Alcian blue (AB)

Author: Nat Pernick, M.D. (see Authors page)

Revised: 18 September 2015, last major update December 2013

Copyright: (c) 2003-2015,, Inc.

PubMed Search: alcian blue[title]
  • Common "routine" stain (not an immunohistochemical stain) to detect mucins (Wikipedia)
  • At pH 2.5, detects acidic mucins
  • At pH 1.0, detects highly acidic mucins
  • Stained parts are blue to bluish-green
  • Note: all references below are to pH 2.5 unless otherwise indicated
Uses by Pathologists
  • Stains acid-simple, non-sulfated and acid-simple mesenchymal mucins at pH 2.5, acid-complex sulfated mucins at pH 1.0 and acid-complex connective tissue mucins at pH 0.5; does NOT stain neutral mucins
  • PAS-Alcian blue may be best pan mucin combination; PAS also stains glycogen, but predigestion with diastase will remove the glycogen
  • Alcian blue-high iron diamine detects sulfomucins (brown) and sialomucins (blue)
Clinical Features
Micro Images

Bladder: urothelial carcinoma with gland-like lumina

Breast: lobular carcinoma (metastatic) and modified Alcian blue stain

Breast: mucoepidermoid carcinoma (Alcian blue-PAS)


Esophagus, Barrett's: blue staining goblet cells and clear staining gastric-type surface columnar cells

Esophagus: Barrett's and mimics

Esophagus, Barrett's: GE junction

Eye: macular corneal dystrophy

Heart: myxoma with glandular structures

Kidney: adenocarcinoma (AB-PAS)

Kidney: mucinous tubular and spindle cell carcinoma

Sacrum, Chordoma: stroma stains with Alcian blue

Scrotum: Paget disease

Soft tissue: proliferative fasciitis - AB-PAS

Stomach: pyloric metaplasia

Thyroid gland: signet ring variant of follicular adenoma

Positive Staining - Normal
  • Colloid of thyroid gland, goblet cells and mucous glands
Positive Staining - Disease
  • Adenocarcinoma, adenosquamous carcinoma, mast cell leukemia (Acta Med Croatica 2013;67:61)
  • Mucinous tumors, myxedema (dermal mucin), myxoma (mucoid matrix), nodular mucinosis (breast, other) and Paget disease of scrotum
Negative Staining
  • Lipids / lipid entities (lipoma, liposarcoma), Paget disease of esophagus, squamous cell carcinoma (acantholytic variant-breast & other sites, pseudoglandular variant-penis & other sites), xanthelasma