Hematoxylin and Eosin (H&E) Stain

Hematoxylin and eosin, or H&E, is the standard stain used on almost every tissue slide. Hematoxylin colors cell nuclei blue-purple and eosin colors the rest of the cell and the surrounding tissue pink. It is the first thing a pathologist looks at, before any special stains or tests.

Origin

Hematoxylin is a dye extracted from the logwood tree, and eosin is a synthetic dye. Both came into use for staining tissue in the nineteenth century, and their combination became the routine stain of histology and surgical pathology by the late 1800s.

Significance in Asbestos Context

On H&E slides a pathologist sees the tumor's pattern and cell shapes, which decide whether a mesothelioma looks epithelioid, sarcomatoid or biphasic, and whether tumor cells invade beneath the lining. H&E also shows lung scarring, pleural plaques, and sometimes asbestos bodies, which appear as golden-brown beaded rods. However, H&E alone usually cannot prove a tumor is mesothelioma rather than a cancer spread from elsewhere; immunohistochemical stains are needed for that. When experts review a case, they typically start with the H&E slides, so these slides and the paraffin blocks they came from are central evidence. Reports often list "H&E" alongside the special stains performed. Faded or broken slides can usually be recut from the block and restained, which is one more reason the blocks themselves should be preserved.

Example Sentence

On the H&E slides the tumor cells formed tubules and papillae invading fat beneath the pleura, and immunostains confirmed epithelioid mesothelioma.

Related Terms

Histology, Histopathology, Immunohistochemistry, Eosinophilic, Pathology Report, Paraffin Block, Asbestos Bodies, Iron Stain (Prussian Blue)

Notes

• Ask the hospital to keep the H&E slides along with the paraffin blocks.
• When slides are sent out for a second opinion, ask that they be returned or tracked.
• The pathology report should list which stains were done; keep a copy.