Table of Contents
Definition / general | Essential features | Terminology | Pathophysiology | Interpretation | Uses by pathologists | Microscopic (histologic) description | Microscopic (histologic) images | Positive staining - normal and disease | Negative staining - disease | Sample pathology report | Additional references | Board review style question #1 | Board review style answer #1 | Board review style question #2 | Board review style answer #2Cite this page: Sağlam A. Jones methenamine silver. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsjms.html. Accessed December 25th, 2024.
Definition / general
- Jones methenamine silver (JMS) is a histochemical stain that highlights carbohydrates that can be oxidized to aldehydes
Essential features
- Delineates basement membranes and connective tissue components
- Routinely used in renal pathology to demonstrate abnormalities of the glomerular basement membrane
- Basement membranes and oxidizable carbohydrates are stained black - argyrophilic
- For optimal results, tissue sections should be thin, about 2 μm (Am J Med Technol 1976;42:220)
Terminology
- Jones methenamine silver, Jones silver stain
- Argyrophilia: silver positive, that is black staining with Jones methenamine silver or other silver stains, like periodic acid silver methamine stain (PAMS), Grocott-Gomori methenamine silver (GMS), Grimelius (with Bouin fixative), modification of the Pascual method (J Histotechnol 1979;2:102)
- Argyrophobia: silver negative, does not stain black with Jones methenamine silver or other silver stains, like periodic acid silver methamine stain (PAMS), Grocott-Gomori methenamine silver (GMS), Grimelius (with Bouin fixative), modification of the Pascual method (J Histotechnol 1979;2:102)
Pathophysiology
- Aldehydes formed by oxidation of carbohydrates reduce a silver solution, causing the silver ions to bind to the carbohydrate and be visualized
Interpretation
- Black staining is positive
Uses by pathologists
- Used primarily by nephropathologists as part of the routine panel for examining nonneoplastic medical renal biopsies and the nonneoplastic kidney in nephrectomy specimens (Mod Pathol 2004;17:1555, Arch Pathol Lab Med 2009;133:181, Arch Pathol Lab Med 2009;133:1012)
Microscopic (histologic) description
- Black staining is positive
- Negative staining, unstained areas / deposits have pink-gray hue and are not black
Microscopic (histologic) images
Contributed by Arzu Sağlam, M.D. and Nicole K. Andeen, M.D.
Positive staining - normal and disease
- Highlights details of the glomerular basement membrane
- Presence of spikes and vacuoles (Pathol Annu 1968;3:145)
- Duplications (tram tracking) (Am J Pathol 1953;29:33, Am J Pathol 1957;33:313)
- Helps delineate the glomerular tuft within glomeruli with extracapillary proliferation and therefore enables better appreciation of the presence of extracapillary proliferation
- Helps delineate mesangial areas of glomeruli which are argyrophilic - presence / absence of expansion
- Highlights basement membrane of tubuli: rupture, thickening and defects
- Also useful in demonstrating tubulitis in cases of T cell mediated renal rejection by highlighting the stromal epithelial interface
- Highlights basement membrane of Bowman capsule: rupture, thickening
- Highlights elastic lamina of vessels: disruption, duplication, fragmentation
- Protein resorption droplets within podocytes and within tubular epithelial cell cytoplasm stain black
- Renin granules within hyperplastic juxtaglomerular apparatus stain black
- Highlights areas of scarring: areas of sclerosis stain black - sclerotic segments of glomeruli, globally sclerosed glomeruli and interstitial fibrosis
- Hyphae and spores of fungi stain black
- Nodules in diabetes and idiopathic nodular glomerulosclerosis are weak positive
Negative staining - disease
- Identification of certain deposits due their nonargyrophilia or argyrophobia (negative staining)
- Amyloid deposits: appear gray
- Deposits in monoclonal immunoglobulin deposition disease and other diseases with paraprotein deposition
- Fibronectin deposits in fibronectin glomerulopathy (are silver negative)
- Hyaline droplets: appear pink / pinkish red
- Fibrin: appears pink-red
- Immune complexes along the glomerular basement membrane: appear pink / pinkish red
- Decreased staining of glomerular basement membrane in dense deposit disease due to negative intramembranous deposits (Kidney Int 1975;7:204)
Sample pathology report
- Exemplary sentences for describing findings with the JMS stain:
- JMS stain reveals presence of vacuoles and spikes along the thickened glomerular capillary basement membrane
- The deposited material is argyrophobic with the JMS stain
- The nodular mesangial widening shows weak argyrophilia with the JMS stain
Additional references
Board review style question #1
Which of the below is positive (argyrophilic) with the Jones methenamine silver stain?
- Amyloid
- Fibrin
- Hyaline deposits
- Intramembranous deposits of dense deposit disease
- Sclerosis
Board review style answer #1
Board review style question #2
A patient with a diagnosis of familial Mediterranean fever undergoes a renal biopsy. Light microscopy reveals acellular eosinophilic nodular expansions within the mesangium that are negative (argyrophobic) with the Jones methenamine silver stain. Presence of which of the following most likely explains this finding?
- Amyloid deposition
- Area of segmental sclerosis
- Dense deposit disease
- Diabetic nodular glomerulosclerosis
- Hyalinosis
Board review style answer #2