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Test Code TLYM T-Cell Lymphoma, FISH, Tissue

Reporting Name

T-cell Lymphoma, FISH, Tissue

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Detecting common, recurrent chromosome abnormalities in various T-cell lymphomas in paraffin-embedded tissue specimens at diagnosis

 

Providing prognostic information in patients with documented systemic ALK-negative anaplastic large cell lymphoma

Method Name

Fluorescence In Situ Hybridization (FISH)


Ordering Guidance


This test does not include a pathology consultation. If a pathology consultation is requested, order PATHC / Pathology Consultation, and appropriate testing will be added at the discretion of the pathologist 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 fluorescence in situ hybridization [FISH] results in context of specific case, when applicable) phases.

 

This assay detects chromosome abnormalities observed in paraffin-embedded tissue samples of patients with T-cell lymphoma. If a non-paraffin embedded bone marrow or blood sample is received for this test, the test will be canceled, and TLPMF / T-Cell Lymphoma, Specified FISH, Varies will be added and performed as the appropriate test.

 

For patients with B-cell lymphoma, order BLYM / B-Cell Lymphoma, FISH, Tissue.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


1. A pathology report is required for testing to be performed. If not provided, appropriate testing and/or interpretation may be compromised or delayed. Acceptable pathology reports include working drafts, preliminary pathology, or surgical pathology reports.

2. The following information must be included in the report provided.?

1. Patient name

2. Block number - must be on all blocks, slides, and paperwork

3. Date of collection

4. Tissue Source

3. 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.

4. A list of probes is required if select probes are necessary or if the patient is being tracked for known abnormalities. See Table in Clinical Information.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred

Specimen Type: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tumor tissue block. Blocks prepared with alternative fixation methods will be attempted but are less favorable for successful results; 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

Specimen Type: Tissue slides

Slides: 1 Hematoxylin and eosin stained and 2 unstained?for each probe set

Collection Instructions:

1. Include 1 hematoxylin and eosin-stained slide for the entire test order.

2. For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides


Specimen Type

Tissue

Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

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

Reject Due To

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

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 is supportive of a diagnosis of a T-cell lymphoma. The specific abnormality detected may help determine a T-cell lymphoma subtype and/or contribute to the prognosis.

 

The absence of an abnormal clone, or negative result, does not rule out the presence of a neoplastic disorder or change the pathologic diagnosis.

Day(s) Performed

Monday through Friday

Report Available

7 to 10 days

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

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)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TLYM T-cell Lymphoma, FISH, Tissue 101682-3

 

Result ID Test Result Name Result LOINC Value
603140 Result Summary 50397-9
603141 Interpretation 69965-2
603142 Result Table 93356-4
603143 Result 62356-1
GC040 Reason for Referral 42349-1
603144 Specimen 31208-2
603145 Source 31208-2
603146 Tissue ID 80398-1
603147 Method 85069-3
603148 Additional Information 48767-8
603149 Disclaimer 62364-5
603150 Released By 18771-6

Forms

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

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_PRAH Probe, Each Additional (TLYM) No, (Bill Only) No

Testing Algorithm

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 all reflex or additional probe sets performed. No analysis charges will be incurred if an insufficient number of representative cells are available for analysis.

 

This FISH test allows different combinations of probes to be utilized based on the suspected lymphoma subtype, patient's age, and clinical question. The most appropriate probes to order are listed in the Common Chromosome Abnormalities in T-cell Lymphomas table in Clinical Information. Both the break apart TCL1A and TRAD FISH probes are performed concurrently and will not be performed in isolation. The TBL1XR1/TP63 FISH probe will only be performed, at the laboratory's discretion, to resolve or confirm TP63 rearrangement concerns.

 

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 information see Anaplastic Large Cell Lymphoma Evaluation Algorithm.