism of action
2.Chemical nature
3.Combination
Determining fixation time of fixatives
• d= K x square root of T
Were d is depth of penetration
K is coefficient of diffusibility
T is period of immersion
Trimming
 After fixation
 To reach a sample size
 Hard tissues (such as
bones and teeth) must
be decalcified before
trimming.
Decalcification
 Complete removal of calcium
salt hard tissue following
fixation.
• Why decalcification?
1. Prevent tearing & ragging of
section
2. Prevent damage of microtome
knife/blades
3. Making bone soft
Achieved by:
• Dissolution of calcium by a
dilute mineral acid.
• Using Chelating agents EDTA
by eclectric current
Tissue processing
(Dehydration, clearing, impregnation)
Impregnation
• Make the tissue firm
• Facilitate easy sectioning
• 2 processes happen simultaneously
 Impregnation of the paraffin wax in to tissue
 Infiltration of clearing agent out of the tissue
• Also called internal embedding since medium penetrates
tissues & provides support from inside of tissue
• High melting point paraffin used
Embedding
• Gives external solid support
• Also called block preparation or external embeding
• Choice of paraffin depends on:
Nature of the tissue
Temp. at which tissues are sectioned
Thickness of the section
Question?
Q. 1. A senior lab technologist was performing
histopathological test in a histopathology lab. He
impregnated the dehydrated and cleared tissue with
molten paraffin wax before embedding. What
differentiates this impregnation process from
embedding?
A.Embedding for external support of tissue
B.Impregnation for external support of tissue
C.Impregnation is done by solid paraffin wax
D.Embedding is done by molten paraffin wax
Sectioning
Sectioning…
Water bath
Question?
• Q. 2. A fresh biopsy -5cm/hr was sent to a lab for
pathological examination. Lab tech. wanted to
make frozen section using cryostst. The cryostst
solidified the tissue in low temp.& produce
qualified thin tissue ribbons. Which activity can
the technologist perform by cryostat?
A. Dehydrating tissue with alcohols
B. Clearing tissue with clearing agents
C. Sectioning tissue to thin sections
D. Embedding tissue with paraffin medium
Microscopy
• Direct staining
Application of simple dye to
stain the tissue in varying
shades of colours
• Progressive staining
Stain applied to the tissue in
strict sequence and for
specific times.
• Regressive staining
Tissue is first overstained
and then the excess stain is
removed from all but the
structures to be
demonstrated. This process
is called differentiation
• Indirect staining
It means use of mordant to
facilitate a particular
staining method or the use
of accentuator to improve
either the selectivity or the
intensity of stain.
• Decolourization
Partial or complete removal
of stain from tissue sections.
E.g. acid alcohol treatment
Dyes used in staining
• Dyes are classified in various ways :
1. According to source (Natural & Synthetic)
2. Affinity to tissues (Acidophilic & Basophilic)
3. Chemical composition (Thiazines, Azo-dyes &
Rosailins)
Factors controlling selectivity of tissue component
 Dyes or stains are not taken by every part of tissue
and this difference is called selectivity of stain
 Factors that determine selectivity of stain include;
1. Number and affinity of binding sites
2. Rate of reagent uptake
3. Rate of reagent loss
4. Presence of non-dye constituent
 Mordants and accentuators
23
• Mordants
Substance that causes certain staining reactions to
take place by forming a link between the tissue and
the stain. The link is referred as lake. e.g. Ammonium
and Potassium alum for haematoxylin.
• Accentuators
Substances that causes increase in selectively or in
staining power of dye. e.g. Phenol in Carbol fuchsin,
KOH in Mehtylene blue
Types of commonly used stains
 Most staining reaction involve chemical interaction b/n dye and
substrate through salt linkage or hydrogen bonds
 Staining with dyes result in predictable color pattern based on
acid/base characteristics of tissue and dye
 Based on these stains can be divided in to
 Acidic
 Basic
 Neutral
 NB: This classification is not based on the pH of stains
25
Types………..
1. Acid dyes:
 Exists as an anion in solution
 has affinity for cytoplasm
• Stains the acidophilic structure
 Most commonly used acidic stain is Eosin
26
Types………..
2. Basic dyes:
 Exists as a cation in solution
 has affinity for nuclei & ribosome
• Stains the basophilic structure
 Most commonly used basic stain is Hematoxylin
27
Types………..
3. Neutral dye:
 Combining aqueous solutions of acid and basic
dyes
 Capable of staining cytoplasm and nucleus
simultaneously and differentially
– This is called methachromatic staining
e.g
• Giemsa’s stain
• leishman’s stain etc.
28
• Haematoxylin and Eosin staining
Procedure
♦ Deparaffinize in hot air oven.
♦ Hydrate the section.
i) 3 dips in xylene (2 Min. each)
ii) 3 dips in acetone / alcohol (2 Min. each)
iii) In running tap water for 5 Minutes.
♦ Mayer's haemotoxylin for 15 minutes.
♦ Wash in running tap water for 20 minutes
♦ Counter stain with eosin for 2 minutes
♦ Dehydrate the section in 95% and absolute alcohol/ acetone 2 changes (2minutes
each).
♦ Clear in xylene 3 changes (2 minutes each)
♦ Mount in DPX
29
Results of tissue staining
• Nucleus - blue
• Cytoplasm and background - pink
Causes of poor quality of staining
1. Poor or inadequate fixation of tissue.
2. Over or under-ripened Haematoxylin.
3. Overused or worked out Haematoxylin.
4. Over or under differentiation of haematoxylin
30
5. Insufficient blueing following differentiation.
6. Failure to wash blueing agent out of section
before counter staining with eosin (especially
when ammonia is used).
7. Insufficient differentiation of eosin during
washing or dehydration.
8. Insufficient dehydration and clearing of sections.
9. Contamination of stains.
31
SPECIAL STAINING
VAN GIESON METHOD- staining of connective
tissue
• Principle: In the routine staining method collagen,
elastic fibres and smooth muscle appear pink or
reddish in colour.
• In the Van Gieson stain, collagen and most
reticulin stain selectively with acid aniline dyes
(acid fuchsin).
• Picric acid acts as counter stain for muscle and
cytoplasm and form complex with the dyes. This
complex has special affinity for collagen
32
Procedure
(1) Deparaffinize with xylene
(2) Hydration take sections to water
(3) Stain with Weigert’s haematoxylin for 20-40
minutes
(4) Wash in distilled water
(5) Van Gieson stain 1-3 min
(6) Rinse well in distilled water
(7) Dehydrate in absolute alcohol (2 changes)
(8) Clear in xylene (2 changes)
(9) Mount in DPX 33
• Results
1. Collagen Red
2. Muscle and Cornified epithelium -Yellow
(B) Nuclei -Blue to Black
34
McMANUS FOR GLYCOGEN (PAS)
Staining and identification of the various types of
carbohydrates
Principle : Tissue structures like liver & heart,
striated muscles are studied by Periodic acid Shiff
stain. Periodic acid reacts with aldehyde group of
the carbohydrates and afterwards reaction with
the schiff’s reagent produces a red or purple red
colour. 35
Procedure
1. Deparaffinize and hydrate to distilled water.
2. Oxidize in periodic acid solution for 5 minutes
3. Rinse in distilled water
4. Schiff’s regent solution for 15 minutes.
5. Wash in running water for 10 minutes for pink
colour to develop.
6. Harris haematoxylin for 6 minutes or light green
counter stain for a few seconds.
7. Wash in running water.
36
8. Differentiate in 1% acid alcohol solution 3-10 quick dips.
9. Wash in running water.
10. Dip in ammonia water to blue the sections
11. Wash in running water for 10 minutes
12. Dehydrate in 95% alcohol, absolute alcohol, clear in
xylene two changes each.
13. Mount in DPX.
37
• Results
With hematoxylin counterstain
1. Nuclei – blue
2. Glycogen, mucin, hyaluronic acid, reticulin, colloid
droplets, amyloid infiltration, thrombi. – purple
red
3. Fungi – Red
4. Background – pale green (with light green
counter staining).
38
Mounting of sections
 After staining the section is mounted under a
cover slip using a syrup fluid
 Why mounting?
1. To protect the specimen from physical injury
2. To protect the section from deterioration
3. To facilitate easy handling.
4. Preserving the slides for permanent storage
Mounting medium
 A syrup fluid applied between the section and the cover slip
Characteristic of a good mounting medium
1. It should not dry quickly
2. It should not dissolve out or fade tissue sections
3. It should not cause shrinkage and distortion of tissues
4. It should set hard thereby producing permanent mounting of sections
5. RI should be as near as possible to that of the glass which is 1.518.
Mounting medium……….
There are two types of mounting media
1.Aqueous media
2.Resinous media
Aqueous media
 designed to mount water miscible preparations
I. Glycerin –RI is 1.47
II. Farrant’s medium –RI of 1.43
III. Apathy’s medium –RI of 1.52
Mounting medium……….
Resinous media
 For preparations that have been dehydrated
 Sections cleared by Toludine/ xylene
1. Canada balsam - Canadian tree Abus Balsamea.
• Mount most type of tissue sections and also for thicker tissues
• refractive index is 1.54
2. DPX - for small tissue sections
• A mixture of distyrene (polystyrene), plasticizer (tricresyl
phosphate), and xylene
• refractive index is 1.53
3.XAM
• synthetic resin mixed with Xylene
• Its refractive index is 1.52.
Mounting
 Make quite sure the sections are clear, do not let the section go dry before
mounting
1. Hold the slide b/n thumb and forefinger and wipe both ends of the slid
2. Clean carefully around section and lay on a clean blotting paper with
section uppermost with appropriate cover slip
3. Place a drop of mountant on the cover slip
4. Invert the slide over the cover slip and lower it so that it just adhere to
the cover slip
43
Mounting…………
5. Quickly turn slide over, then lay it on flat
surface to allow the mountant to spread
6. Wipe around the covers lip for neatness
N.B:
There should be no air bubbles, if any it should be returned to xylene to
remove cover slip
 No attempt should be made to pull the cover slip
Slight warming of the slide from below will make small air bubbles to
escape.
44
• When preparing a tissue for Histopathology
and light microscopy , which method precedes
clearing the specimen with an organic solvent,
a. Fixation
b. Clearing
c. Staining
d. Dehydration
e. Embeding

Histopathology.pptx

  • 1.
  • 2.
    Tissue marking  Givingidentification (prevent loss of small tissue)  Cutting a notch  Dye marking ( E.g. indian ink, Silver nitrate)  Criteria for selection of tissue marker  Relatively insoluble  Can’t cause reagent conta  Remain on surface of specimen  Clearly identifiable
  • 3.
  • 4.
    Fixation • Purpose isto preserve the tissue structure • First step in tissue preparation • Aim:  arrest autolysis  Decomposition  Coagulate the tissue ( make tissue life-like state)  Increase mechanical strength • Fixatives can be classified according to their; 1.Mechanism of action 2.Chemical nature 3.Combination
  • 5.
    Determining fixation timeof fixatives • d= K x square root of T Were d is depth of penetration K is coefficient of diffusibility T is period of immersion
  • 6.
    Trimming  After fixation To reach a sample size  Hard tissues (such as bones and teeth) must be decalcified before trimming. Decalcification  Complete removal of calcium salt hard tissue following fixation. • Why decalcification? 1. Prevent tearing & ragging of section 2. Prevent damage of microtome knife/blades 3. Making bone soft Achieved by: • Dissolution of calcium by a dilute mineral acid. • Using Chelating agents EDTA by eclectric current
  • 8.
  • 13.
    Impregnation • Make thetissue firm • Facilitate easy sectioning • 2 processes happen simultaneously  Impregnation of the paraffin wax in to tissue  Infiltration of clearing agent out of the tissue • Also called internal embedding since medium penetrates tissues & provides support from inside of tissue • High melting point paraffin used
  • 14.
    Embedding • Gives externalsolid support • Also called block preparation or external embeding • Choice of paraffin depends on: Nature of the tissue Temp. at which tissues are sectioned Thickness of the section
  • 15.
    Question? Q. 1. Asenior lab technologist was performing histopathological test in a histopathology lab. He impregnated the dehydrated and cleared tissue with molten paraffin wax before embedding. What differentiates this impregnation process from embedding? A.Embedding for external support of tissue B.Impregnation for external support of tissue C.Impregnation is done by solid paraffin wax D.Embedding is done by molten paraffin wax
  • 16.
  • 17.
  • 18.
    Question? • Q. 2.A fresh biopsy -5cm/hr was sent to a lab for pathological examination. Lab tech. wanted to make frozen section using cryostst. The cryostst solidified the tissue in low temp.& produce qualified thin tissue ribbons. Which activity can the technologist perform by cryostat? A. Dehydrating tissue with alcohols B. Clearing tissue with clearing agents C. Sectioning tissue to thin sections D. Embedding tissue with paraffin medium
  • 20.
  • 21.
    • Direct staining Applicationof simple dye to stain the tissue in varying shades of colours • Progressive staining Stain applied to the tissue in strict sequence and for specific times. • Regressive staining Tissue is first overstained and then the excess stain is removed from all but the structures to be demonstrated. This process is called differentiation • Indirect staining It means use of mordant to facilitate a particular staining method or the use of accentuator to improve either the selectivity or the intensity of stain. • Decolourization Partial or complete removal of stain from tissue sections. E.g. acid alcohol treatment
  • 22.
    Dyes used instaining • Dyes are classified in various ways : 1. According to source (Natural & Synthetic) 2. Affinity to tissues (Acidophilic & Basophilic) 3. Chemical composition (Thiazines, Azo-dyes & Rosailins)
  • 23.
    Factors controlling selectivityof tissue component  Dyes or stains are not taken by every part of tissue and this difference is called selectivity of stain  Factors that determine selectivity of stain include; 1. Number and affinity of binding sites 2. Rate of reagent uptake 3. Rate of reagent loss 4. Presence of non-dye constituent  Mordants and accentuators 23
  • 24.
    • Mordants Substance thatcauses certain staining reactions to take place by forming a link between the tissue and the stain. The link is referred as lake. e.g. Ammonium and Potassium alum for haematoxylin. • Accentuators Substances that causes increase in selectively or in staining power of dye. e.g. Phenol in Carbol fuchsin, KOH in Mehtylene blue
  • 25.
    Types of commonlyused stains  Most staining reaction involve chemical interaction b/n dye and substrate through salt linkage or hydrogen bonds  Staining with dyes result in predictable color pattern based on acid/base characteristics of tissue and dye  Based on these stains can be divided in to  Acidic  Basic  Neutral  NB: This classification is not based on the pH of stains 25
  • 26.
    Types……….. 1. Acid dyes: Exists as an anion in solution  has affinity for cytoplasm • Stains the acidophilic structure  Most commonly used acidic stain is Eosin 26
  • 27.
    Types……….. 2. Basic dyes: Exists as a cation in solution  has affinity for nuclei & ribosome • Stains the basophilic structure  Most commonly used basic stain is Hematoxylin 27
  • 28.
    Types……….. 3. Neutral dye: Combining aqueous solutions of acid and basic dyes  Capable of staining cytoplasm and nucleus simultaneously and differentially – This is called methachromatic staining e.g • Giemsa’s stain • leishman’s stain etc. 28
  • 29.
    • Haematoxylin andEosin staining Procedure ♦ Deparaffinize in hot air oven. ♦ Hydrate the section. i) 3 dips in xylene (2 Min. each) ii) 3 dips in acetone / alcohol (2 Min. each) iii) In running tap water for 5 Minutes. ♦ Mayer's haemotoxylin for 15 minutes. ♦ Wash in running tap water for 20 minutes ♦ Counter stain with eosin for 2 minutes ♦ Dehydrate the section in 95% and absolute alcohol/ acetone 2 changes (2minutes each). ♦ Clear in xylene 3 changes (2 minutes each) ♦ Mount in DPX 29
  • 30.
    Results of tissuestaining • Nucleus - blue • Cytoplasm and background - pink Causes of poor quality of staining 1. Poor or inadequate fixation of tissue. 2. Over or under-ripened Haematoxylin. 3. Overused or worked out Haematoxylin. 4. Over or under differentiation of haematoxylin 30
  • 31.
    5. Insufficient blueingfollowing differentiation. 6. Failure to wash blueing agent out of section before counter staining with eosin (especially when ammonia is used). 7. Insufficient differentiation of eosin during washing or dehydration. 8. Insufficient dehydration and clearing of sections. 9. Contamination of stains. 31
  • 32.
    SPECIAL STAINING VAN GIESONMETHOD- staining of connective tissue • Principle: In the routine staining method collagen, elastic fibres and smooth muscle appear pink or reddish in colour. • In the Van Gieson stain, collagen and most reticulin stain selectively with acid aniline dyes (acid fuchsin). • Picric acid acts as counter stain for muscle and cytoplasm and form complex with the dyes. This complex has special affinity for collagen 32
  • 33.
    Procedure (1) Deparaffinize withxylene (2) Hydration take sections to water (3) Stain with Weigert’s haematoxylin for 20-40 minutes (4) Wash in distilled water (5) Van Gieson stain 1-3 min (6) Rinse well in distilled water (7) Dehydrate in absolute alcohol (2 changes) (8) Clear in xylene (2 changes) (9) Mount in DPX 33
  • 34.
    • Results 1. CollagenRed 2. Muscle and Cornified epithelium -Yellow (B) Nuclei -Blue to Black 34
  • 35.
    McMANUS FOR GLYCOGEN(PAS) Staining and identification of the various types of carbohydrates Principle : Tissue structures like liver & heart, striated muscles are studied by Periodic acid Shiff stain. Periodic acid reacts with aldehyde group of the carbohydrates and afterwards reaction with the schiff’s reagent produces a red or purple red colour. 35
  • 36.
    Procedure 1. Deparaffinize andhydrate to distilled water. 2. Oxidize in periodic acid solution for 5 minutes 3. Rinse in distilled water 4. Schiff’s regent solution for 15 minutes. 5. Wash in running water for 10 minutes for pink colour to develop. 6. Harris haematoxylin for 6 minutes or light green counter stain for a few seconds. 7. Wash in running water. 36
  • 37.
    8. Differentiate in1% acid alcohol solution 3-10 quick dips. 9. Wash in running water. 10. Dip in ammonia water to blue the sections 11. Wash in running water for 10 minutes 12. Dehydrate in 95% alcohol, absolute alcohol, clear in xylene two changes each. 13. Mount in DPX. 37
  • 38.
    • Results With hematoxylincounterstain 1. Nuclei – blue 2. Glycogen, mucin, hyaluronic acid, reticulin, colloid droplets, amyloid infiltration, thrombi. – purple red 3. Fungi – Red 4. Background – pale green (with light green counter staining). 38
  • 39.
    Mounting of sections After staining the section is mounted under a cover slip using a syrup fluid  Why mounting? 1. To protect the specimen from physical injury 2. To protect the section from deterioration 3. To facilitate easy handling. 4. Preserving the slides for permanent storage
  • 40.
    Mounting medium  Asyrup fluid applied between the section and the cover slip Characteristic of a good mounting medium 1. It should not dry quickly 2. It should not dissolve out or fade tissue sections 3. It should not cause shrinkage and distortion of tissues 4. It should set hard thereby producing permanent mounting of sections 5. RI should be as near as possible to that of the glass which is 1.518.
  • 41.
    Mounting medium………. There aretwo types of mounting media 1.Aqueous media 2.Resinous media Aqueous media  designed to mount water miscible preparations I. Glycerin –RI is 1.47 II. Farrant’s medium –RI of 1.43 III. Apathy’s medium –RI of 1.52
  • 42.
    Mounting medium………. Resinous media For preparations that have been dehydrated  Sections cleared by Toludine/ xylene 1. Canada balsam - Canadian tree Abus Balsamea. • Mount most type of tissue sections and also for thicker tissues • refractive index is 1.54 2. DPX - for small tissue sections • A mixture of distyrene (polystyrene), plasticizer (tricresyl phosphate), and xylene • refractive index is 1.53 3.XAM • synthetic resin mixed with Xylene • Its refractive index is 1.52.
  • 43.
    Mounting  Make quitesure the sections are clear, do not let the section go dry before mounting 1. Hold the slide b/n thumb and forefinger and wipe both ends of the slid 2. Clean carefully around section and lay on a clean blotting paper with section uppermost with appropriate cover slip 3. Place a drop of mountant on the cover slip 4. Invert the slide over the cover slip and lower it so that it just adhere to the cover slip 43
  • 44.
    Mounting………… 5. Quickly turnslide over, then lay it on flat surface to allow the mountant to spread 6. Wipe around the covers lip for neatness N.B: There should be no air bubbles, if any it should be returned to xylene to remove cover slip  No attempt should be made to pull the cover slip Slight warming of the slide from below will make small air bubbles to escape. 44
  • 45.
    • When preparinga tissue for Histopathology and light microscopy , which method precedes clearing the specimen with an organic solvent, a. Fixation b. Clearing c. Staining d. Dehydration e. Embeding

Editor's Notes

  • #41 n optics the refractive index or index of refraction n of an optical medium is a dimensionless number that describes how light, or any other radiation, propagates through that medium. It is defined as n=c/v;ll,lmlhjknmnmnmnmmnmknooo;p;p;;p[‘[[‘[ where c is the speed of light in vacuum and v is the phase velocity of light in the medium
  • #43  Canada balsam, also called Canada turpentine or balsam of fir, is a turpentine which is made from the resin of the balsam fir tree (Abies balsamea) of boreal North America. The resin, dissolved in essential oils, is a viscous, sticky, colourless or yellowish liquid that turns to a transparent yellowish mass when the essential oils have been allowed to evaporate. Canada balsam is amorphous when dried. Since it does not crystallize with age, its optical properties do not deteriorate.[citation needed] However, it has poor thermal and solvent resistance.[1] Resin, in the most specific meaning of the term, is a hydrocarbon secretion of many plants, particularly coniferous trees. It is distinct from other liquid compounds found inside plants or exuded by plants, such as sap, latex, or mucilage. More broadly, the term "resin" is also used for many thick liquids, some of them artificial polymer bases (synthetic resins), that during normal use, harden into transparent or opaque solids DPX and BPS Synthetic Resin Mountants A mixture of distyrene (a polystyrene), a plasticizer (tricresyl phosphate), and xylene, called DPX, was introduced in 1939 and later modified by the substitution of a more satisfactory plasticizer, dibutylphthalate (butyl, phthalate, styrene - BPS). This colorless, synthetic resin mounting media is now available at Electron Microscopy Sciences, DPX, and it has generally replaced xylene-balsam. They preserve stains and dry quickly; surplus mount ant may be peeled off the preparation after cutting around the cover slip with a razor bl ade or scalpel. They are not recommended for use with thick sections (eg. cellulose nitrate) where there is a danger of retraction of the mountant upon drying. Refractive index ( 15 C ) 1.525 Canada balsam , yellow, oily, resinous exudation obtained from the balsam fir . It is an oleoresin with a pleasant odor but a biting taste. It is turp entine rather than a true balsam. On standing, the essential oil in Canada balsam eva porates, leaving behind the resin as a hard, transparent varnish. Canada balsam is valued as an optical mounting cement, e.g., for lenses and microscope slides, since it yields, when dissolved in an equal volume of xylene, a noncrystallizing cement with a refractive index nea rly equal to that of ordinary glass. It is used also in paints and polishes. Canada balsam, also called Canada turpentine or bal sam of fir, is a turpentine which is made from the resin of the balsam fir tree (Abies b alsamea). It is the fir's resin, dissolved in essential oils, and is a viscous, sticky, colourless (sometimes yellowish) liquid, that turns to a transparent yell owish mass when the essential oils have been allowed to evaporate. Due to its high optical quality, its refractive index (n = 1.55, very close to that of g lass), and its purity it is mainly used in optics as an invisi ble-when-dry glue for glass. It is soluble in xylene, amorphous when dried, and it does not cryst allize with age, so its optical properties do not deteriorate.[citation needed]