55. cytochemical stains were performed on bone marrow smears from an acute leukemia patient. the majority of the blasts showed varying amounts of myeloperoxidase positivity. some of the blasts stained positive for chloroacetate esterase, some were positive for alpha-naphthyl acetate esterase, and some blasts stained positive for both esterases. what type of leukemia is indicated? a. lymphocytic b. myelogenous c. myelomonocytic d. erythroleukemia

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13-09-2022
Biology

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55. cytochemical stains were performed on bone marrow smears from an acute leukemia patient. the majority of the blasts showed varying amounts of myeloperoxidase positivity. some of the blasts stained positive for chloroacetate esterase, some were positive for alpha-naphthyl acetate esterase, and some blasts stained positive for both esterases. what type of leukemia is indicated? a. lymphocytic b. myelogenous c. myelomonocytic d. erythroleukemia

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tutorconsortium215 tutorconsortium215 · Answer 1 · 2022-09-15T12:07:32-04:00

Myelomonocytic leukemia

Cytochemical diagnosis of acute myelomonocytic leukemia

Overview:

Blood and bone marrow smears from adult patients with acute leukemia were stained for esterase reactions sequentially with naphthol AS D-chloroacetate (chloroacetate esterase) followed by alpha-naphthylbutyrate (non-specific esterase). Two substrates were specific for granulocytes and monocytes, respectively. This method allows her to distinguish between three subgroups of acute nonlymphocytic leukemia. Leukemia cells can be positive for either chloroacetate esterase or non-specific esterases, and the authors suggest that these two subsets can be divided into 'true' granulocytic leukemia and 'pure' monocytic leukemia. I think it represents leukemia. In a third group, leukemic cells contain both esterases in the same cell, and this group is thought to represent "true" myelomonocytic leukemia. In the majority of patients in this group, leukemia developed from the preleukemia stage. Using Romanovsky-stained smears alone, the monocyte-like features and absolute increase in monocyte count in acute granulocytic leukemia may lead the leukemia to be misdiagnosed as acute myelomonocytic leukemia. This occurred in 5 of the 13 cases in the study. The presence of granulocyte- and monocyte-specific esterases in single cells supports the notion of a common origin for granulocytes and monocytes. The authors conclude that the combined esterase reaction can distinguish between acute granulocytic leukemia, acute monocytic leukemia, and acute myelomonocytic leukemia.

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