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Lesson 10-3
Diagnostic Special Stains


Leukocyte Alkaline Phosphatase Stain (LAP).

  • (1) Stains alkaline phosphatase present in the neutrophil.
  • (2) Helpful in differentiating chronic myelogenous leukemia from a leukemoid reaction or polycythemia vera.

Myeloperoxidase Stain (MPO).

  • (1) Stains peroxidase present in primary granules of myeloid cells; demonstrates the presence of Auer rods.
  • (2) Used to differentiate acute myelogenous or monocytic leukemias (+) from acute lymphocytic leukemia (-).

Periodic Acid-Schiff Reaction (PAS).

  • Stains high molecular weight carbohydrates normally present in most blood cell types except pronormoblasts.
  • Used to help diagnose erythroleukemia where normoblasts may be strongly positive.

Sudan Black B (SBB).

  • Stains phospholipids and lipoproteins present in granules of monocytes and granulocytes.
  • Used to differentiate acute myelogenous and myelomonocytic leukemias (+) from acute lymphocytic leukemia (-).

Acid Phosphatase.

  • Stains acid phosphatase present in the lysosomes of all hematopoietic cells.
  • Used to identify T-cell acute lymphocytic leukemia.

Acid Phosphatase (With Tartrate Resistance).

  • Acid phosphatase is present in all hematopoietic cells; -located in lysosomes.
  • Stain is helpful in diagnosing hairy cell leukemia.

Nonspecific Esterase Stain.

  • Stains esterases in monocytes and macrophages.
  • Used to differentiate granulocytic leukemias (-) from monocytic leukemias (+).

Specific Esterase (Naphthol AS-D Chloracetate) Stain (CAE).

  • Stains esterases present in mature and immature neutrophils and mast cells.
  • Used to differentiate neutrophilic cells (+) from monocytic cells (-).

Toluidine Blue.

  • Stains the granules in basophils and mast cells.
  • Used to identify basophilic leukemia and mast cell disease.


David L. Heiserman, Editor

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Revised: June 06, 2015