Intracellular Accumulations → Pigments, Minerals and stains😊

Intracellular Accumulations

Pigments

Melanin:

Locations:

Hair
eyes
skin → stratum basale
substantia nigra (brain).

Special Stains:

Masson fontana
Enzyme stain:

Dopa oxidase.

Immunohistochemistry:

HMB45
S100

Mnemonic: Her Brain was full of Black Malam (Brain has melanin in substantia nigra) → She was dumb (Mandana → masson fontana)→ But Dope (Dopa oxidase) looking and good hump (HMB45) and base (Stratum basale)

Hemosiderin:

History of hemorrhage

Hematoma

Iron overload (hemosiderosis, hemochromatosis).

Special Stains: Pearl stain, Prussian blue stain.

Mnemonic:

Ring nte sidil Russian Pearl → Oppenheimer (Pappenheimer)
Oppenheimer → Alcoholkudich (Alcohol) alanj (ALA dehydratase) → Lead (Lead poisoning) to Bombing of 6 places (B6)

Lipofuscin:

Breakdown: Lipo (fat) + fuscin (fast).

Associations:

Old age
Senile atrophy
Wear and tear pigment

Mechanism:

Telltale sign of free radical injury → lipid peroxidation.

Location:

Perinuclear pigment (brown).
Perinuclear intralysosomal location

Special Stains:

Lipo (fat): Oil Red O.
Fuscin (fast): Ziehl-Neelsen
Others: Sudan black B, Sudan 4 (orange color).

Mnemonic:

Lipofusin → fuse (fuscin) poyalum (old age, senile atrophy) lipstick (lipid) itt nadakkunna ammumma
Epozhum main aytt nadakkan nokkum, pashe sidil ayipovum (Perinuclear)

Copper stains:

Association: ↑↑ in Wilson's disease

Rhodanine

Rubeanic acid

Mnemonic: Copper ends with R, stains begin with R.

Differentiation:

Rhodamine

(M for M) is for Mycobacterium TB.

Mnemonic:

Wilson nte Molu (Tetrathiomolybdate) → 13 year old in 7B
He is Desp (Descmet)
He like Puttu (Putamen)
He does Nine in Road (Rhodanine)

Anthracotic Pigment on biopsy

Definition: Inhaled carbon.

Appearance: Black color lungs.

Sweet stain

Stain Reticulin fibres of liver

Type 3 collagen

Glycogen

Diabetic Nephropathy / Diabetic Glomerulosclerosis

1st finding

GBM thickening

Electron microscopy
Hyperfiltration

M/c finding

Diffuse mesangial expansion/ diffuse glomerulosclerosis

Most characteristic

Kimmelstiel-Wilson (KW) nodules

Armani Ebstein pearls

Glycogen deposits on PCT

Stain: PAS +

stain → pink color
Mnemonic: Girls favourite color pink.

Diastase sensitive

Mnemonic: Girls are usually more sensitive.

Mnemonic for Glycogen

Glycogen → Glucose Daddy → Sugar daddy → Armani lesion

Glucose daddy (glycogen) ne aval Pocketil (PCT) aakki

She likes Pink Pasta (PAS+) and diving (diastase+)

Mnemonic for Antitrypsin deficiency

Tryp (α1 AT) poi

Lovely (Liver, lungs) trip with child (children) for 14 (Chr 14) days

Pizza (PIZZ) kazhichu, Pasta (PAS +ve) kazhichu

But child ullond dive (Diastase resistant) cheythilla

Sarpathina kandu (SERPINA gene)

Lipid

Most Common Organ: Liver → fatty liver.

Heart: Tiger or tabby cat appearance.

Mnemonic:

Taby tiger → Eat strawberry with cream (strawberry GB)

Strawberry Gallbladder:

Cholesterolosis of the gallbladder

aka Adenomyomatosis of gall bladder

Note: Cholesterosis (Strawberry GB) is not a risk factor for GB cancer

Gross specimen:

Strawberry GB appearance

White lines → Comet tail appearance

Special Stains:

Stains	Sections For	Features
Oil Red O (reddish)	Frozen/Fresh section	For fat identification Advantage Tissue frozen → no chemicals added → fat preserved. (Routine processing alcohol washes off fat).
Sudan Black B (black)	Fixed	ㅤ
Sudan 4 (orange)	ㅤ	ㅤ

Calcium

Metastatic Calcification

↑↑ serum Ca

Most common organ:

Lungs
Kidney
Stomach

Conditions

Hyperparathyroidism (M/c)
Sarcoidosis
Increased Vitamin D
Milk-alkali syndrome

Dystrophic calcification → Psammoma Bodies

**Monckeberg's Medial calcific Sclerosis**

Onion skinning, round pattern

Mnemonic: PSM Squared

Monckeberg's Sclerosis (CMD):

Ca in tunica media (old age).

Feature	Details
Foci of dystrophic calcification	• Dead parasite, bacteria, TB • Degenerating tissue • Atherosclerosis Seen in • Papillary RCC • Papillary carcinoma of thyroid • Mesothelioma • Meningioma • Serous cystadenoma of ovary • Prolactinoma • Somatostatinoma Mesa (mesothelioma) ulla serious (serous) men (meningioma) like Milk (prolactinoma) & pappam (PP)

Stain for Calcium	Color	Mnemonic
Von Kossa stain	Black/kala color	Calcium sounds like calcine → Von Kossa kala
Alizarin Red S	Red color	Al for Alizarin

First Site of Calcium Deposition:

Mitochondria
Exception (kidney): Basement membrane.

Mnemonic:

Dystrophin → Destroyed by Red Ali’s (Alizarin) black cash (black Kossa) → Dead ammumma (psammomma)
news came on monkey (monke) media (tunica media) → ammumma died due to atherosclerosis (atheroma)

Stains Table

Cell/Condition	Stain
Most common stain in histopathology	Hematoxylin and Eosin
Most common in hematology	Romanowsky like Leishman, Giemsa
Reticulocyte	Supravital
Lymphoblast	PAS
Myeloblast	NSE, SBB, Oil Red O
Monoblast	NSE (Non-Specific Esterase)
Hairy cell	TRAP
Lipid	Oil Red O, Sudan Black
Iron	Prussian Blue
Calcium	Von Kossa, Alizarin Red S
Glucogen	PAS
Copper (In Wilson’s Disease)	Rhodamine, Rubeanic Acid
• Mast cell, Basophils • Premalignant lesions of Lip	Toluidine Blue (Basic metachromatic dye → Stains excessive nuclear material)
Mucin (Barrett’s Esophagus)	Mucicarmine, Alcian Blue
Reticulin fibres (Liver/Bone Marrow Fibrosis)	Sweet stain → Silver
Elastin fibres	Van Gieson
Collagen	Masson Trichrome
Melanin	Masson Fontana
H. pylori	Warthin Starry Silver
Cryptococcus	India Ink
Fungi	Silver Methenamine, PAS
Amyloid	Congo Red