Breast Cancer Diagnosis and Eosinophilic Cytoplasm
If a suspicious breast lesion is identified on a breast cancer screening mammogram, there is a very good chance that a small tissue sample will be taken for histological analysis.
During this process, the pathologist will drop various protein-based dyes (and other types of dyes) into the tissue sample. If certain proteins or hormones are present in the tissue, they will react to the dye and change color.
Eosin, is an acid-based dye, and if certain biochemical processes are happening within the tissue such that there is a chemical reaction to the eosin dye, those stained cells are called ‘eosinophilic’, which means ‘loves eosin’.
Eosinophilic cytoplasm therefore describes the appearance of cells and structures seen in histological sections. These cells readily ‘take up’ the staining dye eosin.
Proteins are chains of amino acids
Eosin is a bright-pink protein based dye that will therefore react or ‘stain‘ proteins suspended in the cytoplasm of cells as well as extracellular proteins such as collagen. Thus, we get the term ‘eosinophilic cytoplasm’.
A more inclusive term, ‘Acidophilic‘, refers to all cellular tissues which react to an acid dye. Eosin, is just one type of acid dye, but one of the most frequently used. Acid dyes are ‘negative‘, while acidophilic structures and elements (such as suspended proteins in the cytoplasm from new cancer cell growth) and ‘positive’.
As such, the ‘positive‘ and ‘negative‘ elements will experience a chemical reaction, resulting in a change of color.
Hematoxylin and Eosin, or H and E
Eosin stain is usually combined with a stain called hematoxylin, and it is the most widely used stain in medical diagnosis. Hematoxylin, is actually not an acid dye, but rather a ‘basic‘ dye.
There are other structures in tissue that are typically ‘basophilic‘ (or very receptive to ‘basic‘, rather than ‘acidic‘ dyes). Such structures include DNA, RNA, ribosomes, and RER. However, the various biological structures being stained do not have to be acidic or basic to be called basophilic and eosinophilic. The terminology is actually just based on the affinity to the dyes, more of a convenient and practical label rather than a ‘medical‘ one.
Basophilic elements stain blue
Basophilic elements which react to hematoxylin will actually stain blue, so the combination of blue (hematoxylin) and pink (eosin) staining, gives a good indication of a variety of biological processes in the tissue sample.
Pink or acid-protein based staining will be indicative of increased levels of new cell growth generally, while blue or ‘base‘ staining will react with the nuclei and make turn them a blueish color, making them more easy to see. Where there is Mitosis (cell division) going on, there will be an increase in the amount of blue staining in the sample. (There will be larger numbers of blue-stained nuclei, which can be counted).
Other commonly used stains: PAS, Acid Fuschin-Toluidin Blue, Nissl
A dye called Periodic Acid Schiff and Hematoxylin, or PAS, is also sometimes used in the evaluation of biopsy samples for potential breast cancer. It tends to stain in a purple or magenta color, and is useful in detecting mucin, basement membranes, glycogen, and carbohyrdates.
In this way, a PAS dye might be helpful in distinguishing one type of breast cancer from another, based on the origin and function of the affected cells, or in determining that a lesion is in fact not breast cancer.
Toluidin stains basophilic structures such as DNA
Specialists may also sometime use an Acid Fuchsin-Toluidine Blue Stain in breast cancer diagnosis. The acid fuschin part of the mixture is useful to detect acidiphilic structures and will stain pink. The Toluidine is a rich blue and will stain basophilic structures like DNA, RNA, and ribosomes.
Nissl stains assist in neuro-endocrine differentiation of breast cancer cells
A Nissl stain is a blackish blue in color. There is an ‘electrical‘ element to the use of this stain. Indeed, it is mainly useful in identifying neurons, as it will stain negatively charge structures.
When specialists detect a ‘Nissl substance‘ (rough endoplasmic reticulum) in the cellular cytoplasm, it will stain with a dark blue ‘mottled‘ appearance. Mostly, a Nissl stain is useful in the analysis of brain tissue, but medics sometimes use it in breast cancer diagnosis to see if there is neuro-endocrine cells involvment.
Well this is a pretty rare topic to search for… This page probably has more information than anywhere else on the internet. So everything you need to know about Eosinophilic cytoplasm in breast cancer diagnosis is somewhere in the information above…
For further reading, I recommend you visit this page with Histological descriptions of invasive breast cancers.
References
- Petushi S, Garcia FU, Haber MM, Katsinis C, Tozeren A. Large-scale computations on histology images reveal grade-differentiating parameters for breast cancer. BMC Med Imaging. 2006 Oct 27;6:14.
- Dalton LW, Pinder SE, Elston CE, Ellis IO, Page DL, Dupont WD, Blamey RW: Histologic grading of breast cancer: linkage of patient outcome with level of pathologist agreement. Mod Pathol 2000 , 13:730-735.
- Harigopal M, Shin SJ, Murray MP, Tickoo SK, Brogi E, Rosen PP. Aberrant E-cadherin staining patterns in invasive mammary carcinoma. World J Surg Oncol 2005 Nov 14, 3:73
- Ge Y, Sneige N, Eltorky MA, Wang Z, Lin E, Gong Y, Guo M. Immunohistochemical characterization of subtypes of male breast carcinoma. Breast Cancer Res. 2009;11(3):R28.
- Liu XJ, Shen P, Wang XF, Sun K, Sun FF. Solitary adrenal metastasis from invasive ductal breast cancer: an uncommon finding. World J Surg Oncol. 2010 Jan 28;8:7.
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