Section 20: It's Staining Men Flashcards
Which cells stain Positive (+) with MPO?
Myeloblasts and Monoblasts
Which cells stain Positive (+) with NSE?
Monoblasts strongly positive (+++) and Myeloblasts weak (+/=)
Which cells will stain Positive (+) with SPE?
Myeloblasts (“specifically” not staining Monoblasts)
Which cells will stain Positive (+) with NSE w/NaF?
Myeloblasts will stain weak (+/=)
Which cells are identified with TRAP?
Hairy Cells (“Hair gets caught in the drain TRAP”)
Which cells stain Positive (+) with TdT?
Lymphoblasts
Leukemia is defined as:
the malignancy (ie. cancer, “The Big C”) of blood cells.
Which of these characteristics are seen specifically in Acute Leukemias?
a. Arrested Maturation
b. Uncontrolled Proliferation
c. Hiatus Development
d. Anemia
e. Large or Hypogranular Plts
a. Arrested Maturation and b. Hiatus Development are both characteriscs specific to Acute Leukemias.
What is the full name of the MPO stain?
Myeloperoxidase
What structures does MPO stain and how do they appear after staining?
MPO stains the peroxidase present in granules seen in granulocytes (monocytic and myelocytic). The reaction turns the dye substrate black/blue/brown.
What is the full name of the SPE stain?
Specific Esterase (napthol AS-D chloroacetate [CAE])
What structures does SPE stain and how do they appear after staining?
Esterase hydrolyzes an ester substrate and causes a precipitate of the napthol compound and a diazonium salt. The reaction turns the dye substrate stains myeloblastic cells bright red. (“Specific to Myeloblasts”)
What is the full name of the NSE stain?
Non-Specific Esterase (alpha-napthyl acetate or alpha-napthyl butyrate)
What structures does NSE stain and how do they appear after staining?
Principle is the same as the other main esterase stain, SPE. The stain reaction results in black precipitate in Monoblasts.
(As far as slides tell, NSE of the acetate variety turns monoblasts blac
What is the full name of the NSE w/NaF?
Non-Specific Esterase with Sodium Fluoride
What structures does NSE w/NaF stain and how do they appear after staining?
Principle is the inhibition of stain reactivity seen normally in monoblasts. Can be visualized as a lack of reaction seen between NSE and NSE w/NaF. Can be useful in ID’ing lineage.
What’s the Magic Number for categorizing an Acute Leukemia? 🎩 🪄
✨️ > or = to 20% ✨️
What is the full name of the LAP stain?
Leukocyte Alkaline Phosphatase Stain
What is the principle of the LAP stain and what’s being visualized?
LAP is present in the Secondary Granules of neutrophils and hydrolyzes the dye substrate to produce color precipitate (depends on type of dye)
How are LAP scores interpreted?
100 PMNs and bands are scored based on granulation density seen (0-4+).
More stimulated granulocytes = higher score.
Which of these conditions are NOT seen with an Increased LAP?
a. Leukemoid Reaction
b. CML of childhood that’s Ph-22 negative
c. 3rd trimester of Pregnancy
d. Polycythemia Vera
e. Sideroblastic Anemia
E. Sideroblastic Anemia has a decreased LAP score
A-D are all correlated with increased LAPs
Which of these conditions are NOT seen with a Decreased LAP?
a. CML
b. Sideroblastic Anemia
c. Infections
d. Myeloproliferative Disorder
e. Polycythemia Vera
C and E are both seen with increased LAP scores, not decreased
A LAP Score of 150-365 showcases what condition state?
Leukemoid Reaction
A LAP Score of 15-70 showcases what condition state?
Normal Condition
A LAP Score of 0-24 showcases what condition state?
CML
With the exception of Ph-22 neg CML of childhood, which has a high LAP
What’s the full name of the TRAP stain?
Tartrate Resistant Acid Phosphatase (TRAP)
What is the principle behind the TRAP stain?
Acid phosphatase is present in almost all nonerythroid cells → All normal isoenzynes of acid phosphatase are inactivated by tartric acid and will not stain. → Hairy Cell Leukemia isoenzyme #5 is resistant to tartric acid and will stain.
What’s the full name of the TdT stain?
Terminal deoxyribonucleotidal Transferase (TdT)
What is the principle behind the TdT stain?
Specific cell marker (enzyme) that catalyzes the polymerization of deoxynucleotides is found only in lymphocytic precursors. Absent in lymphocytes.
Which Acute Lymphocytic Leukemia FAB classification is TdT negative?
L3
What makes TdT different from other stains discussed in class?
TdT is not a cytochemical stain! Either immunofluorescent stain (flow cytometry) or myeloperoxidase.
