[Histonet] Re: PAS Diastase

[Bob Richmond]

Jennifer MacDonald asked: >>At a local lab when a pathologist orders a
PAS diastase the histotechnicians do just one slide with diastase.
They do not do an undigested slide. How would the pathologist know if
the digested slide had a glycogen to begin with? Am I over thinking
this?<<

If I want an undigested slide, I'll order it along with the PAS
diastase. If I'm just trying to get the glycogen out of the way in a
liver biopsy, I don't need the second slide.

I've usually used the stain when I was looking for the PAS positive
granules seen in hepatocytes in cirrhosis resulting from alpha-1
antitrypsin deficiency.

Several years ago I got an anxious phone call from an internist taking
care of a Baptist preacher who presented with cirrhosis of unknown
cause. The pathologist I was filling in for (who should have known
better), with no history at all, signed the biopsy out simply as
"alcoholic cirrhosis". The internist pointed out that his patient had
a somewhat low serum alpha-1 antitrypsin, in the heterozygous (MZ)
range. I told him I had a stain for that. Sure enough, the man's
hepatocytes contained the characteristic bright red granules. A brief
review of the literature found a few reports of cirrhosis in AAT
heterozygotes.

I may have saved the man's job. Otherwise he would have had to become
an Episcopalian like me.

Bob Richmond
Samurai Pathologist
Knoxville TN