70016 - Specimen: Hematopathology Consultation, Wet Tissue

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Test ID: 70016    
Hematopathology Consultation, Wet Tissue

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 or liquid 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 a wet tissue or liquid specimen is also submitted.

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

-If requesting a peripheral blood smear evaluation only, order SPSM / Morphology Evaluation (Special Smear).

-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 CHRBM / 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.

Specimen Type Describes the specimen type needed for testing

Varies

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.

Transport Container: Pathology Packaging Kit (T554). Attach the green "Attention Pathology" address label included in the kit to the outside of the transport container.

 

Forms:

1. Hematopathology Patient Information Sheet (T676) in Special Instructions

2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

Hematopathology/Cytogenetics Test Request Form (T726) (http://www.mayomedicallaboratories.com/it-mmfiles/hematopathology-request-form.pdf)

Benign Hematology Test Request Form (T755) (http://www.mayomedicallaboratories.com/it-mmfiles/benign-hematology-test-request-form.pdf)

 

Specimens needed to provide a complete pathology consultation:

1. Recent peripheral blood smear with CBC report

2. Bone marrow biopsy and clot (unprocessed)

3. Bone marrow aspirate (stained and unstained slides, and liquid)

4. All pending and finalized reports for ancillary testing on above specimens

 

Additional Information:

All specimens, patient history, and requests should be clearly labeled with correct patient information, and case number. Collection date and patient date of birth are required. All specimens must be labeled with specimen type.  Although a complete pathology report is not expected a brief history and patient information is required. Please use the Hematopathology Request form.

 

Specimen Type: Bone marrow aspirate slides

Container/Tube: Transport in plastic slide holders

Preferred: Fresh prep slides made at the time of sample collection

Acceptable: Slides made from anticoagulated sample

Collection Instructions:

1. Prepare slides of bone marrow aspirate immediately after collection or prepare slides from bone marrow aspirate in EDTA within 2 hours of collection.

2. If bone marrow units are sparse or absent or aspirate is a dry tap, make biopsy touch prep slides.

3. Air dry slides.

4. Send 5 slides unfixed/unstained.

5. Place Parafilm around the slide carriers holding unstained slides to prevent exposure to formalin fumes during transport and place slides in a separate bag apart from any formalin-fixed clot or core biopsy specimens during transport. If using slide carriers, make sure they have not been used to carry fixed slides previously.

 

Specimen Type: Bone marrow aspirate in anticoagulant for possible ancillary testing

Container/Tube: EDTA, heparin, or ACD

Specimen Volume: 5 mL in EDTA, 2-5 mL in ACD, or 2-3 mL in heparin tube

Collection Instructions:

1. Aspirate per standard bone marrow collection procedure.

2. Do not transfer to other tubes or containers.

 

Specimen Type: Bone marrow core biopsy

Container/Tube: Fixed biopsy core in saline solution for transport or fixed biopsy core embedded in paraffin block

Collection Instructions:

1. Process and embed core in paraffin if desired.

2. If processing at Mayo is desired, place biopsy core in 10% formalin immediately after collection.

3. Fix in 10% formalin for 1 to 2 hours.

4. Transfer core to container with saline, volume sufficient to cover core.

 

Specimen Type: Bone marrow aspirate clot

Container/Tube: Bone marrow clot in 10% formalin or fixed clot embedded in paraffin block

Collection Instructions:

1. Place 0.5 mL bone marrow aspirate in clot tube.

2. After clot has formed, place clot in 10% formalin.

3. If embedding in paraffin, fix specimen, process and embed per your standard operating procedures.

4. If submitting to Mayo for possible processing and embedding, submit in container of 10% formalin.

 

Specimen Type: Peripheral blood slides and CBC

Container/Tube: Transport in plastic slide holders.

Preferred: Fresh prep fingerstick slide; include CBC values

Acceptable: Slides made from whole blood in EDTA, made within 8 hours of collection

Collection Instructions:

1. Prepare good quality smear of even thickness from fingerstick.

2. Alternately prepare good quality smear from EDTA vial within 8 hours of collection.

3. Submit unstained and unfixed slides.

Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected

Note: No specimen should be rejected. If specimen not received at appropriate temperature or in wrong anticoagulant, include note to laboratory. If questions, contact laboratory.

Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.

Specimen TypeTemperatureTime
VariesAmbient (preferred)
 Refrigerated 

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