Histopathology Artifacts Quiz



This section shows a starch granuloma. Starch is used as a powder in surgical gloves and can therefore contaminate body tissues during an operation. Over a period of time a granulomatous reaction occurs around the starch which may not necessarily cause the patient any inconvenience but may cause the pathologist a few problems in trying to identify the cause of the granulomatous reaction. Starch contamination can also occur after the specimen reaches the laboratory, during cut-up but of course in that situation there is not a granulomatous reaction. Starch granules can be difficult to see in sections under normal brightfield microscopy. They tend to be spherical to slightly angular (hexagonal), very pale in H&E and some will exhibit a small central dark spot. They do stain very strongly with the Periodic Acid Schiff (PAS) reaction but are most easily seen under polarised light when they show a characteristic "Maltese cross" birefringence. Give yourself a mark if your answer is starch granuloma or glove powder contamination.

© Roy C. Ellis 2004