# Diff-Quik

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{{Short description|Commercial Romanowsky stain variant}}
[[File:Macrophages in bronchial wash specimen -- high mag.jpg|thumb|[Bronchoalveolar lavage](/source/Bronchoalveolar_lavage) specimen stained with Diff-Quik]]
'''Diff-Quik''' is a commercial [Romanowsky stain](/source/Romanowsky_stain) variant used to rapidly stain and differentiate a variety of [pathology](/source/pathology) specimens. It is most frequently used for [blood films](/source/blood_films) and [cytopathological](/source/Cytopathology) smears, including [fine needle aspirates](/source/Fine_needle_aspiration).<ref name="Silverman1990">{{cite journal| author=Silverman JF, Frable WJ| title=The use of the diff-quik stain in the immediate interpretation of fine-needle aspiration biopsies. | journal=Diagnostic Cytopathology | year= 1990 | volume= 6 | issue= 5 | pages= 366–9 | pmid=1705500 | doi= 10.1002/dc.2840060516}} </ref><ref name="Lester2019">{{cite book|author=Susan C. Lester|edition=2nd|title=Diagnostic Pathology: Intraoperative Consultation|chapter-url=https://books.google.com/books?id=YjeZDwAAQBAJ&pg=PA72|date=10 May 2019|publisher=Elsevier Health Sciences|isbn=978-0-323-57020-6|page=69|chapter=Section 2: Methods - Slide preparation}}</ref><ref name="Demay2012">{{cite book | last=Demay | first=Richard | title=The art and science of cytopathology | publisher=Am Soc Clinical Pathology | location=Chicago, IL | year=2012 | isbn=978-0-89189-644-9 | oclc=761848930 | page=1505 |chapter= Chapter 26: Stains}}</ref> The Diff-Quik procedure is based on a modification of the [Wright-Giemsa stain](/source/Wright's_stain) pioneered by Harleco in the 1970s,<ref name="Silverman1990"></ref> and has advantages over the routine Wright-Giemsa staining technique in that it reduces the 4-minute process into a much shorter operation and allows for selective increased eosinophilic or basophilic staining depending upon the time the smear is left in the staining solutions.<ref name="Keebler1993">{{cite book | last=Keebler | first=Catherine | title=The manual of cytotechnology | publisher=ASCP Press | location=Chicago | year=1993 | isbn=0-89189-352-0 | oclc=27435280 |edition=7th}}</ref>

There are generic brands of such stain,<ref name="Silverman1990"></ref><ref name="Dako2010"></ref> and the trade name is sometimes used loosely to refer to any such stain (much as "Coke" or "Band-Aid" are sometimes used imprecisely).

==Usage==
Diff-Quik may be utilized on material which is ''air-dried'' prior to alcohol [fixation](/source/Fixation_(histology)) rather than immersed immediately (i.e. "wet-fixed"), although immediate alcohol fixation results in improved microscopic detail.<ref name="Lester2019"></ref><ref name="Demay2012"></ref><ref name="FinnPeterson2004">{{cite book|author1=William G. Finn|author2=LoAnn C. Peterson|title=Hematopathology in Oncology|chapter-url=https://books.google.com/books?id=qi9c1xbvPyoC&pg=PA184|date=31 May 2004|publisher=Springer Science & Business Media|isbn=978-1-4020-7919-1|page=184|chapter=Role of fine needle aspiration in lymphoma}}</ref> 

The primary use of Romanowsky-type stains in cytopathology is for [cytoplasmic detail](/source/cytoplasm), while [Papanicolaou stain](/source/Papanicolaou_stain) is used for nuclear detail. Diff-Quik stain highlights cytoplasmic elements such as [mucins](/source/mucins), fat droplets and neurosecretory granules. Extracellular substances, such as free mucin, colloid, and [ground substance](/source/ground_substance), are also easily stained, and appear [metachromatic](/source/metachromatic). Major applications include [blood smear](/source/blood_smear)s, [bone marrow](/source/bone_marrow) aspirates, [semen analysis](/source/semen_analysis) and cytology of various [body fluid](/source/body_fluid)s including [urine](/source/urine) and [cerebrospinal fluid](/source/cerebrospinal_fluid).<ref>{{cite web|url=https://www.ral-diagnostics.fr/en/solutions/human-biology-haematology-cytology/ral-diff-quik/|title=RAL DIFF-QUIK|website=RAL diagnostics|accessdate=2021-06-12}}</ref><ref name="WHO2010">{{cite book | title=WHO laboratory manual for the examination and processing of human semen | url=https://archive.org/details/wholaboratoryman00orga | url-access=limited | publisher=World Health Organization | location=Geneva | year=2010 | isbn=978-92-4-154778-9 | oclc=646393549 | page=[https://archive.org/details/wholaboratoryman00orga/page/n76 62] |chapter=Part I: Semen analysis |edition= 5th}}</ref> Microbiologic agents, such as bacteria and fungi, also appear more easily in Diff-Quik.<ref name="Demay2012"/> This is useful for the detection of for example ''[Helicobacter pylori](/source/Helicobacter_pylori)'' from gastric and pyloric specimens.<ref name="Dako2010">{{cite book |last=Kumar |first1=George L. |last2=Kiernan |first2=John A. |last3=Gill |first3=Gary W. |last4=Badve |first4=Sunil |chapter-url=https://www.agilent.com/cs/library/technicaloverviews/public/08066_special_stains_eduguide.pdf |title=Education guide: Special stains and H&E |chapter=Chapter 1: Introduction to special stains |edition=2nd |publisher=Dako North America |year=2010 |page=5 |url-status=live |archive-url=https://web.archive.org/web/20190130220517/https://www.agilent.com/cs/library/technicaloverviews/public/08066_special_stains_eduguide.pdf |archive-date=2019-01-30 |access-date=2019-06-29 }}</ref>

Due to its short staining time, Diff-Quik stain is often used for initial screening of cytopathology specimens. This staining technique allows the [cytotechnologist](/source/cytotechnologist) or [pathologist](/source/pathologist) to quickly assess the adequacy of the specimen, identify possible [neoplastic](/source/neoplastic) or inflammatory changes, and decide whether or not additional staining is required.<ref name="Keebler1993"></ref><ref name="Meena2015">{{cite journal | last=Meena | first=Nikhil | last2=Jeffus | first2=Susanne | last3=Massoll | first3=Nicole | last4=Siegel | first4=Eric R. | last5=Korourian | first5=Soheila | last6=Chen | first6=Chien | last7=Bartter | first7=Thaddeus |display-authors=3| title=Rapid onsite evaluation: A comparison of cytopathologist and pulmonologist performance | journal=Cancer Cytopathology | publisher=Wiley | volume=124 | issue=4 | date=2015 | issn=1934-662X | doi=10.1002/cncy.21637 | pmid=26492064 | pages=279–284| doi-access=free }}</ref><ref name="Roh2015">{{cite journal | last=Roh | first=Michael H. | title=The Utilization of Cytologic Fine-Needle Aspirates of Lung Cancer for Molecular Diagnostic Testing | journal=Journal of Pathology and Translational Medicine | publisher=The Korean Society of Pathologists and The Korean Society for Cytopathology | volume=49 | issue=4 | date=2015 | issn=2383-7837 | doi=10.4132/jptm.2015.06.16 | pmid=26076721 | pages=300–309| pmc=4508567 }}</ref>

== Components ==
The Diff-Quik stain consists of 3 solutions:<ref name=Keebler1993></ref>
*Diff-Quik fixative reagent
**[Triarylmethane dye](/source/Triarylmethane_dye)
**[Methanol](/source/Methanol)
*Diff-Quik solution I ([eosinophilic](/source/eosinophilic))
**[Xanthene](/source/Xanthene) dye ([Eosin Y](/source/Eosin_Y))
**[pH buffer](/source/pH_buffer)
*Diff-Quik solution II ([basophilic](/source/basophilic) [thiazine](/source/thiazine) dyes)
**[Methylene blue](/source/Methylene_blue) 
**[Azure A](/source/Azure_A)
**pH buffer

== Results ==
{| class="wikitable"
! Structure || Colour 
|-
| [Erythrocyte](/source/Erythrocyte)s || Pink/yellowish red
|-
| [Platelet](/source/Platelet)s || Violet/purple granules
|-
| [Neutrophil](/source/Neutrophil)s || Blue nucleus, pink cytoplasm, violet granules
|-
| [Eosinophil](/source/Eosinophil)s || Blue nucleus, blue cytoplasm, red granules
|-
| [Basophil](/source/Basophil)s || Purple/dark blue nucleus, violet granules
|-
| [Monocyte](/source/Monocyte) || Violet nucleus, light blue cytoplasm
|-
| [Bacteria](/source/Bacteria) and [fungi](/source/fungi)|| Dark blue
|-
|Cytoplasm, [collagen](/source/collagen) and [muscle](/source/Muscle_tissue)|| Various shades of pink, orange, yellow and blue<ref name="Polysci">{{cite web |url=https://www.clinisciences.com/coloration-giemsa-3967/differential-quik-stain-kit-modified-351001918.html |format=PDF |title=Differential Quik Stain (Modified Giemsa) |author=Polysciences Inc. |work=Technical Data Sheet #715 |url-status=live |archive-url=https://web.archive.org/web/20190630170431/http://www.polysciences.com/skin/frontend/default/polysciences/pdf/TDS%20715.pdf |access-date=2019-06-30 |archive-date = 2019-06-30}}</ref>
|-
| [Spermatozoa](/source/Spermatozoa) || Light blue [acrosomal region](/source/acrosome), dark blue post-acrosomal region<ref name=WHO2010></ref> 

|}

== Alternatives ==
*[Wright Giemsa stain](/source/Wright's_stain)
*[Papanicolaou stain](/source/Papanicolaou_stain)

== References ==
{{Reflist|30em}}

{{Romanowsky stains}}

Category:Histopathology
Category:Hematopathology
Category:Cytopathology
Category:Romanowsky stains

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Adapted from the Wikipedia article [Diff-Quik](https://en.wikipedia.org/wiki/Diff-Quik) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Diff-Quik?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.