Introduction to Neuropathology
What You'll Learn
- A systematic way to read any neuropathology slide — orient, low power, high power, name the pattern, then order stains
- When to use low vs high magnification
- The core stains and a decision guide for which stain answers which question
- How tissue is prepared (permanent / frozen / smear) and the artifacts that fool you
What You'll Learn
| Power | What it's for | What you read |
|---|
| Low (2–10×) | Screening & architecture | Orientation, lesion distribution (focal/diffuse/perivascular/laminar), cellularity, demarcation, normal-vs-abnormal comparison |
| High (20–40×) | Cytology & detail | Nuclear atypia, mitoses, microvascular proliferation, inclusions, organisms, single-cell reactions (red neurons, chromatolysis) |
Histochemical Stains
| Stain | Target | Key use |
|---|
| H&E | General morphology | Nuclei blue, cytoplasm pink; red neurons bright eosinophilic |
| Nissl (cresyl violet) | Neuronal rough ER | Identifies neurons; Nissl dissolves in chromatolysis |
| Luxol fast blue | Myelin | Myelin blue; pale = demyelination/dysmyelination |
| Silver (Bielschowsky/Bodian) | Axons, tangles, plaques | Argyrophilic; Alzheimer pathology |
| Congo red / thioflavin | Amyloid | Apple-green birefringence (polarized light) |
| PAS | Glycogen, fungi, BM | Lafora bodies, corpora amylacea, fungi |
| GMS / mucicarmine | Fungi | GMS black; mucicarmine = Cryptococcus capsule |
| Ziehl-Neelsen | Acid-fast bacilli | Tuberculosis (red bacilli) |
| Prussian blue (Perls) | Iron / hemosiderin | Old hemorrhage, remote infarct, siderosis |
| Gomori trichrome | Muscle / mitochondria | Ragged red fibers; nemaline rods |
| Masson-Fontana | Melanin | Metastatic melanoma; neuromelanin |
| von Kossa / Alizarin | Calcium | Calcification (psammoma bodies, Fahr) |
| Oil Red O | Neutral lipid | Frozen tissue only; foamy macrophages, myelin debris |
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