Specimen must arrive within 48 hours of collection for spinal fluid, 96 hours for peripheral blood and bone marrow, or 72 hours for fluids.

This test is not appropriate for and cannot support diagnosis of sarcoidosis, hypersensitivity pneumonitis, interstitial lung diseases, or differentiating between pulmonary tuberculosis and sarcoidosis (requests for CD4/CD8 ratios). Specimens sent for these purposes will be rejected.

Bronchoalveolar lavage specimens submitted for evaluation for leukemia or lymphoma are appropriate to send for this test.

The following information is required:

1. Pertinent clinical history including reason for referral or clinical indication

2. Clinical or morphologic suspicion

3. Specimen source

4. Date and time of collection

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)

Submit only 1 of the following specimens:

Specimen Type: Blood

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Heparin, EDTA

Specimen Volume: 10 mL

Collection Instructions:

1. Do not transfer blood to other containers.

2. Include 5 to 10 unstained blood smears, if possible.

3. Label specimen as blood.

Specimen Stability Information: Ambient <96 hours/Refrigerated ≤96 hours

Specimen Type: Bone marrow

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: ACD, Heparin, EDTA

Specimen Volume: 1-5 mL

Collection Instructions:

1. Submission of bilateral specimens is not required.

2. Include 5 to 10 unstained bone marrow aspirate smears, if possible.

3. Label specimen as bone marrow.

Specimen Stability Information: Ambient <96 hours/Refrigerated ≤96 hours

Additional Information: If cytogenetic tests are also desired when drawing LCMS / Leukemia/Lymphoma Immunophenotyping by Flow Cytometry, an additional specimen should be submitted. It is important that the specimen be obtained, processed, and transported according to instructions for the other required test.

Specimen Type: Fluid

Sources: Serous effusions

Container/Tube: Body fluid container

Specimen Volume: 20 mL

Collection Instructions:

1. If possible, the fluids other than spinal fluid should be anticoagulated with heparin (1 U/mL of fluid).

2. The volume of fluid necessary to phenotype the lymphocytes or blasts in serous effusions depends upon the cell count in the specimen. Usually 20 mL of pleural or peritoneal fluid is sufficient. Smaller volumes can be used if there is a high cell count.

3. Label specimen with fluid type.

Specimen Stability Information: Refrigerated <72 hours/Ambient ≤72 hours

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 1-1.5 mL

Collection Instructions:

1. An original cytospin preparation (preferably unstained) must be included with the spinal fluid specimen so correlative morphologic evaluation can occur.

2. The volume of fluid necessary to phenotype the lymphocytes or blasts in spinal fluid depends upon the cell count in the specimen. A cell count should be determined and submitted with the specimen. Usually 1 to 1.5 mL of spinal fluid is sufficient. Smaller volumes can be used if there is a high cell count. If cell count is <10 cells/mcL, a larger volume of spinal fluid may be required. When cell counts drop below 5 cells/mcL, the immunophenotypic analysis may not be successful.

3. Label specimen as spinal fluid.

Specimen Stability Information: Refrigerated <48 hours/Ambient ≤48 hours

Additional Information: Spinal fluid cell and differential counts are required.