Home
HelpTest ID TLYM T-Cell Lymphoma, FISH, Tissue
Ordering Guidance
This test does not include a pathology consultation. If a pathology consultation is requested, order PATHC / Pathology Consultation; the appropriate fluorescence in situ hybridization (FISH) test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the pre-analytic (tissue adequacy and probe selection, when applicable) and post-analytic (interpretation of FISH results in context of specific case, when applicable) phases.
This assay detects chromosome abnormalities observed in paraffin-embedded tissue specimens of patients with T-cell lymphoma. For testing the blood and bone marrow from patients with T-cell lymphoma, see TLPDF / T-Cell Lymphoma, Diagnostic FISH, Varies or TLPMF / T-Cell Lymphoma, Specified FISH, Varies.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. A reason for testing and pathology report are required for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports. The laboratory will not reject testing if a reason for testing is not provided; however appropriate testing and interpretation may be compromised or delayed. If not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.
2. If the patient is being tracked for known abnormalities, an indication of which probes should be used is required for testing to be performed. See Table in Clinical Information.
Specimen Required
Specimen Type: Tissue
Preferred: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.
Additional Information:
1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).
2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.
Acceptable: Tissue slides
Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides. Include 1 hematoxylin and eosin-stained slide for the entire test order.
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Secondary ID
65911Useful For
Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various T-cell lymphomas
Tracking known chromosome abnormalities and response to therapy in patients with T-cell lymphomas
Providing potentially prognostic information in patients with documented systemic anaplastic lymphoma kinase-negative anaplastic large cell lymphoma
Supporting the diagnosis of peripheral T-cell lymphoma when coordinated with consultation by anatomic pathology
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| _PRAH | Probe, Each Additional (TLYM) | No, (Bill Only) | No |
Testing Algorithm
Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in the table Common Chromosome Abnormalities in T-cell Lymphomas in Clinical Information. The TBL1XR1/TP63 FISH probe will only be performed, at the laboratory’s discretion, to resolve or confirm TP63 rearrangement concerns.
If the patient is being tracked for known abnormalities, indicate which probes should be used.
A charge and CPT code is applied for each probe set hybridized, analyzed, and reported.
If, based on testing algorithms, results of the initial probe sets require reflex testing, complete results will be available within 10 days.
For information see Anaplastic Large Cell Lymphoma Evaluation Algorithm.
Special Instructions
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
T-cell Lymphoma, FISH, TissueSpecimen Type
TissueSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Tissue | Ambient (preferred) | |
| Refrigerated | ||
Clinical Information
T-cell malignancies account for approximately 12% of all non-Hodgkin lymphomas. There are several subtypes of T-cell neoplasms: T-cell prolymphocytic leukemia, T-cell large granular lymphocytic leukemia, anaplastic large cell lymphoma (ALCL), peripheral T-cell lymphoma, and various other cutaneous, nodal, and extranodal lymphoma subtypes. The 2 most prevalent lymphoma subtypes are unspecified peripheral T-cell lymphoma (3.7%) and ALCL (2.4%). Fluorescence in situ hybridization (FISH) is available for the specific T-cell lymphoma subtypes; see Table.
Table. Common Chromosome Abnormalities in T-cell Lymphomas
|
Lymphoma type |
Chromosome abnormality |
FISH probe |
|
Anaplastic large cell lymphoma |
2p23 rearrangement |
3'/5' ALK |
|
3q28 rearrangement |
5'/3' TP63 |
|
|
6p25.3 rearrangement |
5'/3' IRF4 (DUSP22) |
|
|
T-cell prolymphocytic leukemia |
inv(14)(q11q32)/ t(14;14)(q11;q32) |
5'/3' TRAD |
|
Hepatosplenic T-cell lymphoma |
Isochromosome 7q |
D7Z1/ D7S486 |
|
trisomy 8 |
D8Z2/MYC |
Reference Values
An interpretive report will be provided.
Cautions
This test is not approved by the US Food and Drug Administration, and it is best used as an adjunct to clinical and pathologic information.
Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for fluorescence in situ hybridization assays.
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
88377 (if 1 probe set)
88377 x 2 (if 2 probe sets)
88377 x 3 (if 3 probe sets)
88377 x 4 (if 4 probe sets)
88377 x 5 (if 5 probe sets)
88377 x 6 (if 6 probe sets)
88377 x 7 (if 7 probe sets)
88377 x 8 (if 8 probe sets)