title: An evaluation of Congo red fluorescence for the diagnosis of amyloidosis.
abstract: Congo red stain apple-green birefringence under polarized light is the most popular method for detecting amyloid; however, it has limitations. The goal of this study was to evaluate if examination of Congo red stain by fluorescent microscopy (FM) significantly enhances the diagnostic yield. Congo red-stained tissue sections were retrospectively and prospectively examined by light microscopy (LM) with and without polarizer and by FM using the Texas red filter and results by each method compared. Congo red-stained amyloid recognized by LM was unequivocally and easily identified by FM in each of 48 cases. In 22 of them, FM either confirmed the presence of a small amount of amyloid or lead to a definitive diagnosis, which was otherwise missed. Eight cases with Congo red-negative by LM were also negative by FM. In 8 cases with a false-positive Congo red stain, FM still detected the signal in 5, but it was absent in 3 cases. In conclusion, Congo red fluorescence improves the diagnostic yield of LM for both positive and negative cases.
authors.affiliation: Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, TX 77030.
authors.forename: Cecilia G
authors.initials: CG
authors.lastname: Clement
authors.affiliation: Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, TX 77030; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065. Electronic address: ltruong@houstonmethodist.org.
authors.forename: Luan D
authors.initials: LD
authors.lastname: Truong
mesh_terms: D000686:Amyloidosis / Q000175:diagnosis*; D003224:Congo Red; D005453:Fluorescence; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis*; D008107:Liver Diseases / Q000175:diagnosis*; D008856:Microscopy, Fluorescence; D012189:Retrospective Studies; D013194:Staining and Labeling
chemical_list: D003224:Congo Red
keywords: Amyloid; Birefringence; Congo red stain; Fluorescence; Polarized light; Texas red filter