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Updated: Jun 1, 2026
Histological-Based Stainings Using Free-Floating Tissue Sections
Published on: August 25, 2020
Hematoxylin and eosin tissue stain in Mohs micrographic surgery: a review
Kassandra Larson1, Hao H Ho, Pushpa L Anumolu
1Department of Dermatology, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA.
Background:
Several factors may affect Mohs micrographic surgery (MMS) tissue section quality. Although other factors may affect section integrity and ease of processing, tissue stains are the cornerstone of histologic diagnosis. When performed incorrectly, visualization and discrimination of microscopic details may be suboptimal and even impossible. Patient harm may result if an accurate diagnosis cannot be made.
Objective:
To review hematoxylin and eosin (H&E) technique, the most commonly used staining technique in MMS tissue preparation.
Materials And Methods:
Review of literature. Tissue sections were H&E stained using a linear stainer where one reagent container was omitted on each trial run to evaluate microscopic differences in staining quality.
Results:
The chemical nature of H&E staining is discussed, along with commonly encountered problems, pitfalls, and troubleshooting tips. H&E stained sections are presented to demonstrate histologic appearance in the absence of certain reagents.
Conclusions:
The success of MMS depends on high-quality tissue sections. The staining process should be optimized to be reproducible and reliable. To readily identify and resolve poor staining quality, a firm understanding of the principles upon which tissue staining is based and its pitfalls is necessary.
Insights
Optimizing hematoxylin and eosin (H&E) staining is crucial for Mohs micrographic surgery (MMS) tissue quality. Proper technique ensures accurate histologic diagnosis and prevents patient harm from suboptimal visualization.
Area of Science:
- Histopathology
- Surgical Pathology
Background:
- Tissue staining is fundamental for histologic diagnosis in Mohs micrographic surgery (MMS).
- Suboptimal staining can impede microscopic detail visualization, potentially leading to diagnostic errors and patient harm.
- Several factors can impact the quality of MMS tissue sections.
Purpose of the Study:
- To review the hematoxylin and eosin (H&E) staining technique.
- To focus on H&E as the most common staining method in MMS tissue preparation.
Main Methods:
- Literature review was conducted.
- Hematoxylin and eosin (H&E) staining was performed on tissue sections using a linear stainer.
- Reagent omissions in sequential trials evaluated microscopic staining quality differences.
Main Results:
- The chemical principles of H&E staining are detailed.
- Commonly encountered issues, potential pitfalls, and troubleshooting strategies are discussed.
- Representative H&E stained sections illustrate histologic appearance when specific reagents are absent.
Conclusions:
- High-quality tissue sections are essential for the success of Mohs micrographic surgery (MMS).
- Optimizing the H&E staining process ensures reproducibility and reliability.
- Understanding staining principles and common pitfalls is necessary for identifying and resolving poor staining quality.
