Acute granulomatous-mono is a kind of acute leukemia due to granulocyte and monocyte two lineages, at the same time, malignant proliferation, clinically both acute granulomatous and acute mono leukemia features, one of the unique subtypes of M4EO incidence accounted for 20% of the M4, the average developmental age of the low, peripheral white blood cell counts are high, often accompanied by liver, spleen, lymph node enlargement. In addition to granulomonocytic hyperplasia, it is accompanied by abnormal eosinophils. This experiment is from Mudanjiang Medical College, undergraduate 5-year laboratory guide for testing majors.

Operation method

Acute granulocytic-monocytic leukemia (M4 type) detection assay

Principle

Acute granulomatous-mono is a kind of acute leukemia due to granulocyte and monocyte two lineages, at the same time, malignant proliferation, clinically both acute granulomatous and acute mono leukemia features, one of the unique subtypes of M4EO incidence accounted for 20% of the M4, the average developmental age of the low, peripheral white blood cell counts are high, often accompanied by liver, spleen, lymph node enlargement. In addition to granulomonocytic hyperplasia, there are abnormal eosinophils.

Move

Hematology:

l. Hb RBC counts are moderately to severely reduced, more so than in acute orders.

2. White blood cell count may be elevated, normal or decreased.

3. The peripheral blood is characterized by a combination of pull-lineage and mononuclear cells, with pro- and juvenile monocytes accounting for about 30-40% of the total number of cells.

Prokaryotic monocytes and young monocytes account for about 30-40% of the total number of cells, and there is active phagocytosis, while granulocytes are easy to be seen in the following stages.

4. platelets are severely reduced.

Bone Marrow;

l. Extremely or markedly active myeloproliferative, with simultaneous proliferation of both granulomatous and mono-granulomatous lineages.

2. granulomatous and monophyletic proliferation at the same time, if the proliferation of progranulocytes and early juvenile granulocytes is dominant, the young mononuclear and mononuclear cells should be more than 20%, if the proliferation of progranulocytes and mononuclear cells is dominant, the progranulocytes and early juvenile granulocytes should be more than 20%, in this type, some of the cells can be seen in the Auer's vesicles, and plasma cells are often increased, which can account for 3-5% of the cells.

This form of leukemia is characterized by morphology:

(1) The cytosol of promyelocytic monocytes is small, irregular in shape, often with small, rounded protrusions.

(2) The nucleus is slightly large and slightly off-set, mostly round, round-like or mildly inconspicuous, folded. The nuclear membrane is clearer.

(3) nuclear chromatin lax, lace-like structure, darker staining, pro-monocyte nucleoli obvious, varying young monocyte nucleoli please clear, to l-2 more common.

(4) less cytoplasm, gray-blue, inside and outside the plasma appeared less, but there is a fog-like turbidity, pro-monocyte granules are sparse, while young monocytes are more.

Cytochemical staining:

l. POX, SB: Positive or weakly positive reaction for pro- and young monocytes. And young granulocytes are positive or strong positive reaction, so it can be initially identified with M2M3 and other autohemorrhagic diseases.

2. Non-specific esterase staining: applying a-naphthol acetic acid or naphthol ASD acetic acid as the substrate for staining, the primary and juvenile granulocytes showed positive reaction, in which the acute granulocytes were not inhibited by sodium fluoride (NaF), while the acute monocytes could be inhibited by NaF, which could be differentiated from acute granulomatous and premature granulomatous leukemia.

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