Diff-Quik

Last updated
Bronchoalveolar lavage specimen stained with Diff-Quik Macrophages in bronchial wash specimen -- high mag.jpg
Bronchoalveolar lavage specimen stained with Diff-Quik

Diff-Quik is a commercial Romanowsky stain variant used to rapidly stain and differentiate a variety of pathology specimens. It is most frequently used for blood films and cytopathological smears, including fine needle aspirates. [1] [2] [3] The Diff-Quik procedure is based on a modification of the Wright-Giemsa stain pioneered by Harleco in the 1970s, [1] and has advantages over the routine Wright-Giemsa staining technique in that it reduces the 4-minute process into a much shorter operation and allows for selective increased eosinophilic or basophilic staining depending upon the time the smear is left in the staining solutions. [4]

Contents

There are generic brands of such stain, [1] [5] and the trade name is sometimes used loosely to refer to any such stain (much as "Coke" or "Band-Aid" are sometimes used imprecisely).

Usage

Diff-Quik may be utilized on material which is air-dried prior to alcohol fixation rather than immersed immediately (i.e. "wet-fixed"), although immediate alcohol fixation results in improved microscopic detail. [2] [3] [6]

The primary use of Romanowsky-type stains in cytopathology is for cytoplasmic detail, while Papanicolaou stain is used for nuclear detail. Diff-Quik stain highlights cytoplasmic elements such as mucins, fat droplets and neurosecretory granules. Extracellular substances, such as free mucin, colloid, and ground substance, are also easily stained, and appear metachromatic. Major applications include blood smears, bone marrow aspirates, semen analysis and cytology of various body fluids including urine and cerebrospinal fluid. [7] [8] Microbiologic agents, such as bacteria and fungi, also appear more easily in Diff-Quik. [3] This is useful for the detection of for example Helicobacter pylori from gastric and pyloric specimens. [5]

Due to its short staining time, Diff-Quik stain is often used for initial screening of cytopathology specimens. This staining technique allows the cytotechnologist or pathologist to quickly assess the adequacy of the specimen, identify possible neoplastic or inflammatory changes, and decide whether or not additional staining is required. [4] [9] [10]

Components

The Diff-Quik stain consists of 3 solutions: [4]

Results

StructureColour
Erythrocytes Pink/yellowish red
Platelets Violet/purple granules
Neutrophils Blue nucleus, pink cytoplasm, violet granules
Eosinophils Blue nucleus, blue cytoplasm, red granules
Basophils Purple/dark blue nucleus, violet granules
Monocyte Violet nucleus, light blue cytoplasm
Bacteria and fungi Dark blue
Cytoplasm, collagen and muscle Various shades of pink, orange, yellow and blue [11]
Spermatozoa Light blue acrosomal region, dark blue post-acrosomal region [8]

Alternatives

Related Research Articles

Pap test Cervical screening test to detect potential cancers

The Papanicolaou test is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix or colon. Abnormal findings are often followed up by more sensitive diagnostic procedures and, if warranted, interventions that aim to prevent progression to cervical cancer. The test was independently invented in the 1920s by Georgios Papanikolaou and Aurel Babeș and named after Papanikolaou. A simplified version of the test was introduced by Anna Marion Hilliard in 1957.

Anatomical pathology Medical specialty

Anatomical pathology (Commonwealth) or Anatomic pathology (U.S.) is a medical specialty that is concerned with the diagnosis of disease based on the macroscopic, microscopic, biochemical, immunologic and molecular examination of organs and tissues. Over the last century, surgical pathology has evolved tremendously: from historical examination of whole bodies (autopsy) to a more modernized practice, centered on the diagnosis and prognosis of cancer to guide treatment decision-making in oncology. Its modern founder was the Italian scientist Giovan Battista Morgagni from Forlì.

Haematoxylin Chemical compound

Haematoxylin or hematoxylin, also called natural black 1 or C.I. 75290, is a compound extracted from heartwood of the logwood tree with a chemical formula of C
16
H
14
O
6
. This naturally derived dye has been used as a histologic stain, ink and as a dye in the textile and leather industry. As a dye, haematoxylin has been called Palo de Campeche, logwood extract, bluewood and blackwood. In histology, haematoxylin staining is commonly followed (counterstained), with eosin, when paired, this staining procedure is known as H&E staining, and is one of the most commonly used combinations in histology. In addition to its use in the H&E stain, haematoxylin is also a component of the Papanicolaou stain which is widely used in the study of cytology specimens.

Georgios Papanikolaou Greek pathologist

Georgios Nikolaou Papanikolaou was a Greek physician who was a pioneer in cytopathology and early cancer detection, and inventor of the "Pap smear".

Cytopathology A branch of pathology that studies and diagnoses diseases on the cellular level

Cytopathology is a branch of pathology that studies and diagnoses diseases on the cellular level. The discipline was founded by George Nicolas Papanicolaou in 1928. Cytopathology is generally used on samples of free cells or tissue fragments, in contrast to histopathology, which studies whole tissues. Cytopathology is frequently, less precisely, called "cytology", which means "the study of cells".

Romanowsky stain Family of related stains for examination of blood including the detection of parasites

Romanowsky staining, also known as Romanowsky–Giemsa staining, is a prototypical staining technique that was the forerunner of several distinct but similar stains widely used in hematology and cytopathology. Romanowsky-type stains are used to differentiate cells for microscopic examination in pathological specimens, especially blood and bone marrow films, and to detect parasites such as malaria within the blood. Stains that are related to or derived from the Romanowsky-type stains include Giemsa, Jenner, Wright, Field, May–Grünwald and Leishman stains. The staining technique is named after the Russian physician Dmitri Leonidovich Romanowsky (1861–1921), who was one of the first to recognize its potential for use as a blood stain.

Staining Technique used to enhance visual contrast of specimens observed under a microscope

Staining is a technique used to enhance contrast in samples, generally at the microscopic level. Stains and dyes are frequently used in histology and in the medical fields of histopathology, hematology, and cytopathology that focus on the study and diagnoses of disease at a microscopic level. Stains may be used to define biological tissues, cell populations, or organelles within individual cells.

Blood smear Stained blood on microscope slide

A blood smear, peripheral blood smear or blood film is a thin layer of blood smeared on a glass microscope slide and then stained in such a way as to allow the various blood cells to be examined microscopically. Blood smears are examined in the investigation of hematological (blood) disorders and are routinely employed to look for blood parasites, such as those of malaria and filariasis.

Wrights stain Hematologic stain that facilitates the differentiation of blood cell types

Wright's stain is a hematologic stain that facilitates the differentiation of blood cell types. It is classically a mixture of eosin (red) and methylene blue dyes. It is used primarily to stain peripheral blood smears, urine samples, and bone marrow aspirates, which are examined under a light microscope. In cytogenetics, it is used to stain chromosomes to facilitate diagnosis of syndromes and diseases.

Giemsa stain

Giemsa stain, named after German chemist and bacteriologist Gustav Giemsa, is a nucleic acid stain used in cytogenetics and for the histopathological diagnosis of malaria and other parasites.

Eosinophilic

Eosinophilic is the staining of tissues, cells, or organelles after they have been washed with eosin, a dye.

Fibroadenoma Medical condition

Fibroadenomas are benign breast tumours characterized by an admixture of stromal and epithelial tissue. Breasts are made of lobules and ducts. These are surrounded by glandular, fibrous and fatty tissues. Fibroadenomas develop from the lobules. The glandular tissue and ducts grow over the lobule to form a solid lump.

Fine-needle aspiration

Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, are examined under a microscope (biopsy). The sampling and biopsy considered together are called fine-needle aspiration biopsy (FNAB) or fine-needle aspiration cytology (FNAC). Fine-needle aspiration biopsies are very safe minor surgical procedures. Often, a major surgical biopsy can be avoided by performing a needle aspiration biopsy instead, eliminating the need for hospitalization. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions.

Papanicolaou stain Histological staining method

Papanicolaou stain is a multichromatic (multicolored) cytological staining technique developed by George Papanicolaou in 1942. The Papanicolaou stain is one of the most widely used stains in cytology, where it is used to aid pathologists in making a diagnosis. Although most notable for its use in the detection of cervical cancer in the Pap test or Pap smear, it is also used to stain non-gynecological specimen preparations from a variety of bodily secretions and from small needle biopsies of organs and tissues. Papanicolaou published three formulations of this stain in 1942, 1954, and 1960.

Leishman stain Diagnostic technique

Leishman stain, also known as Leishman's stain, is used in microscopy for staining blood smears. It is generally used to differentiate between and identify white blood cells, malaria parasites, and trypanosomas. It is based on a methanolic mixture of "polychromed" methylene blue and eosin. The methanolic stock solution is stable and also serves the purpose of directly fixing the smear eliminating a prefixing step. If a working solution is made by dilution with an aqueous buffer, the resulting mixture is very unstable and cannot be used for long. Leishman stain is named after its inventor, the Scottish pathologist William Boog Leishman. It is a version of the Romanowsky stain, and is thus similar to and partially replaceable by Giemsa stain, Jenner's stain, and Wright's stain.

Koilocyte

A koilocyte is a squamous epithelial cell that has undergone a number of structural changes, which occur as a result of infection of the cell by human papillomavirus (HPV). Identification of these cells by pathologists can be useful in diagnosing various HPV-associated lesions.

FNA mapping is an application of fine-needle aspiration (FNA) to the testis for the diagnosis of male infertility. FNA cytology has been used to examine pathological human tissue from various organs for over 100 years. As an alternative to open testicular biopsy for the last 40 years, FNA mapping has helped to characterize states of human male infertility due to defective spermatogenesis. Although recognized as a reliable, and informative technique, testis FNA has not been widely used in U.S. to evaluate male infertility. Recently, however, testicular FNA has gained popularity as both a diagnostic and therapeutic tool for the management of clinical male infertility for several reasons:

  1. The testis is an ideal organ for evaluation by FNA because of its uniform cellularity and easy accessibility.
  2. The trend toward minimally invasive procedures and cost-containment views FNA favorably compared to surgical testis biopsy.
  3. The realization that the specific histologic abnormality observed on testis biopsy has no definite correlation to either the etiology of infertility or to the ability to find sperm for assisted reproduction.
  4. Assisted reproduction has undergone dramatic advances such that testis sperm are routinely used for biological pregnancies, thus fueling the development of novel FNA techniques to both locate and procure sperm.

In diagnostic pathology, a hematoxylin body, or LE body, is a dense, homogeneous, basophilic particle, easily stainable with hematoxylin. It consists of degraded nuclear material from an injured cell, along with autoantibodies and a limited amount of cytoplasm.

Vaginal cytology is a microscopic examination of cells from the vaginal epithelium. In veterinary medicine, it helps differentiate the stages of the mammalian estrous cycle because the vaginal epithelium changes in response to sex hormone levels; practically, it is used to distinguish when a female canine is at a particular point in the estrous cycle. In a normal vaginal smear, lactational cells, navicular cells, endocervical cells, endometrial cells, trophoblastic cells, and leucocytes may be present.

Cytocentrifuge Laboratory equipment

A cytocentrifuge, sometimes referred to as a cytospin, is a specialized centrifuge used to concentrate cells in fluid specimens onto a microscope slide so that they can be stained and examined. Cytocentrifuges are used in various areas of the clinical laboratory, such as cytopathology, hematology and microbiology, as well as in biological research. The method can be used on many different types of specimens, including fine needle aspirates, cerebrospinal fluid, serous and synovial fluid, and urine.

References

  1. 1 2 3 Silverman JF, Frable WJ (1990). "The use of the diff-quik stain in the immediate interpretation of fine-needle aspiration biopsies". Diagnostic Cytopathology. 6 (5): 366–9. doi:10.1002/dc.2840060516. PMID   1705500.
  2. 1 2 Susan C. Lester (10 May 2019). "Section 2: Methods - Slide preparation". Diagnostic Pathology: Intraoperative Consultation (2nd ed.). Elsevier Health Sciences. p. 69. ISBN   978-0-323-57020-6.
  3. 1 2 3 Demay, Richard (2012). "Chapter 26: Stains". The art and science of cytopathology. Chicago, IL: Am Soc Clinical Pathology. p. 1505. ISBN   978-0-89189-644-9. OCLC   761848930.
  4. 1 2 3 Keebler, Catherine (1993). The manual of cytotechnology (7th ed.). Chicago: ASCP Press. ISBN   0-89189-352-0. OCLC   27435280.
  5. 1 2 Kumar, George L.; Kiernan, John A.; Gill, Gary W.; Badve, Sunil (2010). "Chapter 1: Introduction to special stains" (PDF). Education guide: Special stains and H&E (2nd ed.). Dako North America. p. 5. Archived (PDF) from the original on 2019-01-30. Retrieved 2019-06-29.
  6. William G. Finn; LoAnn C. Peterson (31 May 2004). "Role of fine needle aspiration in lymphoma". Hematopathology in Oncology. Springer Science & Business Media. p. 184. ISBN   978-1-4020-7919-1.
  7. "RAL DIFF-QUIK". RAL diagnostics. Retrieved 2021-06-12.
  8. 1 2 "Part I: Semen analysis". WHO laboratory manual for the examination and processing of human semen (5th ed.). Geneva: World Health Organization. 2010. p.  62. ISBN   978-92-4-154778-9. OCLC   646393549.
  9. Meena, Nikhil; Jeffus, Susanne; Massoll, Nicole; et al. (2015). "Rapid onsite evaluation: A comparison of cytopathologist and pulmonologist performance". Cancer Cytopathology. Wiley. 124 (4): 279–284. doi: 10.1002/cncy.21637 . ISSN   1934-662X. PMID   26492064.
  10. Roh, Michael H. (2015). "The Utilization of Cytologic Fine-Needle Aspirates of Lung Cancer for Molecular Diagnostic Testing". Journal of Pathology and Translational Medicine. The Korean Society of Pathologists and The Korean Society for Cytopathology. 49 (4): 300–309. doi:10.4132/jptm.2015.06.16. ISSN   2383-7837. PMC   4508567 . PMID   26076721.
  11. Polysciences Inc. "Differential Quik Stain (Modified Giemsa)" (PDF). Technical Data Sheet #715. Archived (PDF) from the original on 2019-06-30. Retrieved 2019-06-30.