Test ID: 5434
Hematopathology Consultation
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
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.
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
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
-Malignant Lymphoma, Guideline for Bone Marrow Staging Studies
-Acute Promyelocytic Leukemia: Guideline to Diagnosis and Follow-up
-Myelodysplastic Syndrome: Guideline to Diagnosis and Follow-up
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
Method Name A short description of the method used to perform the test
All requests will be processed as a consultation first. Special studies will be performed only if diagnostically indicated. If the need for enzyme cytochemical stains, immunophenotyping, and/or immunohistochemical stains is anticipated, appropriate specimen requirements should be followed as indicated below.
Note: Special stains performed outside of Mayo Medical Laboratories and included with the case may be repeated and charged at the reviewing pathologist's discretion.
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Acute lymphocytic leukemia - differentiate T from non-T cell forms
Bone Marrow Consultation
Cytochemical
Hematology Consultation, Slides or Blocks
Surgical Pathology Consultation, Slides or Blocks
SPCB
Specimen Type Describes the specimen type needed for testing
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.
Forms: If not ordering electronically, please submit a Hematopathology/Molecular Oncology Request Form (Supply T241) with the specimen.
Consultation
Specimen Type: Peripheral blood, bone marrow aspirate, hematoxylin-and-eosin-stained slides of bone marrow biopsy, paraffin blocks
Container/Tube: Wright-Giemsa-stained slides
Collection Instructions:
1. Send stained slides of peripheral blood with CBC/differential.
2. When appropriate, include special stains and/or unstained slides.
3. Label with specimen type.
Additional Information:
1. Collection date is required.
2. A pathology/diagnostic report, the name and phone number of the ordering physician, and a brief history are essential to achieve a consultation fully relevant to the ordering physician's needs.
Enzyme Cytochemical Stains
Specimen Type: Bone marrow aspirate
Container/Tube: Plastic slide container
Specimen Volume: 2 or more smears
Collection Instructions:
1. All smears for cytochemical stains should be air-dried, unfixed, unstained, and no more than 2 weeks old.
2. Label specimen as bone marrow aspirate.
Additional Information: Cytochemical stains will be performed only if diagnostically indicated.
Immunohistochemical Stains
Specimen Type: Tissue
Container/Tube: Paraffin blocks or appropriate number of unstained tissue sections on charged slides
Collection Instructions: Label specimen as tissue.
Additional Information: Immunohistochemical stains will be performed only if diagnostically indicated.
Leukemia Immunophenotyping by Flow Cytometry
Specimen Type: Peripheral blood
Container/Tube: Green top (heparin) or yellow top (ACD solution B)
Specimen Volume: 10 mL
Collection Instructions:
1. Do not transfer blood to other containers.
2. Include 5 to 10 unstained peripheral blood smears, if possible.
3. Label specimen as blood.
Additional Information: Immunophenotyping will be performed only if diagnostically indicated.
Specimen Type: Bone marrow
Container/Tube: Yellow top (ACD solution B)
Specimen Volume: 1-5 mL
Collection Instructions:
1. Include 2 to 5 unstained bone marrow aspirate smears, if possible.
2. Label specimen as bone marrow.
Additional Information: Immunophenotyping will be performed only if diagnostically indicated.
Specimen Type: Tissue (eg, lymph nodes) other than blood and bone marrow
Container/Tube: Sterile container with tissue culture medium (eg, Hank's balanced salt solution [Supply T132], RPMI, or equivalent)
Specimen Volume: 1 cm(3) biopsy
Collection Instructions: Label specimen as tissue.
Additional Information: If, in the opinion of the Mayo hematopathology consultant, the tissue is not adequate for flow cytometric immunophenotyping, a call will be made to the referring pathologist. The specimen can be snap-frozen for phenotyping by immunohistochemistry.
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.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
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 Type | Temperature | Time |
|---|---|---|
| Varies | Ambient | |
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
Method Description Describes how the test is performed and provides a method-specific reference
All requests will be processed as a consultation first. Special studies will be performed only if diagnostically indicated. If the need for enzyme cytochemical stains, immunophenotyping, and/or immunohistochemical stains is anticipated, appropriate specimen requirements should be followed as indicated.
Note: Special stains performed outside of Mayo Medical Laboratories and included with the case may be repeated and charged at the reviewing pathologist's discretion.
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; Varies
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
88325
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 18503 | Accession Number | N/A |
| 18504 | Referring Pathologist/Physician | 46608-6 |
| 18505 | Ref Path/Phys Address | In Process |
| 18506 | Material: | In Process |
| 18528 | Specimen: | 31208-2 |
| 18507 | Peripheral Blood: | N/A |
| 18508 | Bone Marrow Differential: | 47286-0 |
| 18509 | Aspirate: | N/A |
| 18510 | Biopsy: | 52121-1 |
| 18511 | Microscopic Description: | In Process |
| 18512 | Special Studies: | In Process |
| 18513 | Final Diagnosis: | 34574-4 |
| 18514 | Comment: | 48767-8 |
| 18515 | Revision Description: | In Process |
| 18516 | Signing Pathologist: | 19139-5 |
| 18517 | Special Procedures: | N/A |
| 18518 | SP Signing Pathologist: | N/A |
| 18519 | *Previous Report Follows* | N/A |
| 18520 | Addendum: | 35265-8 |
| 19191 | Addendum Comment: | 22638-1 |
| 18521 | Addendum Pathologist: | 19139-5 |
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