Bone Marrow, NSE Stain Test: Booking, Price, and Results
About Bone Marrow, NSE Stain Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Non-Specific Esterase Stain, Alpha-Naphthyl Butyrate Esterase Stain, ANBE Stain, Butyrate Esterase Stain |
| Sample Type | Bone marrow aspirate smears |
| Fasting Required | No |
| Report Time | 2 days |
| Recommended For | All genders and age groups when acute leukaemia is suspected |
| Price | Starting at ₹400 |
What is a Bone Marrow, NSE Stain Test?
The Bone Marrow, NSE Stain test is a specialised cytochemical test that detects the activity of non-specific esterase (NSE) enzymes in bone marrow and blood cells. It is used primarily to identify cells of monocytic origin, which are cells that develop into monocytes (a type of white blood cell). Doctors order this test when they suspect acute leukaemia and need to determine which type of blood cells are involved. It is also known as the Non-Specific Esterase Stain or ANBE Stain.
What Does a Bone Marrow, NSE Stain Test Measure?
This test examines the staining pattern of cells in the bone marrow and peripheral blood. It identifies specific enzyme activity to classify cell types. The key parameters assessed are listed below.
| Parameter | What It Indicates |
|---|---|
| NSE enzyme activity in monocytic cells | Identifies monocytes and their precursors |
| Staining pattern (diffuse red/brown) | Confirms monocytic lineage |
| Granulocytic cell staining | Expected to be negative in normal samples |
| Lymphoid cell staining | Expected to be negative or show only weak focal staining |
| NSE inhibition with sodium fluoride | Confirms monocytic origin when staining is inhibited |
Why is a Bone Marrow, NSE Stain Test Done?
The NSE Stain test plays a key role in classifying acute leukaemias. A doctor may recommend it based on symptoms or abnormal results from earlier blood tests.
Common Symptoms That May Require This Test
Patients are typically referred for this test after presenting with one or more of the following symptoms.
- Persistent and unexplained fatigue
- Recurring fever or night sweats
- Frequent infections that do not resolve easily
- Unexplained weight loss
- Shortness of breath
- Pain in the bones or joints
- Easy bruising, nosebleeds, or bleeding gums
Conditions This Test Can Help Detect
The Bone Marrow, NSE Stain test procedure helps identify or classify the following conditions.
- Acute Myeloid Leukaemia (AML), particularly subtypes with monocytic differentiation
- Acute Myelomonocytic Leukaemia (AML M4), which shows mixed monocytic and granulocytic involvement
- Acute Monocytic Leukaemia (AML M5), where monocytic cells dominate
- Histiocytic lesions, which are tumours involving cells that engulf foreign substances
- Lymphoma, when initial blood results suggest abnormal cell populations
How to Prepare and What to Expect
Preparation for the Bone Marrow, NSE Stain test is straightforward. The key steps below will help you feel ready.
Do You Need to Fast?
No fasting is required before this test. You may eat and drink as normal before your appointment.
Practical Tips Before Your Test
Keep the following points in mind ahead of your appointment.
- Bring a detailed clinical history report, including your symptoms, previous test results, and family history, as this is required for the test
- Carry recent laboratory reports to your appointment, as these are needed alongside the clinical history
- Inform your doctor about all medications you are currently taking, especially blood thinners (anticoagulants)
- Tell your doctor if you have a history of bleeding disorders
- Inform your doctor if you are pregnant
Step-by-Step Procedure
The bone marrow sample is collected in a clinical setting by a trained healthcare professional. Here is what to expect.
- You will be positioned on a table, usually lying on your side or stomach, so the doctor can access the back of your hip bone (the posterior iliac crest).
- The skin and surface of the bone are numbed with a local anaesthetic to reduce discomfort.
- A thin needle is inserted to withdraw a liquid bone marrow sample (bone marrow aspiration). A brief, sharp sensation is normal during this step.
- Smears are prepared from the aspirate. A minimum of four unfixed bone marrow aspirate smears and two peripheral blood smears are submitted for staining.
- The NSE stain is applied to the slides and read under a microscope. Parallel staining with and without sodium fluoride may be performed to confirm cell origin.
- The labelled sample is stored under refrigeration (2 to 8 degrees Celsius) and dispatched to the laboratory for analysis.
Factors That Can Affect Accuracy
Several factors can influence the quality and reliability of results.
- Use of freshly prepared smears (enzyme activity diminishes in older samples)
- Correct fixative used during slide preparation
- Adequate clinical history was provided on the laboratory requisition form
- Proper storage and transport conditions are maintained after collection
Understanding Your Bone Marrow, NSE Stain Test Results
Results from this test are qualitative, meaning they describe staining patterns rather than numbers. Your haematologist or pathologist will interpret the patterns in the context of your full clinical picture.
| Parameter | Normal/Expected Finding |
|---|---|
| Monocytes and precursors | Diffuse red/brown staining (positive) |
| Granulocytic cells | No staining (negative) |
| Lymphoid cells | Negative or weak focal staining |
| NSE inhibition with sodium fluoride | Staining is inhibited (positive inhibition) |
Positive (strong diffuse staining) may indicate:
- If undifferentiated blast cells stain positive, this suggests a leukaemia of monocytic origin, likely monoblastic leukaemia
- If over 20% of cells show monocytic differentiation alongside granulocytic cells, this is consistent with AML M4
- If monocytic cells constitute over 80% of the cells, the diagnosis is consistent with AML M5
Negative or weak staining may indicate:
- Leukaemia of granulocytic origin (granulocytic leukaemia)
- Leukaemia of lymphoid origin (lymphoblastic leukaemia)
Disclaimer: "These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice."
Results During Special Conditions
Certain situations can produce atypical staining patterns that require careful interpretation.
- In acute promyelocytic leukaemia (APL), blast cells are typically NSE-negative; however, approximately 25% of cases may show weak positivity, which can be misleading.
- Lymphoblasts, erythroblasts, and megakaryoblasts (precursor cells for red blood cells and platelets) may show a small number of punctuate (dot-like) positive granules, which should not be mistaken for true monocytic positivity.
- If NSE staining is not inhibited by sodium fluoride, this may suggest the cells are not of monocytic origin.
How to Maintain Healthy Levels
While this test is diagnostic rather than routine monitoring, the following general wellness tips support overall bone marrow and blood health.
- Eat a balanced diet that includes adequate iron, folate, and vitamin B12 to support healthy blood cell production.
- Attend regular health check-ups if you have known risk factors for blood disorders.
- Seek prompt medical attention for unexplained fatigue, recurrent infections, or easy bruising rather than waiting to see if symptoms resolve.
Lupin Diagnostics Bone Marrow, NSE Stain Test Price
The Bone Marrow, NSE Stain test cost at Lupin Diagnostics starts at ₹400. This test requires a visit to a Lupin Diagnostics centre; home collection is not available for this test as bone marrow aspiration must be performed by trained healthcare professionals in a clinical setting.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 400 |
| CHENNAI | 400 |
| HYDERABAD | 400 |
| KOLKATA | 400 |
| NAVI MUMBAI | 400 |
| PUNE | 400 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book your Bone Marrow, NSE Stain test online.
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The Bone Marrow, NSE Stain test is used to identify monocytic cells in bone marrow. It helps doctors classify types of acute leukaemia, particularly those with monocytic differentiation, such as AML M4 and AML M5.
NSE is a monocytic marker, meaning it highlights monocytes and their precursors. Other stains, such as myeloperoxidase (MPO), identify granulocytic cells, while the PAS stain detects glycogen. Each stain gives a different piece of the diagnostic picture, and they are often used together.
The Bone Marrow, NSE Stain test home collection is not possible because the sample requires a bone marrow aspiration procedure. This must be performed by trained medical professionals in a clinical setting using sterile technique and specialised equipment.
Local anaesthesia is used to numb the skin and the surface of the bone. However, the inside of the bone cannot be fully numbed, so you may feel a brief, sharp sensation when the bone marrow liquid is withdrawn. Most patients experience only mild soreness at the site for a few days afterwards.
Results are typically available within 2 days at Lupin Diagnostics. Complex cases may require additional time, particularly if further testing is needed alongside the NSE stain.
A positive result indicates the presence of cells of monocytic origin in the bone marrow. Your doctor will correlate this finding with other cytochemical stains, immunophenotyping, and clinical information to reach a specific diagnosis and plan next steps.
Yes. Bring a detailed clinical history file covering your current symptoms, any previous test results, and relevant family history. Recent laboratory reports are also required and should be carried to your appointment.
Bone Marrow, NSE Stain Test: Booking, Price, and Results
