Table of Contents
Definition / general | Essential features | Terminology | Pathophysiology | Uses by pathologists | Interpretation | Microscopic (histologic) images | Positive staining – normal and disease | Negative staining – disease | Board review style question #1 | Board review answer #1 | Board review style question #2 | Board review answer #2Cite this page: Sağlam A. Jones methenamine silver. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsJMS.html. Accessed May 24th, 2020.
Definition / general
- Jones methenamine silver (JMS) is a histochemical stain which highlights carbohydrates that can be oxidized to aldehydes
Essential features
- Delineates basement membranes and connective tissue components
- Most commonly 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 2µm (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), Grimelius (with Bouin's fixative), modification of Pascual's method (Journal of Histotechnology 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), Grimelius (with Bouin's fixative), modification of Pascual's method (Journal of Histotechnology 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
Uses by pathologists
- Used primarily by nephropathologists as part of the routine panel for renal biopsies (Mod Pathol 2004;17:1555, Arch Pathol Lab Med 2009;133:181) and the nonneoplastic kidney in nephrectomy specimens (Arch Pathol Lab Med 2009;133:1012)
Interpretation
- Black staining is positive
Microscopic (histologic) images
Images hosted on PathOut server:
Contributed by Arzu Sağlam, M.D.
Renal biopsy specimen
Spikes along glomerular basement membrane
Duplications of glomerular basement membrane
Extracapillary proliferation
Stain reveals basement membrane
Tubulitis and peritubular capillaritis
Rupture of Bowman’s capsule
Protein resorption droplets
Reduplication of internal elastic
Tubulointerstitial scarring
Amyloid deposits
Glomerulus with segmental sclerosis
Fibrin is argyrophobic
Immune complexes are argyrophobic
Contributed by Nicole K. Andeen, M.D.
Collapse of the glomerular tuft and prominence of the overlying epithelial cells, Jones stain
Positive staining – normal and disease
- Highlights details of the glomerular basement membrane
- Presence of spikes and vacuoles (Ehrenreich T, Churg J. Pathology of membranous nephropathy. Pathol Annu 1968;3:145)
- Duplications (tram tracking) (Am J Pathol 1953;29:33, Am J Pathol 1957;33:313)
- Helps delineate the glomeruli within crescents and hence highlights the presence of extracapillary proliferation
- Also helps delineate mesangial areas of glomeruli which are argyrophilic - presence / absence of expansion
- Highlights basement membrane of tubuli: rupture, thickening and defects
- Is also useful in demonstrating tubulitis in cases of renal rejection by highlighting the stromal epithelial interface
- Highlights basement membrane of Bowman's capsule: rupture, thickening
- Highlights elastic lamina of vessels: disruption, duplication, fragmentation
- Protein resorption droplets within podocytes and 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 grey
- 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
- 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)
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 answer #1
E. Sclerosis
Board review style question #2
- A patient with a diagnosis of Familial Mediterranean Fever undergoes a renal biopsy. Light microscopy reveals acellular eosinophilic nodular expansion 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 answer #2
