malarial pigment

Joyce Weems at Saint Joseph's Hospital of Atlanta GA asks:

>>I need to determine malarial pigment in a liver bx. What is the best method?<<

H and E, with polarization. (Your urine lab microscope has a polarizer - the pathologist's microscope probably doesn't).

Malarial pigment is an iron-containing pigment that resembles so-called formalin pigment. It is not hemosiderin, and does not turn blue with the Perls prussian blue reaction. It is described as "usually" or "faintly" birefringent (lighting up with crossed polarizers). The malarial parasite in the course of parasitizing and consuming red blood cells detoxifies the iron-containing heme by polymerizing it. This very insoluble precipitate is then deposited in phagocytic cells in the liver, spleen, and elsewhere.

Bob Richmond

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