The most helpful cytochemical reactions of monocytes and granulocytes are included in Table 2. Granulocytes have heavily clumped granules with myeloperoxidase (MPX) activity, while the granules in monocytes with MPX activity are scattered and discrete, and they are far fewer than in granulocytes. Similar activity may be obtained with Sudan black B staining. The naphthol AS-D acetate esterase shows greater activity in monocytes than in granulocytes. The activity is inhibited by sodium fluoride (NaF) in monocytes but not in granulocytes. Monocytes can be well differentiated from granulocytes by the alpha-naphthyl butyrate (or acetate) activity, which is strong in monocytes and scarcely detectable in granulocytes. The naphthol AS-D chloracetate esterase activity in granulocytes differentiates them from monocytes, which have none. This reaction is somewhat similar to that of MPX but is more specific for granulocytes.
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Course Section: 09. Acute Myelomonocytic Leukemia - Monocytic Leukemia - and Erythroleukemia
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