Test Id : MSTF
Myeloid Sarcoma, FISH, Tissue
Useful For
Suggests clinical disorders or settings where the test may be helpful
Supporting the diagnosis of myeloid sarcoma when coordinated with a surgical pathology consultation
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| _I099 | Interphases, 25-99 | No, (Bill Only) | No |
| _I300 | Interphases, >=100 | No, (Bill Only) | No |
| _IL25 | Interphases, <25 | No, (Bill Only) | No |
| _PADD | Probe, +1 | No, (Bill Only) | No |
| _PB02 | Probe, +2 | No, (Bill Only) | No |
| _PB03 | Probe, +3 | No, (Bill Only) | No |
| _PBCT | Probe, +2 | No, (Bill Only) | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
This test does not include a pathology consult. If a pathology consultation is requested, PATHC / Pathology Consultation should be ordered, and the appropriate fluorescence in situ hybridization (FISH) test will be performed at an additional charge.
This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.
The test panel includes analysis for the disease-associated abnormalities using the probes listed below:
t(8;21), [M2], RUNX1T1/RUNX1
t(11q23;var), [M0-M7], MLL (KMT2A)
inv(16), [M4, Eos], MYH11/CBFB
t(15;17), [M3], PML/RARA
t(9;22), BCR/ABL1
If the patient is being treated for known abnormalities, indicate which probes should be used.
Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.
Method Name
A short description of the method used to perform the test
Fluorescence In Situ Hybridization (FISH)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
This test does not include a pathology consult. If a pathology consultation is requested, PATHC / Pathology Consultation should be ordered, and the appropriate fluorescence in situ hybridization (FISH) test will be performed at an additional charge.
This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.
The test panel includes analysis for the disease-associated abnormalities using the probes listed below:
t(8;21), [M2], RUNX1T1/RUNX1
t(11q23;var), [M0-M7], MLL (KMT2A)
inv(16), [M4, Eos], MYH11/CBFB
t(15;17), [M3], PML/RARA
t(9;22), BCR/ABL1
If the patient is being treated for known abnormalities, indicate which probes should be used.
Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.
Specimen Type
Describes the specimen type validated for testing
Tissue
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
A reason for referral and pathology report are required in order for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| CG735 | Reason for Referral | |
| CG736 | Specimen |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Specimen Type: Tissue
Preferred: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.
Acceptable: Slides
Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.
Include 1 hematoxylin and eosin (H and E)-stained slide.
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Tissue | Ambient (preferred) | ||
| Refrigerated | |||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Supporting the diagnosis of myeloid sarcoma when coordinated with a surgical pathology consultation
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
This test does not include a pathology consult. If a pathology consultation is requested, PATHC / Pathology Consultation should be ordered, and the appropriate fluorescence in situ hybridization (FISH) test will be performed at an additional charge.
This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.
The test panel includes analysis for the disease-associated abnormalities using the probes listed below:
t(8;21), [M2], RUNX1T1/RUNX1
t(11q23;var), [M0-M7], MLL (KMT2A)
inv(16), [M4, Eos], MYH11/CBFB
t(15;17), [M3], PML/RARA
t(9;22), BCR/ABL1
If the patient is being treated for known abnormalities, indicate which probes should be used.
Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Myeloid sarcomas are tumors made up of myeloblasts or immature myeloid cells that occur in extramedullary sites or in bone. They can occur concurrently with acute or chronic myeloid leukemia (AML or CML) or may precede the leukemia or other myeloid neoplasms. They may also be the initial manifestation of relapse of a previously treated primary AML in remission. Due to this extramedullary presentation, the bone marrow may have a low number of myeloblasts due to a lack of bone marrow involvement.
The most common abnormalities seen in myeloid sarcomas are fusion of RUNX1T1/RUNX1 (t[8;21][q22;q22]), PML/RARA (t[15;17][q24;q21]), BCR/ABL1 (t[9;22][q34;q11.2]), inversion of MYH11/CBFB (inv[16][q13.1q22]), and rearrangements of MLL (KMT2A; t[11q23;var]).
In general, AML patients with an inv(16), t(8;21), t(9;22), or t(15;17) have a favorable prognosis, while AML patients with a rearrangement of t(11q23) have an unfavorable prognosis. Thus, the detection of these abnormalities in an extramedullary presentation of AML can be prognostically important.
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.
An interpretive report will be provided.
Interpretation
Provides information to assist in interpretation of the test results
A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for a given probe set.
A positive result supports the diagnosis of a myeloid sarcoma.
A negative result does not exclude the diagnosis of a myeloid sarcoma.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Paraffin-embedded tissues that have been decalcified may not be successful for fluorescence in situ hybridization (FISH) analysis. FISH studies will be attempted if sufficient tumor is present for analysis. However, if no FISH signals are observed post-hybridization, the case will be released indicating a lack of FISH results.
Supportive Data
Fluorescence in situ hybridization (FISH) analysis was performed on 25 noncancerous formalin-fixed paraffin-embedded tissue control specimens with the results used to generate the normal cutoff value for each probe set. A retrospective data review of FISH analysis performed on myeloid sarcomas identified 3 cases with RUNX1T1/RUNX1 fusion, 1 case with BCR/ABL1 fusion, 3 cases with rearrangement of MLL (KMT2A), 4 cases with PML/RARA fusion, and 4 cases with MYH11/CBFB fusion.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Slovak ML, Kopecky KJ, Cassileth PA, et al: Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood. 2000;96:4075-4083
2. Swerdlow SH, Campo E, Harris NL, et al: WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues. International Agency for Research on Cancer; 2008:140-141
3. Grimwade D, Hills RK, Moorman AV, et al: Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials. Blood. 2010;116:354-365
Method Description
Describes how the test is performed and provides a method-specific reference
This test is performed using a commercially available MLL (KMT2A) dual-color break-apart strategy probe (BAP), a laboratory developed MYH11/CBFB dual-color, dual-fusion (D-FISH) strategy probe, and commercially available RUNX1T1/RUNX1, BCR/ABL1, and PML/RARA D-FISH strategy probes. Formalin-fixed paraffin-embedded tissues are cut at 5 microns and mounted on positively charged glass slides. The selection of tissue and the identification of target areas on the hematoxylin and eosin (H and E)-stained slide are performed by a pathologist. Using the H and E-stained slide as a reference, target areas are etched with a diamond-tipped etcher on the back of the unstained slide to be assayed. The probe is hybridized to the appropriate target area and 2 technologists each analyze 50 interphase nuclei (100 total for each probe set) with the results expressed as the percent of abnormal nuclei.(Unpublished Mayo method)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
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
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
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 instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
88291
88271 x 2 (if appropriate)
88271 x 2 (if appropriate)
88271 (if appropriate)
88271 x 2 (if appropriate)
88271 x 3 (if appropriate)
88274 w/modifier 52 (if appropriate)
88274 (if appropriate)
88275 (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| MSTF | Myeloid Sarcoma, FISH, Ts | In Process |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 52084 | Result Summary | 50397-9 |
| 52086 | Interpretation | 69965-2 |
| 52085 | Result Table | 93356-4 |
| 54576 | Result | 62356-1 |
| CG735 | Reason for Referral | 42349-1 |
| CG736 | Specimen | 31208-2 |
| 52087 | Source | 31208-2 |
| 52088 | Tissue ID | 80398-1 |
| 52089 | Method | 85069-3 |
| 52090 | Released By | 18771-6 |
| 55121 | Additional Information | 48767-8 |
| 53839 | Disclaimer | 62364-5 |