Cytochemical Staining

• Cytochemical staining is one of the older techniques in diagnosing acute leukemia.
• Most used stains in diagnosing acute leukemia based on the affected cell lineage are?

  Myeloperoxidase, Sudan Black B and the Esterase
• [+] Dark Brown?

  Myeloperoxidase
• Dark Brown [+]

  • Myeloblasts
  • promyelocytes
  • weak activity in monocytes?

  Myeloperoxidase
• Dark Brown [-]

  • Lymphoid cells
  • megakaryocytes
  • immature RBCs?
  • Myeloperoxidase
• Brown to Black?

  Sudan Black B
• Brown to Black [+]

  • Myeloblast
  • Promyelocyte
  • Weak Activity in Monocytes?

  Sudan Black B
• Brown to Black [-] 

  • Myeloblast
  • Promyelocyte
  • Weak Activity in Monocytes?

  Sudan Black B
• Bright Red?

  Specific Esterase
• Bright Red [+] 

  • Myeloblast [Neutrophils]
  • Mast Cells?
  • Specific Esterase
• Bright Red [-] 

  • Eosinophils
  • Lymphoid Cells
  • Monocytes?
  • Specific Esterase
• Dark Red/Reddish Brown?

  Nonspecific esterase
• Dark Red/Reddish Brown [+] 

  • Monoblasts
  • Monocytes?

  Nonspecific esterase
• Dark Red/Reddish Brown [-]

  • Granulocytes
  • Megakaryocytes
  • Lymphoid cells?

  Nonspecific esterase
• [+] Brown?

  Cyanide-resistant peroxidase
• Brown [+]

  • Eosinophils and precursors?

  Cyanide-resistant peroxidase
• Brown [-]

  • Monocytes
  • Granulocytes
  • Lymohocytes?

  Cyanide-resistant peroxidase
• [+] Purple to Dark Red?

  Tartrate resistant acid phosphatase
• Purple to Dark Red [+]

  • Hairy cells in HCL?

  • Tartrate resistant acid phosphatase
• Purple to Dark Red [-]

  • All except hairy cells?
  • Tartrate resistant acid phosphatase
• [+] Magenta?

  Periodic Acid Schiff
• Magenta [+]

  • Multiple Cell Types?

  Periodic Acid Schiff
• Magenta [-]

  • Normal Erythroblasts
  • Lymphoid Cells (L1 and L2)?


  Periodic Acid Schiff
• [-] Black Brown?

  Leukocyte Acid Phosphatase
• Black Brown [+]

  • Neutrophils?

  Leukocyte Acid Phosphatase
• [+] FITC - Fluorescence

  TRITC - Red?

  Terminal Deoxynucleotidyl transferase
• FITC, TRITC [+]

  • T-lymphoblasts (ALL L1 and L2)
  • pre-B cells?
  • Terminal Deoxynucleotidyl transferase
• FITC, TRITC [-]

  • myeloblasts and monoblasts
  • ALL-L3?

  Terminal Deoxynucleotidyl transferase
• MPO?


  Myeloperoxidase
• SBB?


  Sudan Black B
• SE?

  Specific Esterase
• Under Specific Esterase? CAE and NASDA

  • Chloroacetate esterase
  • Naphthol AS-D acetate
• ANAE?

  Alpha-naphthyl acetate esterase
• ANBE?

  Alpha-naphthyl butyrate esterase
• TRAP?

  Tartrate-resistant acid phosphatase
• PAS?

  Periodic acid Schif
• LAP?

  Leukocyte alkaline phosphatase
• TdT?

  Terminal deoxynucleotidyl transferase
• (Myeloperoxidase)

  RBCs may stain diffusely brown because of pseudo-peroxidase activity of hemoglobin
• Lipids in primary and secondary granules?

  Sudan Black B