A liver panel typically consists of the following histochemical special stains:
Reticulin (for reticulin substructure)
Masson's Trichrome (for collagen)
Perls Prussian Blue (for iron)
Rhodanine or Orcein (for copper)
Adding a panel of liver-specific histochemical stains gives your pathologist a wealth of clinically-relevant information about your liver biopsy submission that is not available on routine haematoxylin and eosin staining.
A reticulin histochemical stain reveals architectural changes including areas of parenchymal collapse and extinction, as well as proliferative foci such as hyperplastic, regenerative, benign, and malignant regions. Want to know what the liver nodule you saw really is? You need a reticulin stain!
A trichrome histochemical stain reveals the degree of fibrosis in your patient's liver, whether it be subtle dissecting fibrosis that is reversible, or advanced fibrotic disease. This information will inform your clinical management.
An iron histochemical stain is essential for evaluation of pigment in the liver and definitive identification of iron. Iron is frequently sequestered in the form of haemosiderin in inflammatory conditions and must be diligently differentiated from other pigments including lipofuscin, bile, and copper.
A copper histochemical stain must be employed to understand the contribution of copper accumulation in your patient's hepatopathology. Chelation therapy may be of value in many instances and can only be determined with copper evaluation and its histologic context.
Evaluating liver biopsies without the use of additional liver-specific histochemical stains is a regrettable missed opportunity for fully informed clinical management.
Make the most of your liver biopsy and work with a pathologist that is passionate about hepatopathology!
Comments