Stains - Alcian blue

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Stains

Alcian blue

Reviewer: Nat Pernick, M.D., PathologyOutlines.com, Inc. (see Reviewers page)
Revised: 27 April 2011, last major update April 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

General
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● Common "routine" stain (not an immunohistochemical stain) to detect mucins
● At pH 2.5, detects acidic mucins
● At pH 1.0, detects highly acidic mucins
● Stained parts are blue to bluish-green
● Note: all references below are to pH 2.5 unless otherwise indicated
● Procedure (University of Utahl)

Uses
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(1) Stains acid-simple non-sulfated and acid-simple mesenchymal mucins at pH 2.5, acid-complex sulfated mucins at pH 1.0 and acid-complex connective tissue mucins at pH 0.5; does NOT stain neutral mucins
(2) PAS-Alcian blue may be best pan mucin combination; PAS also stains glycogen, but predigestion with diastase will remove the glycogen
(3) Alcian blue-high iron diamine detects sulfomucins (brown) and sialomucins (blue)
(4) Mixture of carbol fuchsin and Alcian blue may be preferable to Giemsa stain to identify H. pylori (Southeast Asian J Trop Med Public Health 2008;39:659)
(5) Modified Alcian blue stain may be rapid, cheap, highly sensitive and specific for metastatic invasive lobular carcinoma (Arch Pathol Lab Med 2010;134:1513)
(6) As a drug, may have anti-HIV activity (Antimicrob Agents Chemother 2009;53:4852)

Positive staining (normal)
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● Colloid of thyroid gland, goblet cells, mucous glands

Positive staining (disease)
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● Adenocarcinoma, adenosquamous carcinoma, mucinous tumors, myxedema (dermal mucin), myxoma (mucoid matrix), nodular mucinosis (breast, other), Paget's disease of scrotum

Negative staining
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● Lipids / lipid entities (lipoma, liposarcoma), Paget's disease of esophagus, squamous cell carcinoma (acantholytic variant-breast & other sites, pseudoglandular variant-penis & other sites), xanthelasma

Micro images
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Esophagus: normal submucosal glands and ducts


Barrett's esophagus - blue staining goblet cells and clear staining gastric-type surface columnar cells

Barrett's esophagus - GE junction

Barrett's esophagus and mimics

Chordoma-stroma stains with Alcian blue


Kidney-mucinous tubular and spindle cell carcinoma


Lobular carcinoma of breast (metastatic) and modified Alcian blue stain

Mucoepidermoid carcinoma of breast (Alcian blue-PAS)

Myxoma of heart with glandular structures

Paget's disease of scrotum

Signet ring carcinoma of breast-Alcian blue-PAS

Thyroid gland: signet ring variant of follicular adenoma with strong intracytoplasmic staining

Thyroid gland: pretibial myxedema

Urothelial carcinoma with gland-like lumina

End of Stains > Alcian blue

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