Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease

Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. Early and accurate diagnosis is a fundamental step in proper management and prevention of complications. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and...

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Main Authors: Tasmia Islam, Sultana Gulshana Banu, Bishnu Pada Dey, Mohammad Mosiur Rahman, Papiya Rahman, Ummey Salma Shabnam, Syeeda Shiraj Um Mahmuda
Format: Article
Language:English
Published: Bangabandhu Sheikh Mujib Medical University 2023-01-01
Series:Bangabandhu Sheikh Mujib Medical University Journal
Subjects:
Online Access:https://www.banglajol.info/index.php/BSMMUJ/article/view/60863
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author Tasmia Islam
Sultana Gulshana Banu
Bishnu Pada Dey
Mohammad Mosiur Rahman
Papiya Rahman
Ummey Salma Shabnam
Syeeda Shiraj Um Mahmuda
author_facet Tasmia Islam
Sultana Gulshana Banu
Bishnu Pada Dey
Mohammad Mosiur Rahman
Papiya Rahman
Ummey Salma Shabnam
Syeeda Shiraj Um Mahmuda
author_sort Tasmia Islam
collection DOAJ
description Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. Early and accurate diagnosis is a fundamental step in proper management and prevention of complications. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and the typical finding of Hirschsprung disease is the absence of ganglion cells. Toluidine blue stain can act as a double check along with conventional H&E stain for ganglion cell detection. Neuron-specific enolase is an immune-histochemical marker that can also aid in better identifying ganglion cells, especially for small and immature ones. This study aimed to evaluate Toluidine blue stain and Neuron specific enolase immunostain along with conventional H&E stain as a panel for the diagnosis of Hirschsprung disease. This cross-sectional study was conducted from September 2019 to August 2021, involving 55 clinically suspected Hirschsprung disease cases. Paraffin blocks of colorectal biopsy samples were collected from the Department of Pathology, BSMMU. Hematoxylin & Eosin, Toluidine blue stain, and Neuron specific enolase immunohistochemical stain for Hirschsprung disease detection were performed on the sections from the paraffin blocks. Then the sections were examined and an evaluation of the stains was done. Statistical analysis was performed on the tabulated data by chi-square test. Among 55 cases, conventional H&E stain detected ganglion cells in 31 cases, that is 56.4%. Later, Toluidine blue stain and Neuron specific enolase immu- nohistochemical stain detected ganglion cells in 35 cases, that is 63.6%. So, these two addition- al stains were able to detect ganglion cells in four more cases compared to conventional H&E stain. In conclusion, conventional H&E stain, Toluidine blue stain, and NSE immunohisto- chemical stain can improve the diagnostic accuracy of Hirschsprung disease. BSMMU J 2022; 15(2): 102-106
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spelling doaj.art-3590eebb1ff64a6097edc1f2e170027d2023-01-16T09:53:57ZengBangabandhu Sheikh Mujib Medical UniversityBangabandhu Sheikh Mujib Medical University Journal2074-29082224-77502023-01-0115210.3329/bsmmuj.v15i2.60863Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung diseaseTasmia Islam0Sultana Gulshana Banu1Bishnu Pada Dey2Mohammad Mosiur Rahman3Papiya Rahman4Ummey Salma Shabnam5Syeeda Shiraj Um Mahmuda6Department of Pathology, Bangabandhu Sheikh Mujib Medical University, DhakaDepartment of Pathology, Bangabandhu Sheikh Mujib Medical University, DhakaDepartment of Pathology, Bangabandhu Sheikh Mujib Medical University, DhakaDepartment of Pathology, Bangabandhu Sheikh Mujib Medical University, DhakaDepartment of Pathology, Shaheed Suhrawardy Medical College, DhakaDepartment of Pathology, National Institute of Diseases of the Chest and Hospital, DhakaDepartment of Pathology, Colonel Malek Medical College, Manikganj Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. Early and accurate diagnosis is a fundamental step in proper management and prevention of complications. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and the typical finding of Hirschsprung disease is the absence of ganglion cells. Toluidine blue stain can act as a double check along with conventional H&E stain for ganglion cell detection. Neuron-specific enolase is an immune-histochemical marker that can also aid in better identifying ganglion cells, especially for small and immature ones. This study aimed to evaluate Toluidine blue stain and Neuron specific enolase immunostain along with conventional H&E stain as a panel for the diagnosis of Hirschsprung disease. This cross-sectional study was conducted from September 2019 to August 2021, involving 55 clinically suspected Hirschsprung disease cases. Paraffin blocks of colorectal biopsy samples were collected from the Department of Pathology, BSMMU. Hematoxylin & Eosin, Toluidine blue stain, and Neuron specific enolase immunohistochemical stain for Hirschsprung disease detection were performed on the sections from the paraffin blocks. Then the sections were examined and an evaluation of the stains was done. Statistical analysis was performed on the tabulated data by chi-square test. Among 55 cases, conventional H&E stain detected ganglion cells in 31 cases, that is 56.4%. Later, Toluidine blue stain and Neuron specific enolase immu- nohistochemical stain detected ganglion cells in 35 cases, that is 63.6%. So, these two addition- al stains were able to detect ganglion cells in four more cases compared to conventional H&E stain. In conclusion, conventional H&E stain, Toluidine blue stain, and NSE immunohisto- chemical stain can improve the diagnostic accuracy of Hirschsprung disease. BSMMU J 2022; 15(2): 102-106 https://www.banglajol.info/index.php/BSMMUJ/article/view/60863Hirschsprung disease, Toluidine blue, Neuron specific Enolase
spellingShingle Tasmia Islam
Sultana Gulshana Banu
Bishnu Pada Dey
Mohammad Mosiur Rahman
Papiya Rahman
Ummey Salma Shabnam
Syeeda Shiraj Um Mahmuda
Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease
Bangabandhu Sheikh Mujib Medical University Journal
Hirschsprung disease, Toluidine blue, Neuron specific Enolase
title Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease
title_full Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease
title_fullStr Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease
title_full_unstemmed Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease
title_short Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease
title_sort application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease
topic Hirschsprung disease, Toluidine blue, Neuron specific Enolase
url https://www.banglajol.info/index.php/BSMMUJ/article/view/60863
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