Test ID: 5434
Hematopathology Consultation
Useful For
Suggests clinical disorders or settings where the test may be helpful
Obtaining a rapid, expert second opinion on specimens referred by the primary pathologist
Obtaining special studies not available locally
Note: If the need for special studies is anticipated, appropriate material should be sent. See Specimen Required.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Diagnostic hematopathology has become an increasingly complex subspecialty, particularly with neoplastic disorders of blood and bone marrow. The clinical, therapeutic, and prognostic features of these disorders are often distinctive, while the pathologic features are quite subtle, requiring the application of ancillary studies (eg, cytochemistry, immunohistochemistry, flow cytometric immunophenotyping, cytogenetics, and molecular genetics) to establish a diagnosis. Furthermore, these ancillary studies are expensive, labor intensive, and are most efficiently utilized and interpreted in the context of the morphologic features.
It is the Division of Hematopathology's goal to provide the highest possible level of diagnostic consultative service, trying to balance optimal patient care with a cost-conscious approach to solving difficult diagnostic problems.
All blood and bone marrow studies are available within the context of a hematopathology consultation. Requests for specific ancillary tests, including enzyme cytochemical stains, immunocytochemistry (slide immunophenotyping), and immunohistochemistry are not available through Mayo Medical Laboratories as individually ordered tests, but rather in association with a consultation. If the Mayo consultant would approach the diagnosis in a different way than the referring physician, then the Mayo consultant will call the referring physician to discuss the case prior to performing any additional studies. Referring physicians are welcome to suggest which specific ancillary studies should be performed, but before they are done, a morphologic review by one of the Mayo consulting staff hematopathologists will confirm the diagnostic problem presented by the morphologic differential diagnosis.
The following algorithms are available in Special Instructions:
-Myeloproliferative Neoplasm: A Diagnostic Approach to Bone Marrow Evaluation
-Myeloproliferative Neoplasm: A Diagnostic Approach to Peripheral Blood Evaluation
-Laboratory Approach to the Diagnosis of Amyloidosis
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
This request will be processed as a consultation. An interpretation will be provided for every case. Appropriate studies and/or stains (as described in Specimen Required) will be performed, only if indicated, and charged separately.
Interpretation
Provides information to assist in interpretation of the test results
Results will be reported as a morphologic description followed by a specific diagnosis and also includes a description of the ancillary test results and an interpretive comment.
When the case is completed, all results will be communicated by a phone call and a formal pathology report.
Through this enhanced consultative process, we strive to bring the customer the highest quality of diagnostic hematopathology, aiming to utilize only those ancillary tests that support the diagnosis in a cost-effective manner, and to provide a rapid turnaround time for diagnostic results.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Appropriate stained/unstained slides and tissue sampling/fixation is required in order to make a diagnosis on routine stains and on the special stains or studies which may be required.
The referring pathologist's name and phone number are essential.
Clinical Reference
Provides recommendations for further in-depth reading of a clinical nature
Not applicable
Special Instructions and Forms
Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
- Laboratory Approach to the Diagnosis of Amyloidosis
- Myeloproliferative Neoplasm: A Diagnostic Approach to Peripheral Blood Evaluation
- Myeloproliferative Neoplasm: A Diagnostic Approach to Bone Marrow Evaluation
- Malignant Lymphoma, Guideline for Bone Marrow Staging Studies
- Myelodysplastic Syndrome: Guideline to Diagnosis and Follow-up
- Acute Promyelocytic Leukemia: Guideline to Diagnosis and Follow-up


