Evaluation of tissues for potential involvement by:
-Chronic lymphoproliferative disorders
-Malignant lymphomas
-Acute lymphoblastic leukemia
-Acute myelogenous leukemia
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
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 |
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
FIRST | Flow Cytometry, Cell Surface, First | No, (Bill Only) | Yes |
ADD1 | Flow Cytometry, Cell Surface, Addl | No, (Bill Only) | Yes |
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, and increased numbers of blasts and plasma cells by CD45 expression along with side scatter gating. The panel can also evaluate T cells with CD3, CD5, and CD7. Additionally, viability is assessed on all tissue specimens using 7-AAD exclusion.
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.
In addition to reflexing flow cytometric panels, fluorescence in situ hybridization (FISH) or molecular testing may be recommended by the Mayo pathologist to facilitate diagnosis. They will contact the referring physician or pathologist to confirm the addition of these tests.
Immunophenotyping
Flow Cytometry, Tissue
Leukemia Immunophenotyping, Tissue Panel
Lymphoma Immunophenotyping by Flow Cytometry
Lymphoma Immunophenotyping, Tissue
Tissue Panel, Leukemia Immunophenotyping
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, and increased numbers of blasts and plasma cells by CD45 expression along with side scatter gating. The panel can also evaluate T cells with CD3, CD5, and CD7. Additionally, viability is assessed on all tissue specimens using 7-AAD exclusion.
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.
In addition to reflexing flow cytometric panels, fluorescence in situ hybridization (FISH) or molecular testing may be recommended by the Mayo pathologist to facilitate diagnosis. They will contact the referring physician or pathologist to confirm the addition of these tests.
Tissue
Specimen must arrive within 96 hours of collection.
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 testing or clinical suspicion are required before the specimen will be processed.
Supplies: Hank's Solution (T132)
Container/Tube: Sterile container with 15 mL of tissue culture medium (eg, Hank's balanced salt solution, RPMI, or equivalent)
Specimen Volume: 5 mm(3) or larger biopsy
Collection Instructions:
2. Send intact specimen (do not mince).
3. Specimen cannot be fixed.
1. Hematopathology Patient Information (T676) in Special Instructions
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
1 mm(3)
Fixed, paraffin-embedded, or minced tissue | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Tissue | Refrigerated (preferred) | ||
Ambient |
Evaluation of tissues for potential involvement by:
-Chronic lymphoproliferative disorders
-Malignant lymphomas
-Acute lymphoblastic leukemia
-Acute myelogenous leukemia
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, and increased numbers of blasts and plasma cells by CD45 expression along with side scatter gating. The panel can also evaluate T cells with CD3, CD5, and CD7. Additionally, viability is assessed on all tissue specimens using 7-AAD exclusion.
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.
In addition to reflexing flow cytometric panels, fluorescence in situ hybridization (FISH) or molecular testing may be recommended by the Mayo pathologist to facilitate diagnosis. They will contact the referring physician or pathologist to confirm the addition of these tests.
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.
An interpretive report will be provided.
Normal tissues typically contain a mixture of B cells with polytypic surface immunoglobulin light chain expression and T cells with unremarkable expression of the T cell-associated antigens CD3, CD5, and CD7. Typically, no appreciable blast population is present by CD45 and side scatter analysis.
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 less than 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 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.
1. Morice WG, Hodnefield JM, Kurtin PJ, Hanson CA: An unusual case of leukemic mantle cell lymphoma with a blastoid component showing loss of CD5 and aberrant expression of CD10. Am J Clin Pathol. 2004 July;122(1):122-127
2. Hanson CA: Acute leukemias and myelodysplastic syndromes. In: McClatchey KD, ed. Clinical Laboratory Medicine. Williams and Wilkins Inc; 1994:939-969
3. Jaffe ES, Cossman J: Immunodiagnosis of lymphoid and mononuclear phagocytic neoplasms. In: Rose NR, Friedman H, Fahey JL, eds. Manual of Clinical Immunology. 3rd ed. ASM Press; 1987:779-790
4. Witzig TE, Banks PM, Stenson MJ, et al: Rapid immunotyping of B-cell non-Hodgkin's lymphomas by flow cytometry. A comparison with the standard frozen-section method. Am J Clin Pathol. 1990 Sep;94(3):280-286
5. Jevremovic D, Dronca RS, Morice WG, et al: CD5+ B-cell lymphoproliferative disorders: Beyond chronic lymphocytic leukemia and mantle cell lymphoma. Leuk Res. 2010 Sep;34(9):1235-1238
6. Jevremovic D, Olteanu H: Flow cytometry applications in the diagnosis of T/NK-cell lymphoproliferative disorders. Cytometry B Clin Cytom. 2019 Mar;96(2):99-115
7. Shi M, Jevremovic D, Otteson GE, Timm MM, Olteanu H, Horna P: Single antibody detection of T-Cell receptor alpha beta clonality by flow cytometry rapidly identifies mature T-Cell neoplasms and monotypic small CD8-positive subsets of uncertain significance. Cytometry B Clin Cytom. 2020 Jan;98(1):99-107
Flow cytometric immunophenotyping of tissues is performed using the following antibodies:
Tissue Panel: CD3, CD5, CD7, CD10, CD19, CD20, CD23, CD45, 7-AAD, and kappa and lambda light chains.
Possible additional panels:
B-cell Panel: CD5, CD11c, CD19, CD20, CD22, CD23, CD38, CD45, CD103, CD200 and kappa and lambda light chains
T-cell Panel: CD2, CD3, CD4, CD5, CD7, CD8, CD45, TRBC1, and gamma/delta
KIR Panel: CD3, CD8, CD16, CD56, CD57, CD94, CD158a, CD158b, CD158e (p70) and NKG2a
Acute Panel: CD2, CD3, CD5, CD7, CD13, CD15, CD19, CD20, CD33, CD34, CD45, CD56, CD117 and HLA-DR
B-cell ALL, minimal residual disease (MRD) panel: CD10, CD19, CD20, CD22, CD24, CD34, CD38, CD45, CD58, and CD66c
Myeloperoxidase (MPO)/terminal deoxynucleotidyl transferase (TdT) (MPO/TdT) Panel: cytoplasmic CD3, CD13, cytoplasmic CD22, CD34, CD45, cytoplasmic CD79a, nuclear TDT, and cytoplasmic MPO
Plasma Cell Panel: CD19, CD38, CD45, CD138, and cytoplasmic kappa and lambda light chains
Mast Cell Panel: CD2, CD25, CD69, CD117.(Keren P, McCoy JP, Carey J, eds. Flow Cytometry in Clinical Diagnosis. 4th ed. ASCP Press; 2007; Betters DM: Use of flow cytometry in clinical practice. J Adv Pract Oncol. 2015 Sep-Oct;6[5]:435-440)
Monday through Saturday
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.
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)
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
LLPT | Leukemia Lymphoma Phenotype, Tissue | 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.
|
---|---|---|
19562 | Accession Number | 57723-9 |
19569 | Material: | 81178-6 |
19568 | Specimen: | 31208-2 |
19574 | Final Diagnosis: | 34574-4 |
19563 | Referring Pathologist/Physician | 46608-6 |
19564 | Ref Path/Phys Address | 74221-3 |
19565 | Place of Death: | 21987-3 |
19566 | Date and Time of Death: | 81956-5 |
19567 | Date of Autopsy: | 75711-2 |
19570 | Tissue Discription: | 22634-0 |
19572 | Clinical History: | 22636-5 |
19576 | Revision Description: | 81317-0 |
19577 | Signing Pathologist: | 19139-5 |
19578 | Special Procedures: | 30954-2 |
19579 | SP Signing Pathologist: | 19139-5 |
19580 | *Previous Report Follows* | 22639-9 |
19581 | Addendum: | 35265-8 |
19582 | Addendum Comment: | 22638-1 |
19583 | Addendum Pathologist: | 19139-5 |
19571 | Microscopic Description | 22635-7 |
19573 | Final Diagnosis: | 34574-4 |
19575 | Special Studies | 30954-2 |
CK139 | LLPT Result | No LOINC Needed |