Efficacy of Kumkum as a Surrogate for Eosin in Routine Histological Sections: An Observational Study

Abstract

Introduction: Stains are a crucial component of laboratory procedure. They help in highlighting the different tissues, both normal and abnormal, which plays an important role in diagnostic histopathology. Synthetic dyes are utilised for majority of the stains in histology. Among the natural surrogates studied, Kumkum is less researched. Aim: To compare the staining characteristics of Kumkum, which imparts red colour as an alternative to eosin. Materials and Methods: This observational study was conducted at Histopathology section, Pathology department at Chettinad Hospital and Research Institute for a period of six months from January 2022 to June 2022. In 50 tissue blocks, each was made into two sections and one was stained with routine Haematoxylin and Eosin (H&E), while the other was stained with Haematoxylin and Kumkum solution (H&K). The Cellular Architecture (CA) (based on distinct or indistinct nucleus, cytoplasm) and quality of staining (poor, satisfactory or good) of H&E and H&K solution was compared and a scoring system was given. The scores were analysed with Chi-square test using SPSS software (version 25). Results: Out of 100 slides, 45 (90%) stained with H&E and 48 (96%) with H&K showed distinct CA. A total of 47 slides (94%) stained with H&K and 41 (82%) with H&E showed good quality of staining. Conclusion: Kumkum solution appears to be an efficient counterstain in place of eosin in highlighting the normal structures in histopathological sections. It highlighted the RBCs in the arteries and cytoplasm of the cells in glandular and squamous epithelium better than or equally good as eosin.