A patient has a very high white blood count with many blasts in the blood and bone marrow. Esterase stains using both naphthol AS-D chloroacetate and a-naphthyl acetate esterase as substrates are both positive. What condition is likely?
a. Chronic myelogenous leukemia
b. Acute lymphoblastic leukemia
c. Acute myelomonocytic leukemia
d. Hairy cell leukemia
ANS: C
Myelomonocytic leukemia will be positive for both naphthol AS-D chloroacetate and a-naphthyl acetate esterase stains. The others mentioned are either negative for both or positive for only one. The stain is not useful for the diagnosis of chronic myelogenous leukemia.
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