Dr. Smitirupa Mishra, Consultant Pathologist, Sparsh Hospital, Bhubaneswar
Special stains in hematology are often considered “old-school,” but they still remain incredibly valuable in day-to-day diagnostic practice.
From differentiating AML vs ALL, identifying monocytic differentiation, assessing marrow iron stores, detecting ring sideroblasts, evaluating marrow fibrosis, to diagnosing conditions like Hairy Cell Leukemia — these stains provide rapid, reliable, and cost-effective diagnostic clues.
What makes them even more important is that most of these stains are:
• Easy to perform
• Affordable
• Require minimal additional infrastructure
• Can be incorporated into routine hematology and bone marrow workup in almost all laboratories
In many setups where advanced molecular or flow cytometry facilities may not be immediately available, cytochemistry and special stains continue to serve as excellent first-line diagnostic tools and guide further testing.
A good hematology laboratory should aim not only for automation but also for strong fundamentals. Proper use and interpretation of special stains can significantly improve diagnostic accuracy and turnaround time.
Bringing these stains back into regular practice can strengthen both teaching and patient care.
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