Test Id : TLPMF
T-Cell Lymphoma, Specified FISH, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detecting common chromosome abnormalities associated with specific T-cell lymphoma subtypes using client-specified probe set(s)
This test should not be used to screen for residual T-cell lymphoma
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 |
|---|---|---|---|
| TLPMB | Probe, Each Additional (TLPMF) | No | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
This test includes a charge for the probe application, analysis, and professional interpretation of results for one probe set (2 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for additional probe sets 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.
This test is performed using client-specified FISH probes and is not intended as a panel test. Specific probes or suspected T-cell lymphoma subtype must be listed in the probe request field. Reflex probes can be performed when appropriate if specified in the order request field.
When specified, any of the following probes for the following known subtypes of T-cell lymphoma will be performed:
i(7q) or isochromosome 7q, request probe D7Z1/D7S486
+8 or trisomy 8, request probe D8Z2/MYC
t(14q32.1;var) or TCL1A rearrangement, request probe TCL1A break-apart
t(14q11.2;var) or TRA rearrangement, request probe TRA break-apart
TCL1A and TRAD break-apart probe sets will be performed simultaneously and cannot be ordered independently.
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal T-cells are available for FISH testing. If the result does not identify a sufficient clonal T-cell population, this FISH test order will be canceled, and no charges will be incurred. The T-cell lymphoma subtype will be used by the laboratory to determine appropriate FISH probes, if determined and applicable.
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.
For more information see Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm.
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
Aliases
Lists additional common names for a test, as an aid in searching
T-prolymphocytic leukemia (T-PLL)
Hepatosplenic T-cell lymphoma (HSTCL)
Iso(7q)-isochromosome 7q
+8 (trisomy 8)/i(8q)
TRA (14q11.2) rearrangement
TCL1A (14q32.1) rearrangement
inv(14)(q11.2q32.1) or TCL1A::TRA fusion
t(14;14)(q11.2;q32.1) or TCL1A::TRA fusion
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
This test includes a charge for the probe application, analysis, and professional interpretation of results for one probe set (2 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for additional probe sets 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.
This test is performed using client-specified FISH probes and is not intended as a panel test. Specific probes or suspected T-cell lymphoma subtype must be listed in the probe request field. Reflex probes can be performed when appropriate if specified in the order request field.
When specified, any of the following probes for the following known subtypes of T-cell lymphoma will be performed:
i(7q) or isochromosome 7q, request probe D7Z1/D7S486
+8 or trisomy 8, request probe D8Z2/MYC
t(14q32.1;var) or TCL1A rearrangement, request probe TCL1A break-apart
t(14q11.2;var) or TRA rearrangement, request probe TRA break-apart
TCL1A and TRAD break-apart probe sets will be performed simultaneously and cannot be ordered independently.
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal T-cells are available for FISH testing. If the result does not identify a sufficient clonal T-cell population, this FISH test order will be canceled, and no charges will be incurred. The T-cell lymphoma subtype will be used by the laboratory to determine appropriate FISH probes, if determined and applicable.
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.
For more information see Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm.
Specimen Type
Describes the specimen type validated for testing
Varies
Ordering Guidance
This test is intended for instances when limited T-cell lymphoma fluorescence in situ hybridization (FISH) probes are needed based on specific abnormalities or abnormalities identified in the diagnostic sample. The FISH probes to be analyzed must be specified on the ordering request. If targeted FISH probes are not included with this test order, test processing will be delayed.
This test should only be ordered if the specimen is known to have a sufficient clonal T-cell population. If a flow cytometry result is available and does not identify a sufficient clonal T-cell population, this test order will be canceled, and no charges will be incurred.
TCL1A and TRA break-apart probe sets are performed simultaneously and cannot be ordered independently.
This test should NOT be used to screen for residual T-cell lymphoma.
If a complete T-cell lymphoma panel is preferred, order TLPFD / T-Cell Lymphoma BM/BL Panel, Diagnostic, FISH, Varies.
This test should NOT be used to screen for residual T-cell lymphoma.
This assay detects chromosome abnormalities observed in blood or bone marrow specimens of patients with T-cell lymphoma. If a paraffin-embedded tissue specimen is submitted, the test will be canceled and TLYM / T-Cell Lymphoma, FISH, Tissue will be added and performed as the appropriate test.
For patients with T-cell acute lymphoblastic leukemia/lymphoma, order either TALAF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies or TALFP / Pediatric T-Lymphoblastic Leukemia/Lymphoma Panel, FISH, Varies,?depending on the age of the patient. For testing paraffin-embedded tissue samples from patients with T-cell lymphoblastic Lymphoma, see TLBLF / T-Lymphoblastic Leukemia/Lymphoma, FISH, Tissue.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. A list of probes requested for analysis is required. Probes available for this test are listed in the Testing Algorithm section.
2. A reason for testing must be provided. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.
3. A flow cytometry and/or a bone marrow pathology report should be submitted with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| GC141 | Reason for Referral | |
| GC142 | Probes Requested | |
| GC143 | Specimen |
Whole blood ACD Bone marrow ACD Whole blood Na Hep Bone marrow Na Hep Whole blood EDTA Bone marrow EDTA |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Submit only 1 of the following specimens:
Preferred
Specimen Type: Bone marrow
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (sodium heparin) or lavender top (EDTA)
Specimen Volume: 2 to 3 mL
Collection Instructions:
1. It is preferable to send the first aspirate from the bone marrow collection.
2. Invert several times to mix bone marrow.
3. Send bone marrow in original tube. Do not aliquot.
Acceptable
Specimen Type: Whole Blood
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (sodium heparin) or lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
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.
Bone marrow: 1 mL; Whole blood: 2 mL
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 |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detecting common chromosome abnormalities associated with specific T-cell lymphoma subtypes using client-specified probe set(s)
This test should not be used to screen for residual T-cell lymphoma
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
This test includes a charge for the probe application, analysis, and professional interpretation of results for one probe set (2 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for additional probe sets 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.
This test is performed using client-specified FISH probes and is not intended as a panel test. Specific probes or suspected T-cell lymphoma subtype must be listed in the probe request field. Reflex probes can be performed when appropriate if specified in the order request field.
When specified, any of the following probes for the following known subtypes of T-cell lymphoma will be performed:
i(7q) or isochromosome 7q, request probe D7Z1/D7S486
+8 or trisomy 8, request probe D8Z2/MYC
t(14q32.1;var) or TCL1A rearrangement, request probe TCL1A break-apart
t(14q11.2;var) or TRA rearrangement, request probe TRA break-apart
TCL1A and TRAD break-apart probe sets will be performed simultaneously and cannot be ordered independently.
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal T-cells are available for FISH testing. If the result does not identify a sufficient clonal T-cell population, this FISH test order will be canceled, and no charges will be incurred. The T-cell lymphoma subtype will be used by the laboratory to determine appropriate FISH probes, if determined and applicable.
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.
For more information see Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
T-cell malignancies account for approximately 10% of all non-Hodgkin lymphomas. Genetic abnormalities can assist diagnosis and have served as important prognostic markers in T-cell lymphomas. Fluorescence in situ hybridization (FISH) permits the detection of recurrent gene rearrangements associated with various chromosomal abnormalities in specific T-cell lymphoma subtypes (see Table).
Table. Common Chromosome Abnormalities in T-cell Lymphomas
| Lymphoma type | Chromosome abnormality | FISH probe |
| T-cell prolymphocytic leukemia | inv(14)(q11q32)/ (14;14)(q11;q32) | 5'/3' TRA |
| Hepatosplenic T-cell lymphoma | Isochromosome 7q | D7Z1/ D7S486 |
| Trisomy 8 | D8Z2/MYC |
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 any given probe set.
The absence of an abnormal clone does not rule out the presence of lymphoma or another neoplastic disorder.
Detection of an abnormal clone supports a diagnosis of T-cell lymphoma. The specific abnormality detected may help to determine a specific T-cell lymphoma subtype.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test is not approved by the US Food and Drug Administration and is best used as an adjunct to existing clinical and pathologic information.
Bone marrow is the preferred specimen type for this fluorescence in situ hybridization (FISH) test. If bone marrow is not available, a blood specimen may be used if there are neoplastic cells in the blood specimen (as verified by a hematopathologist).
If no FISH signals are observed post-hybridization, the case will be released indicating a lack of FISH results.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Swerdlow S, Campo E, Harris NL, et al, eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press; 2017
2. Gesk S, Martin-Subero JI, Harder L, et al. Molecular cytogenetic detection of chromosomal breakpoints in T-cell receptor gene loci. Leukemia. 2003;17(4):738-745
3. Chin M, Mugishima H, Takamura M, et al. Hemophagocytic syndrome and hepatosplenic (gamma)(delta) T-cell lymphoma with isochromosome 7q and 8 trisomy. J Pediatr Hematol Oncol. 2004;26(6):375-378
Method Description
Describes how the test is performed and provides a method-specific reference
This test is performed using commercially available and laboratory-developed probes. Rearrangements involving TCL1A and TRA are detected using a dual-color break-apart strategy probe. Trisomy of chromosome 8 and isochromosome 7q are detected using enumeration strategy probes. For each probe set, 100 interphase nuclei are scored. All results are expressed as the percent 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 and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It 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.
88271x2, 88275 x1, 88291x1- FISH Probe, Analysis, Interpretation; 1 probe set
88271x2, 88275 x1 - FISH Probe, Analysis; each additional probe set (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 |
|---|---|---|
| TLPMF | T-cell Lymphoma B/BM, Spec FISH | 101682-3 |
| 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.
|
|---|---|---|
| 614348 | Result Summary | 50397-9 |
| 614349 | Interpretation | 69965-2 |
| 614350 | Result Table | 93356-4 |
| 614351 | Result | 62356-1 |
| GC141 | Reason for Referral | 42349-1 |
| GC142 | Probes Requested | 78040-3 |
| GC143 | Specimen | 31208-2 |
| 614352 | Source | 31208-2 |
| 614353 | Method | 85069-3 |
| 614354 | Additional Information | 48767-8 |
| 614355 | Disclaimer | 62364-5 |
| 614356 | Released By | 18771-6 |