Romanowsky staining in cytopathology: history, advantages and limitations

Abstract

If the entire discipline of diagnostic cytopathology could be distilled into a single theme, it would be the Papanicolaou stain. Yet it was the Romanowsky stain upon which the discipline of cytopathology was founded. Both stains are used today in the cytopathology laboratory, each for a different and complementary purpose. We trace the history of cytopathological stains and discuss the advantages and limitations of Romanowsky-type stains for cytological evaluation. We also provide suggestions for the advantageous use of Romanowsky-type stains in cytopathology.

Guidelines for May‐Grünwald–Giemsa staining in haematology and non‐gynaecological cytopathology: recommendations of the French Society of Clinical Cytology (SFCC) and of the French Association for Quality Assurance in Anatomic and Cytologic Pathology (AFAQAP)

“…To the best of our knowledge, guidelines and professional recommendations concerning staining procedures in haematology and non‐gynaecological cytopathology have only been published by the ICSH in 1984, by the EQALM and by the ASC, both in 2004. The present recommendations take into account all available contributions to the field, including baseline studies and the more recently published studies . They aim at serving as actualised, best practice recommendations for proper handling of air‐dried cytological specimens.…”

“…Issued from Pappenheim's combination, MGG is a neutral stain composed of a mixture of oxidised methylene blue (azure) dyes and eosin Y . The association of azure B and eosin Y is required to produce the so‐called Romanowsky‐Giemsa effect (RGE), a paradox that refers to the fact that the purple colour cannot be obtained by either methylene blue subcomponents or eosin alone.…”

Comparison between May‐Grünwald‐Giemsa and rapid cytological stains in fine‐needle aspirates of canine mast cell tumour: Diagnostic and prognostic implications

“…10 The staining affinity of RS is similar to that of methanolic stains, although the majority of cytology textbooks report that, in a variable proportion of cases, RS may not adequately stain the granules of mast cells. 1,9,11,12 It has been hypothesized that this may be related to the water-soluble nature of the granule content and inability to form a stable precipitate. 12 Thus, depending on the poor differentiation of the neoplasm and inexperience of the cytologist, MCTs could be misdiagnosed with other tumour types, including histiocytoma, lymphoma, plasma cell tumour and melanoma, with detrimental clinical consequences.…”

“…The staining affinity of RS is similar to that of methanolic stains, although the majority of cytology textbooks report that, in a variable proportion of cases, RS may not adequately stain the granules of mast cells . It has been hypothesized that this may be related to the water‐soluble nature of the granule content and inability to form a stable precipitate .…”

Pappenheim-Färbung: Beschreibung einer hämatologischen Standardfärbung – Geschichte, Chemie, Durchführung, Artefakte und Problemlösungen/Pappenheim Stain: Description of a hematological standard stain – history, chemistry, procedure, artifacts and problem solutions

“…Die intensive Lufttrocknung und intensive Fixation mit Methanol sind insbesondere f ü r die Darstellung des Chromatins und f ü r die Beurteilung der GewebeStrukturen von entscheidender Bedeutung, wahrscheinlich bedeutsamer als geringe Variationen der restlichen F ä rbe-Prozedur [1] . Dies ist vor allem bei der Bearbeitung von ausw ä rts angefertigten Ausstrichen zu beachten (Einsender entsprechend informieren!…”