Debbie J. Siena, HT(ASCP)QIHC, Histopathology Manager, Baylor University 
Medical Center in Dallas TX asks about staining goblet cells in Barrett's 
esophagus: >>There is a discussion going on here at Baylor as to whether 
Alcian Blue pH 2.5 or pH 1.0 is better and is it better with or without PAS 
counterstain.<<

Usually what I see in my travels is the so-called pH 2.5 stain, though it's a 
rare lab that possesses a pH meter. I don't think the PAS counterstain adds 
much, and I think a red counterstain such as nuclear fast red or - plug-ola 
for Dick Dapson at Anatech coming on - Brazilliant (aluminum-mordanted 
brazilin) is probably preferable.

The stain is really useful in making the diagnosis - in fact, the temptation 
is to let the stain make the diagnosis, which is not a good thing to do. For 
the fish otolith folks - Barrett's lesion of the esophagus occurs when 
stomach acid chronically assaults the squamous epithelium of the esophagus, 
eventually turning it into abnormal (intestinalized - with intestinal goblet 
cells) - mucosa, which is fairly often a precursor lesion to adenocarcinoma 
of the esophagus, a disease that is becoming considerably more common than it 
used to be.

Bob Richmond
Samurai Pathologist
Knoxville TN