Which of the following statement is true in cytochemistry of ALL
## **Core Concept**
Acute Lymphoblastic Leukemia (ALL) is a type of cancer characterized by the overproduction of lymphoblasts in the bone marrow. Cytochemistry plays a crucial role in the diagnosis and classification of leukemia. The specific cytochemical features of ALL help differentiate it from other types of leukemia.
## **Why the Correct Answer is Right**
The correct answer, , indicates that in the cytochemistry of ALL, the leukemic cells are typically **periodic acid-Schiff (PAS) positive**. This is because lymphoblasts in ALL often show a block or a patchy positivity for PAS staining, which is a characteristic feature helping to distinguish ALL from Acute Myeloid Leukemia (AML). The PAS positivity is due to the presence of glycogen in the cells.
## **Why Each Wrong Option is Incorrect**
- **Option A:** - This option is incorrect because **specific esterase** is more specific to monocytic lineage, and ALL cells do not typically show positivity for this stain.
- **Option B:** - This option is incorrect as **Sudan Black B (SBB)** positivity is characteristic of myeloid lineage cells (like in AML), not lymphoid lineage cells (like in ALL).
- **Option D:** - This option is incorrect because **non-specific esterase** is positive in cells of monocytic lineage, and while it might be seen in some ALL cases due to the presence of admixed normal monocytes, it is not a specific or diagnostic feature of ALL.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl for ALL diagnosis is that **lymphoblasts in ALL are often PAS positive and TdT (terminal deoxynucleotidyl transferase) positive**. The TdT positivity is particularly helpful in distinguishing ALL from other types of leukemia, as TdT is a marker of immature lymphoid cells.
## **Correct Answer:** . PAS positivity.