Acute myelomonocytic leukemia


Megakaryoblastic leukemia ro

Nonenzymatic PAS

Sudan black Enzymatic Peroxidase

Alkaline phosphatase Esterases

Naphthol AS-D chloroacetate Naphthol AS-D acetate a-Naphthyl acetate Acid phosphatase

Present as coarse granules or blocks in a variable number of cells





Negative or weakly positive


Positive in T-ALL

Negative or diffusely positive


Positive0 Low

Positive Positive (not inhibited by fluoride) Negative Negative

Negative or fine granulation


Usually negative High

Negative Strongly positive (inhibited by fluoride) Strongly positive Negative

Strongly positive granular


Positive Normal or high

Negative Weakly positive

Strongly positive Negative

Positive or negative

Negative Negative

Positive or negative

Positive or negative Positive (localized pattern)

"The peroxidase reaction, when positive, is considered to indicate the presence of myeloblastic rather than lymphoblastic elements. Unfortunately, myeloblasts that contain no specific granules will be peroxidase negative. It is these cells that cause the greatest difficulty in morphologic classification. Generally, when morphologic classification is difficult, these histochemical tests are of little help. However, demonstration of MPO (myeloperoxidase) by immunologic techniques or expression of MPO by molecular methods can be performed in specialized research laboratories.

ro ro

TCR A rearrangement TCR i rearrangement TCR p rearrangement TCR a rearrangement CD7 CD5 CD2 CD1 CD4 CD8 C03

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