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20 Cards in this Set

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Peroxidase (Myeloperoxidase (MPO)) Principle
Peroxidase found in granules of cells in myelocytic and monocytic cell lines plus H202 oxidizes a dye substrate creating a black-blue-brown precipitate
MPO Interpretation
Myeloperoxidase Interpretation
Cells Series Blast ------- Mature cells
Myelocytic + ++ ++++
Monocytic + ++ +++
Lymphocytic = = =
Erythrocytic = = =
Sudan Black B (SBB)
Principle
Stains lipids such as sterols, neutral fats, and phospholipids. These lipids are found primaryly in granules of Neutrophils and Granulocytes.
Esterases principle
Esterases hydrolyzes an ester substrate. A naphthol compound is realeased and combines with a diazonium salt that precipitates.
1. Specific Esterases
2. Non -specific Esterases
3. Combined Esterase
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.
Periodic Acid Schiff Principle
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.
PAS Interpretation
1.Useful in diagnosing both ___ and ___.
2.Look for a ____ appearance
3.Some lymphoblast of ALL may be _____negative.
1.acute and chronic leukemias
2. chunky or block
3.PAS negative.
Leukocyte Alkaline Phospatase
LAP Principle
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).
LAP interpretation
1.Used to investigate:
2.Neutrophils in leukomoid rxn are stimulated, Inc or Dec or LAP?
1.a shift to the left.
Malignant granulocytes (CML) which causes decrease in LAP.
Other causes of dec LAP:
PNH; Sideroblastic anemia; Myeloproliferative disorder.
Tartrate Resistant Acid Phosphatase Principle
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
TRAP Interpretation
1.In ______ leukemia, isoenzyme # 5 is resistant to tartric acid and will stain
2.Useful for confirming ____
1. Hairy cell leukemia
2. Hairy cell leukemia
TDT Terminal deoxyribonucleotidal Transferase:
1.This is a specific cell marker that catalyzes the __________.
2.Not a cytochemical stain, its a ________
3.positive in________
1.polymerization of deoxynucleotides found only in lymphocytic precursors.
2. immunofluorescent stain
3.lymphocytic leukocytes.
I.Myeloproliferative Disorders include:
II. Classifications:
1.CML
2.Polycythemia Vera
3.Essiential (primary) Thrombosis
4. Agnogentic myeloid metaplasia.
II. -Acute: acute lymphocytic leukemia
-subacute: myelodysplastic syndromes
-chronic: myeloproliferative disorders
Different Polycythemias are:
1. Polycythemia vera=Malignant increase in red cell mass
2.Secondary Polycythemia= hypoxia
3. Relative Erythrocytosis=Decreasd Plasma volume
Myelodisplastic Syndromes
1.Previously called:
2._________abnormality
3.specific immunological marker for MDS?
1.preleukemias
2.clonal of pluripotent stem cells
3. not been found
Myelodysplastic Syndromes Diagnostic Morphology:
1.Dyserythropoeisis
2.Dysmehloporesis
3.Dysmegakarocytes:
FAB Classifications of Myleodysplastic Syndromes
1.RA
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.
RARS: Refractory Anemia with Ringed Sideroblast
1.Similar to RA; >15% ringed sideroblast in BM; iron not incorporated properly
RAEB: Refractory Anemia with Excess blast
rbc, wbc and plt abnormalities appear;
RAEB-T:Refractory Anemia with Excess blast in Transformation
20 to 30% myeloblast in BM; >5% myeloblast in blood.