Differential Diagnosis for Cells Staining Positive with Acid Phosphatase Not Inhibited by Tartrate
- Single Most Likely Diagnosis
- A. Hairy Cell Leukemia: This condition is characterized by the presence of hairy cells that typically stain positive for acid phosphatase and are not inhibited by tartrate. This unique enzymatic profile is a hallmark for the diagnosis of hairy cell leukemia.
- Other Likely Diagnoses
- B. Acute Myeloblastic Leukemia: While not as specific as hairy cell leukemia, some cases of acute myeloblastic leukemia (AML) may exhibit acid phosphatase positivity. However, the tartrate resistance is more characteristic of hairy cell leukemia.
- C. Chronic Myelocytic Leukemia: Although less common, chronic myelocytic leukemia (CML) cells may also show positivity for acid phosphatase. The lack of tartrate inhibition is less specific for CML but can be seen in some cases.
- Do Not Miss Diagnoses
- E. Infectious Mononucleosis: While infectious mononucleosis (caused by Epstein-Barr virus) primarily affects lymphocytes and does not typically present with the specific acid phosphatase staining pattern described, it can sometimes mimic lymphoproliferative disorders. Missing this diagnosis could lead to inappropriate treatment and significant morbidity.
- Rare Diagnoses
- D. T-cell ALL: T-cell acute lymphoblastic leukemia (T-cell ALL) is less likely to present with the specific enzymatic staining pattern of acid phosphatase positivity without tartrate inhibition. However, given the aggressive nature of T-cell ALL, considering it in the differential, especially in pediatric or young adult patients, is crucial.
- Other rare lymphoproliferative disorders or leukemias might also exhibit unusual enzymatic staining patterns, but these would be less common and typically identified through a combination of clinical presentation, morphology, and additional diagnostic tests.