Leukemia/Lymphoma Immunophenotyping by Flow Cytometry, Tissue
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, a screening panel and a professional interpretation will always be charged. The screening panel will be charged based on number of makers tested (FIRST for first marker, ADD1 for each additional marker). The interpretation will be set based on markers tested in increments of 9 to 15, or 16 and greater. In addition, reflex testing may occur to fully characterize a disease state or clarify any abnormalities from the screening test. Reflex tests will be performed at an additional charge for each marker tested (FIRST if applicable, ADD1 if applicable).
The tissue panel is initially performed to evaluate for monotypic B-cells by kappa and lambda light chain expression, and increased numbers of blasts and plasma cells by CD45 expression along with side scatter gating. The panel can also evaluate T cells with CD3, CD5, and CD7. Additionally, viability is assessed on all tissue specimens using 7-AAD exclusion.
This panel, together with the provided clinical history and morphologic review, is used to determine what, if any, further testing is needed for disease diagnosis or classification. If additional testing is required, it will be added per algorithm to fully characterize a disease state with a charge per unique antibody tested.
In addition to reflexing flow cytometric panels, FISH or molecular testing may be recommended by the Mayo pathologist to facilitate diagnosis. They will contact the referring physician or pathologist to confirm the addition of these tests.
Specimen Type Describes the specimen type needed for testing
Specimen must arrive within 96 hours of collection.
1. Date, time of collection, tissue type, and location are required.
2. A pathology/diagnostic report including the client surgical pathology case number, a brief history, reason for referral or clinical suspicion are required before the specimen will be processed.
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Supplies: Hank's Solution (T132)
Container/Tube: Sterile container with 15 mL of tissue culture medium (eg, Hank's balanced salt solution [T132], RPMI, or equivalent)
Specimen Volume: 5 mm(3) or larger biopsy
1. Collect fine-needle aspirate.
2. Send intact specimen (do not mince).
3. Specimen cannot be fixed.
1. Hematopathology Patient Information Sheet (T676) in Special Instructions
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request Form (T726) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/hematopathology-request-form.pdf)
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.