TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: HPCUT    
Hematopathology Consultation, Client Embed

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

A Mayo Clinic hematopathologist will provide a full bone marrow workup that includes an evaluation of the specimen and determination of a diagnosis provided within a formal pathology report.

 

Ancillary Testing:

Based on Mayo Clinic-approved algorithms or at a staff hematopathologist's discretion, ancillary testing may be performed to assist in rendering an accurate diagnosis and provide important prognostic information. These test results (eg, cytochemical stains on bone marrow aspirate smear, immunohistochemical stains on bone marrow biopsy or clot sections, chromosome analysis, fluorescence in situ hybridization: FISH, flow cytometry, microarray, molecular and/or next-generation sequencing (NGS) testing) will be reported and billed separately. While reported separately, these results will continue to be considered and referred to in the pathology final interpretation.

 

If ancillary testing (eg, flow cytometry) is desired by the client outside of this consultation, each test must be ordered separately. Tests ordered outside of the consultation may or may not be integrated into the final pathology report based on the staff hematopathologist's discretion.

If the volume of bone marrow aspirate is limited, prioritization of testing will be determined by the staff hematopathologist. Testing requested or suggested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing staff hematopathologist.

 

Note: Calls are not routinely made; however, depending on the nature of the case, a call may be placed to the ordering provider or pathologist. These situations include, but are not limited to, a new diagnosis of acute leukemia or aggressive high grade lymphoma. To contact a Mayo Clinic Hematopathologist, call the Hematopathology Communications team at 507-284-5600.

 

Embedding at the client site may delay specimen arrival at Mayo Clinic Laboratories and preclude the ability to perform some ancillary testing due to specimen stability.

 

See Pathology Consultation Ordering Algorithm in Special Instructions.

Specimen Type Describes the specimen type validated for testing

Varies

Ordering Guidance

1. If requesting a peripheral blood smear evaluation only, order SPSMS / Morphology Evaluation (Special Smear), Blood.

2. If requesting a hematopathology consultation and only paraffin-embedded biopsy/clot samples (ie, no bone marrow aspirate), order PATHC / Pathology Consultation. Also include a cover letter indicating hematopathology review requested.

3. If requesting a hematopathology consultation using biopsy or clot samples for embedding at Mayo Clinic Laboratories and bone marrow aspirate, order HPWET / Hematopathology Consultation, MCL Embed.

Necessary Information

1. Collection date and patient date of birth are required.

2. The referring pathologist's and clinician's name and phone numbers are required.

3. All specimens must be labeled with specimen type.

4. All specimens, patient history, and requests should be clearly labeled with correct patient information, and case number.

5. Although a complete pathology report is not expected, a brief history and patient information is required. Use the Hematopathology Patient Information (T676) in Special Instructions.

Specimen Required Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Information on collecting, packaging, and shipping specimens, is available in Special Instructions:

-Bone Marrow Core Biopsy, Clot, and Aspirate Collection Guideline  

-Assistance with Bone Marrow Collection  

 

Submit the following specimens:

 

Specimen Type: Bone marrow aspirate slides

Container/Tube: Transport in plastic slide holders

Preferred: Fresh prep slides made at the time of sample collection

Acceptable: Slides made from anticoagulated sample

Collection Instructions:

1. Prepare slides of bone marrow aspirate immediately after collection or prepare slides from bone marrow aspirate in EDTA within 2 hours of collection.

2. If bone marrow units are sparse or absent or aspirate is a dry tap, make biopsy touch prep slides.

3. Make 2 good direct smears and 3 good unit preps, per unilateral collection.

4. Air dry slides.

5. Send 5 slides unfixed/unstained.

6. Place Parafilm around the slide carriers holding unstained slides to prevent exposure to formalin fumes during transport and place slides in a separate bag apart from any formalin-fixed clot or core biopsy specimens during transport. If using slide carriers, make sure they have not been used to carry fixed slides previously.

 

Specimen Type: Bone marrow aspirate in anticoagulant for possible ancillary testing

Container/Tube: Lavender top (EDTA), green top (heparin), and yellow top (ACD)

Specimen Volume: 3 mL in EDTA, 3 mL in heparin, and 4 mL in ACD

Collection Instructions:

1. Aspirate per standard bone marrow collection procedure.

2. Send specimens in original tubes. Do not transfer to other tubes or containers.

 

Specimen Type: Bone marrow core biopsy

Container/Tube: Fixed biopsy core embedded in paraffin block

Collection Instructions: Process and embed core in paraffin.

 

Specimen Type: Bone marrow aspirate clot

Container/Tube: Bone marrow clot embedded in paraffin block

Collection Instructions: Process and embed clot in paraffin

 

Specimen Type: Peripheral blood slides and CBC

Container/Tube: Transport in plastic slide holders.

Preferred: 2 Fresh prep fingerstick slide; include CBC values

Acceptable: 2 Slides made from whole blood in EDTA, made within 8 hours of collection

Collection Instructions:

1. Prepare 2 good quality smear of even thickness from fingerstick.

2. Alternatively, prepare good quality smear from EDTA whole blood within 8 hours of collection.

3. Submit unstained and unfixed slides.

4. Place Parafilm around the slide carriers holding unstained slides to prevent exposure to formalin fumes during transport and place slides in a separate bag apart from any formalin-fixed clot or core biopsy specimens during transport. If using slide carriers, make sure they have not been used to carry fixed slides previously.

Special Instructions Library of PDFs including pertinent information and forms related to the test

Forms

1. Hematopathology Patient Information (T676) is required, see Special Instructions.

2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Hematopathology/Cytogenetics Test Request (T726)

-Benign Hematology Test Request (T755)

Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected

No specimen should 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 TypeTemperatureTimeSpecial Container
VariesAmbient