Test Id : TLYM

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.

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.

Advise Express Mail or equivalent if not on courier service.

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 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.

If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.

See Specimen Required

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

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.

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

An interpretive report will be provided.

A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for any given probe.

Detection of an abnormal clone is supportive of a diagnosis of a T-cell lymphoma. The specific abnormality detected may help subtype the neoplasm.

The absence of an abnormal clone does not rule out the presence of a neoplastic disorder.

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.

Each probe was independently tested on a set of formalin-fixed, paraffin-embedded tissue specimens from patients diagnosed with a T-cell lymphoma and noncancerous lymph node specimens. Normal cutoffs were calculated based on the results from 25 normal specimens. For each probe set, a series of chromosomally abnormal specimens were evaluated to confirm each probe set detected the anomaly it was designed to detect.

1. Swerdlow SH, Campo E, Harris NL, eds, et al: WHO Classification of Tumours. Vol 2. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. IARC; 2017

2. Feldman AL, Law M, Remstein ED, et al: Recurrent translocations involving the IRF4 oncogene locus in peripheral T-cell lymphomas. Leukemia. 2009 Mar;23(3):574-580

3. Feldman AL, Dogan A, Smith Dl, et al: Discovery of recurrent t(6:7)(p25.3;q32.3) translocations in ALK-negative anaplastic large cell lymphomas by massively parallel genomics sequencing. Blood. 2011 Jan 20;117(3):915-919

4. Parilla Castellar ER, Jaffe ES, Said JW, et al: ALK-negative anaplastic large cell lymphoma is a genetically heterogeneous disease with widely disparate clinical outcomes. Blood. 2014 Aug 28;124(9):1473-1480

5. Vasmatzis G, Johnson SH, Knudson RA, et al: Genomics-wide analysis reveals recurrent structural abnormalities of TP63 and other p53-releated genes in peripheral T-cell lymphomas. Blood. 2012 Sep 13;120(11):2280-2289

This test is performed using commercially available and laboratory-developed probes. Rearrangements involving ALK, IRF4 (DUSP22), TCL1A, TRAD, and TP63 are detected using a dual-color break-apart strategy probe. Trisomy of chromosome 8 and isochromosome 7q are detected using enumeration strategy probes. TP63/TBL1XR1 is detected using a dual color, dual fusion probe set. TBL1XR1/TP63 will only be performed when necessary to resolve or confirm TP63 rearrangement concerns.

Formalin-fixed, paraffin-embedded tissues are cut at 5 microns and mounted on positively charged glass slides. The selection of tissue and the target areas on the hematoxylin and eosin (H and E)-stained slide is 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 set is hybridized to the appropriate target areas and 2 technologists each analyze 50 interphase nuclei (100 total) with the results expressed as the percent abnormal nuclei.(Unpublished Mayo method)

Monday through Friday

• 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 Regional Manager. For assistance, contact Customer Service.

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.

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)

Sample Reports

Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports

International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports