On liver biopsy of a 32-year-old woman with elevated serum ALT, a Kayser-Fleischer ring on slit-lamp examination, and low serum ceruloplasmin, the histological stain MOST useful for confirming copper accumulation is:
- A Prussian blue (Perls' stain) for ferric iron
- B PAS-diastase for alpha-1-antitrypsin globules
- C Rhodanine (or orcein) stain for copper-associated protein ✓
- D Reticulin stain for hepatic architecture
Correct answer: C. Rhodanine (or orcein) stain for copper-associated protein
Explanation
In Wilson disease, hepatic copper accumulates and can be visualised by rhodanine stain (for free copper) or orcein stain (for copper-binding protein/metallothionein complexes) on liver biopsy. Quantitative liver copper >250 µg/g dry weight is diagnostic. Prussian blue stains iron (used in haemochromatosis); PAS-D stains alpha-1-antitrypsin globules; reticulin assesses fibrosis pattern.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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