Special stains in diagnostic liver pathology

The comprehensive histopathologic evaluation of liver tissue, including biopsy, explant, and postmortem specimens, utilizes a standard panel of special histochemical stains as well as selective immunohistochemistry. These methods provide increased accuracy in addressing common diagnostic problems such as determining the stage of fibrosis in chronic hepatitis, documenting the presence of cirrhosis or other causes of portal hypertension, iron, and copper overload, disorders of the biliary tract, and tumor histogenesis. This review discusses the indications for various staining methods and the specific uses of trichrome and reticulin connective tissue stains, periodic acid-Schiff (PAS) and diastase-pretreated PAS (DPAS), iron, and Victoria blue methods. Diagnostic applications of immunohistochemical stains are also described.