Special Tests PDF

64 Special Tests TEST MEASURES INDICATIONS COMMENTS FLAER Test Absence of GPI Anchor Proteins...

64 Special Tests TEST MEASURES INDICATIONS COMMENTS FLAER Test Absence of GPI Anchor Proteins PNH More specific and sensitive (Fluorescent Aerolysin) for CD 55 and CD59 Flow Cytometry Deficiency of CD 55 and CD 59 PNH Less sensitive than FLAER test on RBCs and granulocytes Heinz Body Prep Effect of Oxidizing Agent on G6PD Deficiency Formation Triggered by Oxidants (supravital stain) Hemoglobin Unstable Hemoglobins such as Anti-Malarial Drugs, (Precipitated globin chains) HbH Fava Beans & Sulphur Drugs Sickle Cell Screen Reduced Solubility of HbS Reducing Agent: Deoxygenated Hemoglobin S Na Dithionate Kleihauer-Betke Acid Resistance of Fetal Hemoglobin Fetal-Maternal Hemorrhage; Cells with +HbF Stain Pink; Elution to Acid Elution Hereditary Persistence of Fetal Normal Adult Cells ~ Ghost Cells Hemoglobin Hemo~obin Migration of Various Suspected Hemoglobinopathies May be Performed at Various pHs Electrop oresis Hemoglobins Cold Agglutinin Titer Presence of Cold Autoantibody Cold Autoimmune Hemolytic lgM Ab, Anti-I Specificity Anemia Donath Landsteiner Test Presence of Biphasic DL Antibody Paroxysmal Cold Hemoglobinuria lgG Ab, Anti-P specificity GPI- Glycosylphosphatidylinositol FLAER- Fluorescent Aerolysin REMEMBER! Kleiheur-Betke Fetal Hb is Resistant to Principles and Indications of Special Te8t8 Acid Elution (Adult Cells Appear as Ghost Cells.) (~~ ( "' 20% blasts) HEREDITARY CONDITIONS ❖ AML with recurrent chrom osomal CONDITION) CHARACTERISTICS COMMENTS abnormalities iw t(8;21) Alder-Reilly Large Azurophilic ,t.Mucopolysaccharides 1& Inv (16) or t(l6;16) Granules (Hunter, Hurler) i& t(l5 ;17) Chediak- Large Lysosomes (Fusion Albinism, i& llq23 Higashi of Primary Granules) + susceptibility to ❖ AML with dyspfasia Infection I& may follow MDS Does Not Affect ❖ AML & MDS therapy related May-Hegglin La~e Platelets, t Number, i:ih le Bodies in Segs, Leukocyte Function ❖ AML not otherwise classifi.ed - Monos, and Lymptis defaults to the FAB classification ❖ AML of ambiguous lineage Pelger-Huet Hyposegmented Polys Normal Function b. French , American, British (FAB) classi- fication (>30% blasts) MYELOPROUFERATIVE DISEASES 1. Myelodysplastic Syndromes- neoplastic, AML PREDOMINANT CELL SEEN clonal,stem cell disorder s characterized MO Myeloblast without differentiation by cytopenias and BM dyspoiesis Ml Myeloblast with minimal maturation a. Refractory Anemia (RA)- 20% plasm a cells i 11 p eripher al lmmunoglobulin lgG lgM circulation (Bence-Jones) (Heavy Chain: Special Cytochemical Stains/ Inclusions/ Markers STAIN/ INCLUSION/ MARKERS INDICATES: SIGNIFICANCE: Prussian Blue Iron Sideroblastic Anemia, Iron overload LAP Leukocyte Alkaline Phosphatase ,+. Leukemoid Reaction, P. vera; t CML Peroxidase/Sudan Black Myeloperoxidase/Lipid Myeloid Precursors Pos / Lymphoid Precursors Neg Specific Esterase Granulocyte Precursors Negative in Monocytic Leukemia Non-Specific Esterase Monocyte Precursors Positive in Monocytic Leukemias TRAP Tartrate-Resistant Acid Phosphatase Hairy Cell Leukemia Auer rods Coalition of 1° Granules Acute Myeloid Leukemia CD13, CD33 Myeloid Lineage Myeloid / Monocytoid Leukemias CD4 l , CD42, CD6l Megakaryocytes Megakaryocytic Leukemia CD14, CD64 Monocyte lineage Monocytoid Leukemias CO2, CD3, CDS, CD7 T-lineage T-cell Neoplasms CD10 (CALLA), CD19, C022 B-lineage B-cell Neoplasms CD34 Stem Cells Stem Cells for Transplantation, Acute Leukemia CD71 Transferrin receptor Erythroleukemia C045 Common Leukocyte Antigen Found on all Leukocytes CD103 , CDllc, CD25 HCL Also seen in other Lymphoproliferative Disorders JAK 2 Mutation PV Also seen in other MPN  67 Lysosome and Lipid storage Disorders DISEASE ACCUMULATED LIPID LAB DIAGNOSIS Gaucher Glucocerebroside BM Macrophages with wrinkled or striated cytoplasm Niemann-Pick Sphingomyelin BM Macrophages with globular or foamy cytoplasm, Sea-blue Histiocytes REMEMBER! Tartrate-Resistant Apid ,,, Phosphatase'for Hairy Cell Leukemi.a lR.A.P. the Hairy Beast REMEMBER! "!!)= REMEMBE c!] c::; (? JAK2 WHO mutation Classification and of Acute P. vera Leukemia JAcK loves PQly Yera ,, Be able to identifv mature, immature, and abnormal RBCs and WBCs from graphic images. Correlate abnormal findi.ngs with appropriate disease states.