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Test ID: 70016    
Hematopathology Consultation, Wet Tissue

Useful For Suggests clinical disorders or settings where the test may be helpful

Obtaining a rapid, expert opinion on unprocessed specimens referred by the primary pathologist

 

Obtaining special studies not available locally

Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.

This request will be processed as a consultation case. An interpretation, which includes an evaluation of the specimen and determination of a  diagnosis, will be provided by staff hematopathologists within a formal pathology report to the referring pathologist.

 

-This test should be ordered when submitting any wet-tissue specimen along with a request for a Hematopathology consultation

-This test should be used when all processing of a formalin-fixed biopsy core is to be performed by Mayo Clinic.

-This test can be used when requesting that a Mayo Hematopathologist provides full bone marrow workup, including appropriate ancillary testing, interpretation and reporting. This could include processing of the formalin-fixed biopsy as above or use of a paraffin embedded bone marrow biopsy block, as long as wet tissue is also submitted.

-Appropriate additional stains and other ancillary testing may be performed in order to render an accurate diagnosis. These additional stains/tests ordered will have the results included within the final pathology report and will be charged separately.

-If requesting a Hematopathology consultation on paraffin-embedded tissue and slides only, order 70012 / Pathology Consultation.

-If requesting stand-alone specific testing, please refer to the MML catalog for order codes.

-Flow cytometry on blood or bone marrow order LCMS / Leukemia/Lymphoma Immunophenotyping by Flow Cytometry

-Flow cytometry for tissue order LLPT / Leukemia/Lymphoma Immunophenotyping by Flow Cytometry, Tissue

-Chromosome analysis, order BM / Chromosome Analysis, Hematologic Disorders, Bone Marrow

 

Note: Testing requested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing Mayo Hematopathologist. For all pathology consultations, ancillary testing necessary to determine a diagnosis is ordered at the discretion of the Mayo pathologist.

 

See Pathology Consultation Ordering Algorithm in Special Instructions.

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. If requesting a full bone marrow workup, the Mayo consultant will approach the diagnosis in a way consistent with Mayo Clinic practice. The Mayo Hematopathologist may call the referring physician/pathologist 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.

Interpretation Provides information to assist in interpretation of the test results

Results of the consultation are reported in a formal pathology report that includes a description of ancillary test results (if applicable) and an interpretive comment. When the case is completed, results may be communicated by a phone call. The formal pathology report is faxed.  

 

In our consultative practice, we strive to bring the customer the highest quality of diagnostic pathology, in all areas of expertise, 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 and unstained slides and tissue sampling/fixation are required in order to make a diagnosis on routine stains, and on which special stains or studies may be required. The referring pathologist's name and phone number are essential. Specific diagnosis may require correlation with clinical information.

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