Evaluation of efficacy of Modified Cajal’s Trichrome Stain in oral lesions in comparison with Hematoxylin & Eosin stain – A Histopathological study

Abstract

BACKGROUND: Hematoxylin and Eosin (H&E) staining is the standard stain routinely employed in histopathological labs. Special stains are used in doubtful diagnostic cases to affirm the correct diagnosis. Modified Cajal’s Trichrome Stain (MCTS) is one of the age old special stains, rarely used in recent days.
AIM: To assess the efficacy of MCTS as compared to H&E in various oral lesions
MATERIALS & METHODS: Twenty formalin-fixed, paraffin-embedded tissue blocks, including epithelial pathologies (n=6), salivary gland pathologies (n=3), skin pathologies (n=2), muscle tumours (n=2), odontogenic tumours (n=2) and normal oral epithelium (n=5) were taken. Two sections from each block were made and subsequently stained with H&E as well as MCTS. Nuclear intensity, crispiness, epithelial basement membrane interface and connective tissue
components in both the stains were observed and evaluated. Chi square test was employed to find the p value. RESULT: MCTS stains nuclei red-purple, epithelial cytoplasm pink-green, collagen blue, keratin and muscle green. The nuclear intensity is better seen in H&E stain (p=0.002). Nuclear crispiness
shown in MCTS is in par with H&E (p= 0.098). Epithelium basement membrane interface is more clearly delineated in MCTS (p= 0.01). MCTS helps in ruling out micro invasive squamous cell carcinoma, easily locates keratin pearls in pleomorphic adenoma, intraepithelial and basement membrane splits in skin diagnosis, and identifies undifferentiated tumours. 
CONCLUSION: Due to its ability to delineate various structural components of epithelium and connective tissue, ease of usage, and cost effectiveness, MCTS can be used as an adjuvant to H&E in routine histopathological practice.