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Test Code LABTLPF T-Cell Lymphoma, FISH, Blood or Bone Marrow

Additional Codes

Test Name in EPIC EPIC Test Code Mnemonic Mayo Test ID
T-CELL LYMPHOMA, FISH, BLOOD OR BONE MARROW LABTLPF TLPF TLPF

 

Useful For

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 lymphoma

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_I099 Interphases, 25-99 No, (Bill Only) No
_I300 Interphases, >=100 No, (Bill Only) No
_IL25 Interphases, <25 No, (Bill Only) No
_PADD Probe, +1 No, (Bill Only) No
_PB02 Probe, +2 No, (Bill Only) No
_PB03 Probe, +3 No, (Bill Only) No
_PBCT Probe, +2 No, (Bill Only) No

Testing Algorithm

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results.

 

Additional charges will be incurred for all reflex probes 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.

 

See Malignant Lymphoma, Guideline for Bone Marrow Staging Studies in Special Instructions.

 

Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in Clinical Information.

 

If the patient is being tracked for known abnormalities, indicate which probes should be used.

 

Panel includes testing for the following abnormalities using the probes listed:

14q32.1 rearrangement, TCL1A

-7/7q-/i(7q), D7S486/D7Z1

+8, D8Z2/MYC

 

This assay detects chromosome abnormalities observed in the blood and bone marrow of patients with T-cell lymphoma. For testing paraffin-embedded tissue samples from patients with T-cell lymphoma, order TLYMF / T-Cell Lymphoma, FISH, Tissue.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

T-cell Lymphoma, FISH, B/BM

Specimen Type

Varies


Specimen Required


Provide a reason for referral 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.

 

Advise Express Mail or equivalent if not on courier service.

 

Submit only 1 of the following specimens:

 

Specimen Type: Blood

Container/Tube: Green top (sodium heparin)

Specimen Volume: 7-10 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.

 

Specimen Type: Bone marrow

Container/Tube: Green top (sodium heparin)

Specimen Volume: 1-2 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.


Specimen Minimum Volume

Blood: 2 mL/Bone Marrow: 1 mL

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)
  Refrigerated 

Reject Due To

No specimen should be rejected. If specimen not received at appropriate temperature or in wrong anticoagulant, include note to laboratory. Contact the laboratory with questions.

Clinical Information

T-cell neoplasms are relatively uncommon, accounting for approximately 12% of all non-Hodgkin lymphomas. There are several subtypes of T-cell neoplasms: T-cell acute lymphoblastic leukemia (T-ALL), T-cell prolymphocytic leukemia (T-PLL), T-cell large granular lymphocytic leukemia (T-LGL), 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%). T-cell neoplasms are among the most aggressive of all hematologic and lymphoid neoplasms with the exception of ALCL, which is usually responsive to chemotherapy.

 

There are a few common chromosome abnormalities associated with specific subtypes, which this FISH test can detect:

-inv(14)(q11q32) and t(14;14)(q11;q32), which involve the T-cell leukemia/lymphoma 1 gene (TCL1A) and have been associated with T-PLL

-Isochromosome 7q and trisomy 8, which have been associated with hepatosplenic T-cell lymphoma

These probes have diagnostic relevance and can also be used to track response to therapy.

 

This assay detects chromosome abnormalities observed in the blood and bone marrow of patients with T-cell lymphoma (for patients with T-cell acute leukemia, order TALLF / T-Cell Acute Lymphoblastic Leukemia [T-ALL], FISH).

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.

 

Detection of an abnormal clone supports 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 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 FISH test. If bone marrow is not available, a blood specimen may be used if there are malignant cells in the blood specimen (as verified by hematopathology).

 

This test should not be ordered on patients with T-cell acute lymphoblastic leukemia. In these situations, order TALLF / T-Cell Acute Lymphoblastic Leukemia (T-ALL), FISH.

 

This test is not appropriate for testing paraffin-embedded tissue samples from patients with T-cell lymphoma, order TLYMF / T-Cell Lymphoma, FISH, Tissue.

Supportive Data

Each probe was independently tested on a set of normal bone marrow control samples, and when available bone marrow samples from patients diagnosed with a T-cell lymphoma. Normal cutoffs were calculated based on the results from 25 normal specimens. Each probe set was evaluated to confirm the probe set detected the abnormality it was designed to detect.

Method Description

This test is performed using commercially available and laboratory-developed probes. Rearrangements involving TCL1 are detected using a dual-color break-apart (BAP) strategy probe. Trisomy of chromosome 8 and isochromosome 7q are detected using enumeration strategy probes. For each probe set, 200 interphase nuclei are scored and results are expressed as the percent abnormal nuclei.(Unpublished Mayo method)

Day(s) and Time(s) Performed

Samples processed Monday through Sunday. Results reported Monday through Friday, 8 a.m.-5 p.m. CT.

Analytic Time

7 days

Specimen Retention Time

Four weeks

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

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 U.S. Food and Drug Administration.

CPT Code Information

88271x2, 88291 – DNA probe, each (first probe set), Interpretation and report

88271x2 – DNA probe, each; each additional probe set (if appropriate)

88271x1 – DNA probe, each; coverage for sets containing 3 probes (if appropriate)

88271x2 – DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271x3 – DNA probe, each; coverage for sets containing 5 probes (if appropriate)

88274 w/modifier 52 – Interphase in situ hybridization, <25 cells, each probe set (if appropriate)

88274 – Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)     

88275 – Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TLPF T-cell Lymphoma, FISH, B/BM In Process

 

Result ID Test Result Name Result LOINC Value
52009 Result Summary 50397-9
52011 Interpretation In Process
52010 Result Table No LOINC Needed
54566 Result In Process
CG719 Reason for Referral 42349-1
CG720 Specimen 31208-2
52012 Source 31208-2
52013 Method 49549-9
55118 Additional Information 48767-8
53849 Disclaimer 62364-5
52014 Released By 18771-6

Forms

If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request Form (T726) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/hematopathology-request-form.pdf)