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Test Code LABTLPDF T-Cell Lymphoma, Diagnostic FISH, Varies

Additional Codes

Test Name in EPIC

EPIC Test Code

Mnemonic

Mayo Test ID

T-CELL LYMPHOMA, DIAGNOSTIC FISH, VARIES

 LABTLPDF TLPDF TLPDF

 


Ordering Guidance


This test should only be ordered if the sample 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 will be canceled and no charges will be incurred.

 

This test is intended for instances when a non-specific T-cell lymphoma fluorescence in situ hybridization (FISH) panel is needed. This test should NOT be used to screen for residual T-cell lymphoma.

 

If limited T-cell lymphoma FISH probes are preferred, order TLPMF / T-Cell Lymphoma, Specified FISH, Varies, and request specific probes for targeted abnormalities.

  

This assay detects chromosome abnormalities observed in blood or bone marrow samples 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 (T-ALL/LBL), order either TALAF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies or TALPF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies, depending on the age of the patient.

 

For testing paraffin-embedded tissue samples from patients with T-cell lymphoblastic Lymphoma, see TLBLF / T-Cell Lymphoblastic Leukemia/Lymphoma, FISH, Tissue.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


1. 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.

2. 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.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred

Specimen Type: Bone marrow

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Green top (heparin) or lavender top (EDTA)

Specimen Volume: 2-3 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 (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.


Useful For

Detecting, at diagnosis, common chromosome abnormalities associated with specific T-cell lymphoma subtypes using a laboratory-designated probe set algorithm

Testing Algorithm

This test includes a charge for the probe application, analysis, and professional interpretation of results for 3 probe sets (6 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.

 

The initial (diagnostic) T-cell lymphoma FISH panel includes testing for the following abnormalities using the FISH probes listed:

14q32.1 rearrangement, TCL1A break-apart

14q11.2 rearrangement, TRAD break-apart

i(7q), D7Z1/D7S486

+8, D8Z2/MYC

 

TCL1A and TRAD break-apart probe sets will be performed simultaneously.

 

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.

 

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 Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

T-cell Lymphoma B/BM, Diag FISH

Specimen Type

Varies

Specimen Minimum Volume

Bone marrow: 1 mL; Whole blood: 2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)
  Refrigerated 

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

T-cell malignancies account for approximately 10% of all non-Hodgkin lymphomas. There are subtypes of T-cell malignancies with diagnostic and prognostic genetic abnormalities. Fluorescence in situ hybridization (FISH) is available for specific abnormalities in the following 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'TRAD

5'/3'TCLA1

Hepatosplenic T-cell lymphoma

Isochromosome 7q

D7Z1/ D7S486

Trisomy 8

D8Z2/MYC

Reference Values

An interpretive report will be provided.

Interpretation

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

 

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.

 

The absence of an abnormal clone does not rule out the presence of lymphoma or another neoplastic disorder.

Cautions

This test is not approved by the U.S. Food and Drug Administration, and it is best used as an adjunct to existing clinical and pathologic information.

 

Bone marrow is the preferred sample type for this fluorescence in situ hybridization 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.

Method Description

This test is performed using commercially available and laboratory-developed probes. Rearrangements involving TCL1A and TRAD 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)

Day(s) Performed

Monday through Friday

Report Available

7 to 10 days

Specimen Retention Time

4 weeks

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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

88271 x6, 88275 x3, 88291 x1- FISH Probe, Analysis, Interpretation; 3 probe set

88271 x2, 88275 x1 - FISH Probe, Analysis; each additional probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TLPDF T-cell Lymphoma B/BM, Diag FISH 101682-3

 

Result ID Test Result Name Result LOINC Value
614337 Result Summary 50397-9
614338 Interpretation 69965-2
614339 Result Table 93356-4
614340 Result 62356-1
GC138 Reason for Referral 42349-1
GC139 Specimen 31208-2
614341 Source 31208-2
614342 Method 85069-3
614343 Additional Information 48767-8
614344 Disclaimer 62364-5
614345 Released By 18771-6

Forms

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