Histopathology basics · USMLE Step 1

Why might a pathologist request additional special stains beyond H&E when evaluating a liver biopsy suspected for fibrosis or cirrhosis?

  1. Because H&E cannot detect any of the abnormal cells present
  2. Because collagen stains like trichrome or Van Gieson reveal fibrosis better than H&E
  3. Because H&E overstains collagen, making it hard to see
  4. Because special stains are required to visualize lipid content only
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Correct answer: Because collagen stains like trichrome or Van Gieson reveal fibrosis better than H&E

Fibrosis involves collagen deposition; special stains that highlight collagen (like trichrome or Van Gieson) make the extent and pattern of fibrosis more evident than H&E, thus aiding accurate diagnosis.

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