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HelpTest Code SZDIA Sezary Diagnostic Flow Cytometry, Blood
Reporting Name
Sezary Diagnostic Flow Cytometry, BPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Identifying immunophenotypically aberrant T-cell populations with restricted expression of T-cell receptor beta-chain constant in peripheral blood, to roughly assess the circulating tumor burden in cutaneous T-cell lymphomas
Method Name
Immunophenotyping
Ordering Guidance
This test is not indicated for monitoring patients with a diagnosis of Sezary syndrome. For monitoring purposes, order SZMON / Sezary Monitoring Flow Cytometry, Blood.
Specimen Required
Container/Tube:
Preferred: Yellow top (ACD solution A or B)
Acceptable: Lavender top (EDTA), green top (sodium heparin)
Specimen Volume: 6 mL
Collection Instructions:
1. Send whole blood specimen in original tube. Do not aliquot.
2. Label specimen as blood.
Specimen Type
Whole bloodSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole blood | Ambient (preferred) | 4 days | |
| Refrigerated | 4 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
Reference Values
An interpretive report will be provided. This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic findings and, if available, morphologic features will be provided by a board-certified hematopathologist for every case.
Interpretation
An immunophenotypically distinct T-cell population is suggestive of clonality when the subset exhibits a restricted T-cell receptor beta-chain constant (TRBC) staining pattern defined as either 1) >85% of TRBC1-positive events, 2) <15% TRBC1-positive events, or 3) homogenous TRBC1-dim expression. The immunophenotype of the distinct T-cell population, its percentage of total lymphocytes, and its percentage of total analyzed events will be reported. The test will be resulted as "No phenotypically aberrant T-cell population detected" if there is no specific immunophenotype that allows the detection of TRBC-restricted T cells.
Day(s) Performed
Monday through Saturday
Report Available
1 to 3 daysTest 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 US Food and Drug Administration.CPT Code Information
88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker x 1
88185-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each)
88188-Flow Cytometry Interpretation, 9 to15 markers (if appropriate)
88189-Flow Cytometry Interpretation, 16 or more markers (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SZDIA | Sezary Diagnostic Flow Cytometry, B | 101118-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CK126 | Sezary Diagnostic | No LOINC Needed |
| CK127 | Final Diagnosis | 50398-7 |
| CK128 | Special Studies | 30954-2 |
| CK129 | Microscopic Description | 22635-7 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FIRST | Flow Cytometry, Cell Surface, First | No | Yes |
| ADD1 | Flow Cytometry, Cell Surface, Addl | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FCIMS | Flow Cytometry Interp, 9-15 Markers | No | No |
| FCINS | Flow Cytometry Interp,16 or greater | No | No |
Testing Algorithm
This Sezary panel is ordered for patients with a clinical suspicion of Sezary syndrome or cutaneous T-cell lymphoma with peripheral blood involvement without a previously confirmed diagnosis. A Triage panel and Sezary panel will always be performed. This test is not indicated for monitoring peripheral blood involvement in patients with a diagnosis of Sezary syndrome or mycosis fungoides. For monitoring purposes, order SZMON / Sezary Monitoring Flow Cytometry, Blood.
The panel is charged based on number of markers tested (FIRST for first marker, ADD1 for each additional marker). 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 (ADD1 if applicable).
The testing process begins with a triage panel to evaluate for and exclude monotypic B cells or increased numbers of blasts. The triage panel also includes antibodies to assess the number of CD3-positive T cells and CD16-positive/CD3-negative natural killer cells present. Additional reflex testing may occur to fully characterize a disease state per algorithmic approach or clarify any abnormalities from the screening test at an additional charge for each marker tested (ADD1 if applicable). For a comprehensive list of potential additional panels, refer to LCMS / Leukemia/Lymphoma Immunophenotyping, Flow Cytometry, Varies.
The Sezary panel will further evaluate the T cells for expression of CD2, CD4, CD5, CD7, CD8, CD26, and TRBC1.