Chapter 7 - Cytochemistry

Question 1

is defined as the microscopic study and identification of chemical constituents within individual cells.

Answer 1

Cytochemistry

Question 2

It is useful in the identification of malignant cell types on the basis of cytoplasmic or nuclear chemistry; cellular constituents that are present in abnormal form or amount; lack of cellular constituent; and cells exhibiting functional abnormalities

Answer 2

Cytochemistry

Question 3

Enzymatic stains:

Question 4

Non-Enzymatic Stains:

Question 5

􏰆 Stains NEUTROPHILS (the only leukocytes that contain this activity)

Answer 5

Leukocyte/Neutrophil Alkaline Phosphatase (LAP/NAP)

Question 6

􏰆 Differentiates Leukemoid reaction (LR) from Chronic myeloid leukemia (CML)

Answer 6

Leukocyte/Neutrophil Alkaline Phosphatase (LAP/NAP)

Question 7

􏰆 Leukocyte/Neutrophil Alkaline Phosphatase (LAP/NAP) Reference Value:

Answer 7

30 -185 LAP score

Question 8

Inc LAP score:

Answer 8

• during the last trimester of pregnancy
• Polycythemia vera
• Aplastic anemia
• Hodgkin disease
• Multiple myeloma
• Obstructive jaundice

Question 9

KAPLOW􏰄s Scoring (Count 100 cells and grade them as follows)
0 =
1+ =
2+ =
3+ =
4+ =

Answer 9

no staining
faint & diffuse staining
pale moderate amount of blue staining strong blue precipitate
deep blue or brilliant

Question 10

Stain marker for primary granules & auer rods

Answer 10

Peroxidase/Myeloperoxidase (MPO)

Question 11

Differentiates AML from ALL

Answer 11

Peroxidase/Myeloperoxidase (MPO)

Question 12

(+) Activity: reddish-brown deposits (in cytoplasm of granulocytes and monocytes)

Answer 12

Peroxidase/Myeloperoxidase (MPO)

Question 13

Note: (?) deteriorates; Stain should be done only on fresh specimens

Answer 13

Myeloperoxidase enzyme

Question 14

For the diagnosis of Hairy cell leukemia (HCL)

Answer 14

Tartaric Acid Resistant Acid Phosphatase (TRAP)

Question 15

Other Tartrate Resistant cells: Sezary cells; Histiocyte; T-cell of acute lymphocytic leukemia

Answer 15

Tartaric Acid Resistant Acid Phosphatase (TRAP)

Question 16

Activity is indicated by purple to dark red granules in cytoplasm

Answer 16

Tartaric Acid Resistant Acid Phosphatase (TRAP)

Question 17

For identification of Eosinophilic components

Answer 17

Cyanide-Resistant Peroxidase

Question 18

(+) Activity: brown

Answer 18

Cyanide-Resistant Peroxidase

Question 19

Marker for cells of Monocytic origin

Answer 19

a-Naphthyl Acetate Esterase & 􏰉-Naphthyl Butyrate Esterase (Non-Specific Esterases/NSE)

Question 20

Other cells (+) : Megakaryocytes, Platelets, Histiocytes, Plasmacytes, some T-lymphocytes

Answer 20

a-Naphthyl Acetate Esterase & 􏰉-Naphthyl Butyrate Esterase (Non-Specific Esterases/NSE)

Question 21

(+) Activity: red-brown/dark red

Answer 21

a-Naphthyl Acetate Esterase & 􏰉-Naphthyl Butyrate Esterase (Non-Specific Esterases/NSE)

Question 22

Marker for mature & immature Neutrophil and mast cells

Answer 22

Naphthol ASD Chloroacetate Esterase (Specific Esterase)

Question 23

(+) Activity: bright red granules in cytoplasm

Answer 23

Naphthol ASD Chloroacetate Esterase (Specific Esterase)

Question 24

This enzyme is stable and may last for months

Answer 24

Naphthol ASD Chloroacetate Esterase (Specific Esterase)

Question 25

Stains DNA polymerase immunoperoxidase

Answer 25

Terminal Deoxyribonucleotidyl Transferase (TdT)

Question 26

Marker for immature Lymphoid cell

Answer 26

Terminal Deoxyribonucleotidyl Transferase (TdT)

Question 27

Positive in almost 90% cases of ALL

Answer 27

Terminal Deoxyribonucleotidyl Transferase (TdT)

Question 28

Also useful in the detection of the “lymphoblastic transformation” of chronic myeloid leukemia (CML)

Answer 28

Terminal Deoxyribonucleotidyl Transferase (TdT)

Question 29

Present in all hematopoietic cells and found in lysosomes

Answer 29

Acid Phosphatase

Question 30

Activity is indicated by purple to red granules

Answer 30

Acid Phosphatase

Question 31

Unstable, cannot be stored

Answer 31

Acid Phosphatase

Question 32

Stains siderotic granules (for the diagnosis of sideroblastic anemia)

Answer 32

Prussian Blue stain

Question 33

Used to detect hemosiderin in urine

Answer 33

Prussian Blue stain

Question 34

Stain reacts w/ aldehyde groups in glycogen, mucoprotein, glycoproteins, and high molecular weight carbohydrates

Answer 34

Periodic Acid Schiff (PAS)

Question 35

Positive in erythroblasts in Di Guglielmo disease / Erythroleukemia

Answer 35

Periodic Acid Schiff (PAS)

Question 36

(-) Activity: bright fuchsia pink (Pattern of staining varies with each cell type)

Answer 36

Periodic Acid Schiff (PAS)

Question 37

Also differentiates Acute Lymphoblastic leukemias

Answer 37

Periodic Acid Schiff (PAS)

Question 38

Marker for phospholipids and lipids

Answer 38

Sudan Black B (SBB)

Question 39

Gives the same information as Peroxidase in the interpretation

Answer 39

Sudan Black B (SBB)

Question 40

Differentiates AML from ALL

Answer 40

Sudan Black B (SBB)

Question 41

(+) Result: Dark purple-black granules

Answer 41

Sudan Black B (SBB)

Question 42

Can be done on stored specimens.

Answer 42

Sudan Black B (SBB)

Question 43

More sensitive than chloroacetate in the demonstration of mature & immature neutrophils and mast cells

Answer 43

Sudan Black B (SBB)

Question 44

A metachromatic stain

Answer 44

Toluidine Blue O

Question 45

Binds with mucopolysaccharides in blood cells

Answer 45

Toluidine Blue O

Question 46

For the recognition of basophils and mast cells

Answer 46

Toluidine Blue O

Question 47

(+) Result: Reddish-Violet

Answer 47

Toluidine Blue O