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What is Reticulin Stain test?

Reticulin stain is commonly used in histopathology laboratories to visualise biopsy specimens of body tissues, most commonly the liver tissue but also of kidney or spleen.

Histopathological staining is employed as an aid to the treatment of diseases when a closer examination of tissues is needed to ascertain the presence of abnormalities. Staining highlights the features of the tissue and enhances its contrast, which allows the examiner to visualise it with better clarity. 

Reticulin is a form of collagen, which is present in the membranes of certain body organs. Reticulin fibres form a mesh-like structure in these organs and helps support the soft tissues structures. On staining, this mesh-like structure appears in shades of black under the microscope.

Reticulin stain is made of ammoniacal silver and formalin and the process of staining is called metal impregnation. The silver initially binds to the tissue and formalin reacts with it to make a coloured precipitate that makes it possible to visualise the tissue.

The tissue sample to be tested is obtained through biopsy.

Reticulin staining is a commonly used method for diagnosing tumours

  1. Why is Reticulin Stain test performed?
  2. How do you prepare for Reticulin Stain test?
  3. How is Reticulin Stain test performed?
  4. What do Reticulin Stain test results mean?

Reticulin staining is performed to detect reticulin fibres and assess body cells (from liver, kidney, spleen) for conditions such as necrosis (unplanned death of the cells constituting a tissue), and hyperplasia (increase in size of tissue due to excessive cell division). 

The stain may also be used to assess the bone marrow.

You may have to take several measures before going for this test. 

Your doctor will advise you on what needs to be done. He/she may ask you to refrain from eating anything for about eight hours before the test. You must arrange for a ride home as most patients are unable to drive themselves after undergoing a biopsy.

Most importantly, make sure that you talk to your doctor if they are taking the following medications or supplements:

  • Blood thinners
  • Antibiotics
  • Antidepressants
  • Diabetes medications
  • Pain killers
  • Aspirin

If you are required to undergo a liver biopsy, then you can expect the following steps to be done:

  • A nurse will provide you with a gown to wear for the test.
  • Your doctor will give you a sedative through IV so that you may relax. 
  • If a percutaneous (through the skin) biopsy is being done, then the doctor will insert a fine needle through your abdomen and into your liver to obtain the tissue sample. 
  • If a transjugular biopsy is being done, then a needle attached with a wire will be inserted through a small incision in your neck and will be passed into a vein into your liver to obtain a sample of the liver tissue. This type of biopsy is likely to be used if you have a bleeding disorder and are prone to get excessive bleeding after a small puncture.
  • A laparoscopic biopsy is done by making a small incision in the abdominal area through which a tube-like instrument is inserted to collect the sample.

For a bone marrow biopsy, you will have to lie on your side with your knees pointing toward your chest and the needle will be inserted into your hip bone to draw out some liquid bone marrow.

Normal results:

Normal results will show the usual mesh-like structure of the reticular fibres.

Abnormal results:

An abnormal result will be given if disturbed patterns of reticular fibres are seen under the microscope. It may indicate liver cirrhosis or tumours.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. Bergman S, et al. The usefulness of the reticulin stain in the differential diagnosis of liver nodules on fine needle aspiration biopsy cell block preparations. Mod Pathol. Dec 1997, 10(12):1258-1264 PMID: 9436973.
  2. Alturkistani Hani A.,Tashkandi Faris M., and Mohammedsaleh Zuhair M. Histological Stains: A Literature Review and Case Study. Glob J Health Sci. 2016 Mar; 8(3): 72–79. PMID: 26493433.
  3. Ushiki T. Collagen fibers, reticular fibers and elastic fibers. A comprehensive understanding from a morphological viewpoint.. Arch Histol Cytol. Jun 2002; 65(2):109-126. PMID 12164335.
  4. The Royal College of Pathologists [internet]. England. U.K.; What is biopsy
  5. Krishna Murli. Role of special stains in diagnostic liver pathology. Clinical Liver Disease. 2013 March; 2(S1):s8-10.
  6. UCSF Department of Surgery [internet]. University of California. Oakland. California. U.S.A.; Liver Biopsy
  7. American Liver Foundation [internet]. New York (NY): American Association for the Study of Liver Diseases; Liver Biopsy
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