Stain | Material stained | Relevance in liver biopsy |
Reticulin | Type III collagen fibres | Useful for assessing gross architecture of the specimen. Condensation of reticulin fibres is seen in areas of recent hepatocellular necrosis and in fibrosis Also useful for highlighting nodular changes in nodular regenerative hyperplasia |
Haematoxylin van Gieson* | Type I collagen fibres | Normally only present in portal tracts and around hepatic veins; increased staining seen in fibrosis |
Orcein | Hepatitis B surface antigen | May be present in chronic Hepatitis B infection |
Copper-associated protein | Can be increased in any cause of chronic cholestasis and Wilson’s disease | |
Elastic fibres | Produced in longstanding fibrosis and can help differentiate this from recent architectural changes caused by necrosis and collapse | |
Periodic acid–Schiff | Glycogen | Stains hepatocytes which contain abundant glycogen, useful to both detect hepatocytes and show their absence (for example in confluent necrosis) |
Periodic acid–Schiff diastase | Mucin Alpha-1 antitrypsin | Following the digestion of glycogen with diastase abnormal polymers of alpha-1 antitrypsin can be seen in cases of alpha-1 antitrypsin deficiency |
Perls’ stain | Haemosiderin (ferric iron) | Increased iron deposition is seen in any cause of iron overload |
*Other stains such as Sirius red and trichrome may also be used to visualise collagen fibres.