Cytochemical Stains Hematology

Front 1

Peroxidase (Myeloperoxidase (MPO)) Principle

Back 1

Peroxidase found in granules of cells in myelocytic and monocytic cell lines plus H202 oxidizes a dye substrate creating a black-blue-brown precipitate

Front 2

MPO Interpretation

Back 2

Myeloperoxidase Interpretation
Cells Series Blast ------- Mature cells
Myelocytic + ++ ++++
Monocytic + ++ +++
Lymphocytic = = =
Erythrocytic = = =

Front 3

Sudan Black B (SBB)
Principle

Back 3

Stains lipids such as sterols, neutral fats, and phospholipids. These lipids are found primaryly in granules of Neutrophils and Granulocytes.

Front 4

Esterases principle

Back 4

Esterases hydrolyzes an ester substrate. A naphthol compound is realeased and combines with a diazonium salt that precipitates.

Front 5

1. Specific Esterases
2. Non -specific Esterases
3. Combined Esterase

Back 5

1.Naphthol AS-D chloroacetate
Granulocyte esterase
2. Alpha-naphthyl acetate or alpha-naphthyl butyrate;monocytic cells are strongly positive and is inhibited with NaF;myelocytic cells may be weakly positive and remain weakly pos with NaF.

Front 6

Periodic Acid Schiff Principle

Back 6

Periodic acid oxydizes glycogen, mucoproteins and other high molecular weight carbohydrates to aldehydes to turns "bright Pink". Pos. rxn means lymphocytic and erythrocytic cells. Neg. rxn in benign cells.

Front 7

PAS Interpretation
1.Useful in diagnosing both ___ and ___.
2.Look for a ____ appearance
3.Some lymphoblast of ALL may be _____negative.

Back 7

1.acute and chronic leukemias
2. chunky or block
3.PAS negative.

Front 8

Leukocyte Alkaline Phospatase
LAP Principle

Back 8

Found in 2ndary granules of neutrophils
Substrate naphthol AS-BI phophate is hydrolyzed by LAP. The hydrolyzed substrate combines with a dye and precipitates (blue and black).

Front 9

LAP interpretation
1.Used to investigate:
2.Neutrophils in leukomoid rxn are stimulated, Inc or Dec or LAP?

Back 9

1.a shift to the left.
Malignant granulocytes (CML) which causes decrease in LAP.
Other causes of dec LAP:
PNH; Sideroblastic anemia; Myeloproliferative disorder.

Front 10

Tartrate Resistant Acid Phosphatase Principle

Back 10

Acid phosphatase is present in all nonerythroid cells and hydrolyzes substrate naphthol AS-BI phosphoric acid. The hydrolized substrate couples with a dye to form a precipitate red. All normal isoenzymes of acid phospatase are inactivated by tartric acid and will not stain

Front 11

TRAP Interpretation
1.In ______ leukemia, isoenzyme # 5 is resistant to tartric acid and will stain
2.Useful for confirming ____

Back 11

1. Hairy cell leukemia
2. Hairy cell leukemia

Front 12

TDT Terminal deoxyribonucleotidal Transferase:
1.This is a specific cell marker that catalyzes the __________.
2.Not a cytochemical stain, its a ________
3.positive in________

Back 12

1.polymerization of deoxynucleotides found only in lymphocytic precursors.
2. immunofluorescent stain
3.lymphocytic leukocytes.

Front 13

I.Myeloproliferative Disorders include:
II. Classifications:

Back 13

1.CML
2.Polycythemia Vera
3.Essiential (primary) Thrombosis
4. Agnogentic myeloid metaplasia.
II. -Acute: acute lymphocytic leukemia
-subacute: myelodysplastic syndromes
-chronic: myeloproliferative disorders

Front 14

Different Polycythemias are:

Back 14

1. Polycythemia vera=Malignant increase in red cell mass
2.Secondary Polycythemia= hypoxia
3. Relative Erythrocytosis=Decreasd Plasma volume

Front 15

Myelodisplastic Syndromes
1.Previously called:
2._________abnormality
3.specific immunological marker for MDS?

Back 15

1.preleukemias
2.clonal of pluripotent stem cells
3. not been found

Front 16

Myelodysplastic Syndromes Diagnostic Morphology:

Back 16

1.Dyserythropoeisis
2.Dysmehloporesis
3.Dysmegakarocytes:

Front 17

FAB Classifications of Myleodysplastic Syndromes
1.RA

Back 17

Refractory Anemia:
1.WBC <3,900
2. iron stores increased
3.no ringed sideroblasts
4.rare blast in blood
5. Neutropenia and thrombocytopenia may be present.

Front 18

RARS: Refractory Anemia with Ringed Sideroblast

Back 18

1.Similar to RA; >15% ringed sideroblast in BM; iron not incorporated properly

Front 19

RAEB: Refractory Anemia with Excess blast

Back 19

rbc, wbc and plt abnormalities appear;

Front 20

RAEB-T:Refractory Anemia with Excess blast in Transformation

Back 20

20 to 30% myeloblast in BM; >5% myeloblast in blood.