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Correspondence |

Use of Standard Hematoxylin-eosin to Stain Gouty Tophus Specimens

Curtis E. Margo, MD, MPH
Arch Ophthalmol. 2004;122(4):665. doi:10.1001/archopht.122.4.665.
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The nice clinicopathologic case report of a gouty tophus at the lateralcanthus by Morris and Fleming1 illustratesthe difficulty of identifying urate crystals in histologic sections when tissueis fixed in formalin solution and processed routinely. The authors recommendthat if a gouty tophus is suspected, the specimen should be fixed in absolutealcohol, and the tissue should be processed and stained with an alcoholiceosin without hematoxylin. I would like to share my experience in studyingthe histologic features of a periocular gouty tophus after it was fixed inCarnoy solution and then routinely processed, embedded in paraffin, and stainedwith standard hematoxylin-eosin.

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Figure 1.

Gouty tophus showing numerousaggregates of thin brown crystals. Crystals within each aggregate appear toradiate from a central nidus. Dissolved crystals within the pink amorphousmaterial appear as fine needle-like clefts and are virtually imperceptibleat this magnification (hematoxylin-eosin, original magnification ×125).

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Figure 2.

In cross-polarized light, thebrown crystals display strong birefringent properties and are slightly yellow-green(hematoxylin-eosin, original magnification ×125).

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