Page 706 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

690 PART 8 ■ Fundamentals of Hematological Analysis

SPECIAL STAINS (continued)

Di use staining may be present in more mature nucleate SIDEROCYTE STAIN: PRUSSIAN BLUE STAINING

erythrocytes. METHOD

T is proce ure in CLSI ormat is provi e on this book’s Principle

companion Web site at thepoint.lww.com/ urgeon6e.
Te Prussian blue reaction precipitates ree iron into small blue

PEROXIDASE (MYELOPEROXIDASE) IN or blue-green granules in erythrocytes. Free iron is not i enti-

LEUKOCYTES: CYTOCHEMICAL STAINING fable on Wright- or Wright-Giemsa–staine bloo smears. An

METHOD immature or mature erythrocyte containing ree iron is re erre

Principle to as a si eroblast or si erocyte, respectively. Increase numbers
o si erocytes are seen in isor ers such as thalassemia major or
Myeloperoxi ase (MP) is etecte by means o the enzyme’s in patients a er a splenectomy. I the iron granules encircle the

interaction with iaminobenzi ine (DAB), a benzi ine substi- nucleus o the erythrocyte, it is re erre to as a ringe si eroblast.

tute. T e brown reaction pro uct is f rst intensif e with copper Although alcoholism is the most common cause o ringe si ero-

salts ollowe by Gill’s mo if e Papanicolaou stain, which results blasts, they may also be seen in cases o lea poisoning or anemia.

in intense gray-black granules at sites o neutrophil an mono-

cyte MP activity (Fig. 32.17). T e reaction can be illustrate as: Clinical Applications

An increase in si eroblasts is associate with thalassemia major
DAB H O MP → oxi ize DAB
+
2 2 or minor an with the si eroblastic anemias. T e si eroblastic
( light brown pigment) anemias are a miscellaneous group o iseases cause by rugs

( )
Oxi ize DAB Cu NO → gray-black pigment or chemicals, as well as various isor ers, an are o here itary
+
33
2
or i iopathic origin. Si erocytes are uncommon in peripheral
Tis proce ure i erentiates cells o lymphoi origin rom bloo but may be seen a er a splenectomy.

granulocytes an their precursors an monocytes. Tis proce ure in CLSI ormat is provi e on this book’s

Clinical Applications companion Web site at thepoint.lww.com/ urgeon6e.

T e most probable results to be expecte with peroxi ase- SUDAN BLACK B STAIN: CYTOCHEMICAL

staining proce ures in cases o acute nonlymphocytic leuke- STAINING METHOD

mia (ANLL) are: Principle

M1 →5% to 15% o blasts may be positive Following f xation, bloo or bone marrow f lms are immerse
M2 an M3 →positive in a bu ere Su an black B solution. A er rinsing, sli es are

M4 →positive (usually a mixe population o cells) counterstaine with Mayer’s hematoxylin. Cells are examine

M5a →may be positive microscopically or the presence o blue-black iscrete gran-
M5b →a f ne granular eposit may be observe in more ulation (Fig. 32.18). Cells committe to the lymphoi path-

mature cells way isplay negative staining reactions, whereas myeloi an

M6 an M7 →myelocytic cells are positive monocytoi orms isplay characteristic positive reactions.

ALL →negative (L1, L2, an L3) Te Su an black B staining pattern usually parallels the MP

stain an is use ul in the i entif cation o myelogenous an
Tis proce ure in CLSI ormat is provi e on this book’s

companion Web site at thepoint.lww.com/ urgeon6e. myelomonocytic leukemias.

FIGURE 32.17 Myeloperoxi ase stain o acute myelogenous leu- FIGURE 32.18 Su an black B (lef ) stain o acute myelogenous

kemia M2. (Reprinte rom McClatchey KD. Clinical Laboratory leukemia M4. (Reprinte rom McClatchey KD. Clinical Laboratory
Medicine, 2n e , Phila elphia, PA: Lippincott Williams & Medicine, 2n e , Phila elphia, PA: Lippincott Williams & Wilkins,

Wilkins, 2002, with permission.) 2002, with permission.)