Test ID: 82091
Amyloid Protein Identification, Paraffin, LC MS/MS
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
Identification of proteins associated with extracellular deposits, including amyloidosis
This test is appropriate for all tissue types in routinely processed paraffin- embedded biopsy specimens
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| 89054 | Congo Red, Stain | No | Yes |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the Congo Red stain will always be performed at an additional charge.
Method Name A short description of the method used to perform the test
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Includes pathology consultation and Congo Red stain charged separately.
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
Amyloid AL
Amyloid ATTR
APIP
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.
This test is not an orderable test. Order 5439 Surgical Pathology Consultation. The consultant will determine the need for special stains.
Specimen Type: A formalin-fixed or B5-fixed, paraffin-embedded tissue block
Container/Tube: Surgical Pathology Packaging Kit (Supply T554)
Collection Instructions:
1. Do not send fixed tissue slides. Testing can only be done on paraffin-embedded tissue blocks.
2. Attach the green pathology address label included in the kit to the outside of the transport container.
Additional Information:
1. Preliminary pathology report and history are required.
2. A brief explanatory note or consultative letter is also recommended.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | Fixed tissue slides |
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 |
|---|---|---|
| Tissue | Ambient | |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Certain diseases are caused by abnormal deposition of proteins in extracellular sites. An example is amyloid which consists of several subtypes--systemic, familial, localized, and secondary. Each subtype is caused by a different protein. Because the management of amyloidosis relies on the treatment of the underlying etiology and differs radically for different amyloid subtypes, accurate characterization of the amyloid fibrils is important. This assay identifies the proteins associated with extracellular deposits including the proteins important in typing amyloidosis: for instance, ATTR (transthyretin/prealbumin; familial amyloidosis), AA (serum amyloid A), SAA (secondary amyloidosis), and AL (immunoglobulin light chain, lambda or kappa; primary 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 interpretive report will be provided.
Interpretation Provides information to assist in interpretation of the test results
This test will be processed as a pathology consultation. An interpretation will be provided.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Vrana JA, Gamez JD, Madden BJ, et al: Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens. Blood 2009;114(24):4957-4959
2. Rodriguez FJ, Gamez JD, Vrana JA, et al: Immunoglobulin derived depositions in the nervous system: novel mass spectrometry application for protein characterization in formalin-fixed tissues. Lab. Invest. 2008;88(10);1024-1037
3. Picken MM: New insights into systemic amyloidosis: the importance of diagnosis of specific type. Curr Opin Nephrol Hypertens 2007;16:196-203
4. Dispenzieri A, Gertz MA: The laboratory diagnosis and monitoring of amyloidosis. Communique 2002;27(9):1-10
Method Description Describes how the test is performed and provides a method-specific reference
Affected areas are removed from paraffin-embedded tissues by laser microdissection. Protein digestion is performed, followed by LC MS/MS. (Unpublished Mayo method)
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
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
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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.
83788-Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not elsewhere specified; qualitative, each specimen
88313-Congo Red, Stain
88380-Microdissection; laser capture
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 |
|---|---|---|
| 82091 | Amyloid Protein ID, Par, LC-MS/MS | In Process |
The Amyloid Protein Identification test employs Liquid Tissue® sample preparation licensed from Expression Pathology Inc., Rockville MD, under U.S. Patent 7,473,532 and patents pending and foreign equivalents thereof.
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