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HelpTest ID LLPT Leukemia/Lymphoma Immunophenotyping by Flow Cytometry, Tissue
Secondary ID
19499Useful For
Evaluation of tissues for potential involvement by:
-Chronic lymphoproliferative disorders
-Malignant lymphomas
-Acute lymphoblastic leukemia
-Acute myelogenous leukemia
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FIRST | Flow Cytometry, Cell Surface, First | No, (Bill Only) | No |
| ADD1 | Flow Cytometry, Cell Surface, Addl | No, (Bill Only) | No |
| FCINT | Flow Cytometry Interp, 2-8 Markers | No, (Bill Only) | No |
| FCIMS | Flow Cytometry Interp, 9-15 Markers | No, (Bill Only) | No |
| FCINS | Flow Cytometry Interp,16 or greater | No, (Bill Only) | No |
Testing Algorithm
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, increased numbers of blasts and plasma cells by CD45 expression along with side scatter gating. The tissue panel also includes antibodies to assess T cells.
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.
Note: FISH testing may be recommended by the Mayo pathologist in some cases. They will contact the referring physician or pathologist to confirm the addition of these tests.
Special Instructions
Method Name
Immunophenotyping
Reporting Name
Leukemia Lymphoma Phenotype, TissueSpecimen Type
TissueSpecimen must arrive within 96 hours of collection.
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
Collection Instructions:
1. Send intact specimen (do not mince).
2. Specimen cannot be fixed.
Additional Information:
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.
Forms:
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
1 mm(3)
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Tissue | Refrigerated (preferred) | |
| Ambient | ||
Clinical Information
Cellular immunophenotyping, characterizing cells by using antibodies directed against cell surface markers, is generally regarded as a fundamental element in establishing a diagnosis of tissue involvement by hematolymphoid malignancies, when used in conjunction with morphologic assessment. It is also an essential component in subclassification of hematolymphoid malignancies, when present.
Reference Values
An interpretive report will be provided.
Cautions
It is well recognized that a negative flow cytometry result does not exclude tissue involvement by hematolymphoid malignancy. This may be attributable to sampling bias, although some malignancies, such as Hodgkin lymphoma, are not detected by this technique.
Viability will be assessed in all tissue specimens. Cases in which the viability is low (<50%) are prone to false-negative results and, therefore, must be interpreted with caution. In cases with viability <30%, testing will be attempted but may not be interpretable. Fine-needle aspiration and small biopsy specimens have a higher frequency of low cell counts and/or poor viability, which may be uninterpretable.
Even when abnormal, in most instances the results of flow cytometry are insufficient for complete subclassification of a hematolymphoid malignancy. Precise subclassification requires correlation with the histopathologic features in paraffin-embedded materials and also, in some instances, the results of cytogenetic analyses.
The tissue used for flow cytometry cannot be subsequently submitted for histopathologic evaluation. For this reason, this technique should be avoided in small biopsy specimens.
Day(s) Performed
Specimens are processed and reported Monday through Saturday
Report Available
2 daysPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Laboratory Medicine and Pathology, Mayo Clinic. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker x 1
88185-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each)
88187-Flow Cytometry Interpretation, 2 to 8 Markers (if appropriate)
88188-Flow Cytometry Interpretation, 9 to 15 Markers (if appropriate)
88189-Flow Cytometry Interpretation, 16 or More Markers (if appropriate)