Head and neck connective tissue lesions may have diverse calcifications within the fibrous connective tissue stroma. The perplexity involved in the identification and determination of the nature or degree of calcification through routine
hematoxylin and
eosin (H&E) stains necessitates the usage of a specific, simple, and cost- and time-effective differential staining techniques. The aim of the present study was to develop criteria to distinguish bone formation from
bone resorption using
methylene blue-
acid fuchsin (MB/AF)
stain and the role of
collagen fibers in the identification of stromal calcifications using polarizing microscopy with
picrosirius red stain. Twenty cases with pathological diagnoses for various stromal calcifications in maxillofacial lesions were retrieved from the departmental archives. Decalcified
formalin fixed
paraffin embedded tissue sections were stained with
hematoxylin and
eosin, Masson's trichrome (MT),
methylene blue-
acid fuchsin (MB/AF), and
picrosirius red. The stained sections were assessed to identify the calcifications found in the surrounding connective tissue stroma. It was observed that most cases showed maximum staining intensity with MB/AF
stain as compared to the other staining methods. Moreover, the results suggested that contrast between calcification and stromal soft tissue was best distinguished with the MB/AF
stain except in the case of dystrophic calcifications. Along with this, polarizing microscopy with
picrosirius red enables better characterization of stromal components. Although the H&E
stain and a connective tissue
stain i.e. Masson's trichrome, are employed routinely in histopathology; the use of special stains such as MB-AF and
picrosirius red facilitates the identification of calcifications from the stromal tissues.