A special stain is a test that helps pathologists see details in a tissue sample that cannot be seen with the routine stain called hematoxylin and eosin. Pathologists perform a special stain by adding a coloured dye (the stain) to a tissue sample which is then examined under a microscope. The stain causes the tissue to change colour. The colour depends on the type of stain used and the tissue.

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There are hundreds of different special stains available and the special stain selected will depend on the question your pathologist is trying to answer. For example, some infectious micro-organisms such as fungi or bacteria are almost invisible when examined with a routine stain. When a special stain is added to the tissue, these micro-organisms turn black or red which makes them much easier to see.

 

Some of the most common special stains include:

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• PAS/D - This special stain is commonly used to highlight fungal organisms and biological materials such as mucin and glycogen.

• Masson trichrome - This special stain is commonly used to highlight a type of scar tissue in tissue that pathologists call fibrosis.

• Mucicarcime - This special stain is used to highlight the biological material mucin inside cells.

• Ziehl-Neelsen - This special stain is used to highlight the micro-organisms that cause tuberculosis in tissue, however, it can also be used to identify other types of micro-organisms. 

• Elastic - This special stain is used to highlight a type of tissue called elastic fibers. These fibers are found normally around blood vessels and on the outer surface of the lung (the pleura). The stain is usually used by pathologists to see if the elastic fibers have been damaged either by cancer cells or an inflammatory process.

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