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The page below is a sample from the LabCE course Autoimmune Diseases and Antinuclear Antibody Testing: Methods and Staining Patterns. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Description of Unusual or Atypical Speckled Patterns

Multiple nuclear dots (MND) ANA pattern or NSp I (AC-6)

This pattern is characterized by several (15 to 30) discrete speckles, or dots, in the nucleus of the interphase cells. There is no staining in the nucleoli, and the chromosome area of the metaphase mitotics is negative. This pattern is distinguished from centromere by having fewer speckles and negative mitotics. Follow-up testing for antibodies to Sp-100 is available. These antibodies are seen in patients with primary biliary cirrhosis.

This pattern is reported as "ANA positive; unusual or atypicial speckled; titering is optional."

ANA pattern with antibodies to CENP-F or NSp II (AC-14)

This pattern is characterized by the absence of staining in the interphase cells. In late interphase, speckling begins to appear. The metaphase mitotics demonstrate staining similar to centromere pattern, but the speckling is often in two rows. No follow-up testing is available. These antibodies are seen inpatients with various cancers.

This pattern is reported as "ANA positive, NSp II or CENP-F; titering is optional."