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HelpTest Code LLPT Leukemia/Lymphoma Immunophenotyping, Flow Cytometry, Tissue
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FCINT | Flow Cytometry Interp, 2-8 Markers | No, (Bill Only) | No |
| FCIMS | Flow Cytometry Interp, 9-15 Markers | No, (Bill Only) | No |
| FCINS | Flow Cytometry Interp,16 or greater | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, a screening panel and a professional interpretation will always be charged. The screening panel will be charged based on number of makers tested (FIRST for first marker, ADD1 for each additional marker). The interpretation will be set based on markers tested in increments of 9 to 15, or 16 and greater. 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 (FIRST if applicable, ADD1 if applicable).
The tissue panel is initially performed to evaluate for monotypic B cells by kappa and lambda immunoglobulin light chain expression, CD5, CD10, CD19, CD20, and CD23.Increased numbers of blasts and plasma cells are identified by CD45 expression along with side scatter gating. The panel can also evaluate T cells with CD3, CD5, and CD7. Additionally, viability is assessed on all tissue specimens using 7-AAD (7-amino actinomycin d) exclusion.
This panel, together with the provided clinical history and morphologic review is used to determine what, if any, further testing is needed for disease diagnosis or classification. If additional testing is required, it will be added per algorithm to fully characterize a disease state with a charge per unique antibody tested.
In addition to reflexing flow cytometric panels, fluorescence in situ hybridization (FISH), molecular testing or cytochemical stains may be recommended by the Mayo Clinic pathologist to facilitate diagnosis. They will contact the referring provider or pathologist to confirm the addition of these tests.
If no abnormalities are detected by the initial panel, no further flow cytometric assessment will be performed unless otherwise indicated by specific features of the clinical presentation or prior laboratory results.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
TissueOrdering Guidance
Order LCMS / Leukemia/Lymphoma Immunophenotyping, Flow Cytometry, Varies if the specimen is a fresh (less than 4 days post-collection), unfixed, non-embedded bone marrow core biopsy, bone or bone lesion. This is an equivalent source for bone marrow aspirate only in the event of a dry tap during the bone marrow harvesting procedure. Indicate “dry tap" in performing lab notes or paperwork when submitting this specimen type.
This test is not intended for product of conception (POC) specimens. For POC specimens see CMAPC / Chromosomal Microarray, Autopsy, Products of Conception, or Stillbirth.
Shipping Instructions
Specimen must arrive within 4 days of collection.
Necessary Information
The following information is required:
1. Pertinent clinical history, including reason for testing or clinical indication/morphologic suspicion
2. Provide the following:
-Tissue type
-Location
-Pathology/diagnostic report, including the client surgical pathology case number
Specimen Required
Submit 1 of the following specimens:
Preferred
Specimen Type: Tissue
Supplies: Hank's Solution (T132)
Container/Tube: Sterile container with 15 mL of tissue culture medium (eg, Hank's balanced salt solution, RPMI, or equivalent)
Specimen Volume: 5 mm(3) or larger biopsy
Collection Instructions:
1. Place tissue into a sterile container with 15 mL of tissue culture medium (eg, Hank's balanced salt solution, RPMI, or equivalent).
2. Send intact specimen (do not mince)
3. Specimen cannot be fixed.
Specimen Stability Information: Ambient 4 days/Refrigerated 4 days
Acceptable
Specimen Type: Fine needle aspirate (FNA)
Supplies: Hank's Solution (T132)
Container/Tube: Sterile container with 15 mL of tissue culture medium (eg, Hank's balanced salt solution, RPMI, or equivalent)
Specimen Volume: Entire collection
Collection Instructions:
1. Collect FNA and transfer entire collection into a sterile container with 15 mL of tissue culture medium (eg, Hank's balanced salt solution, RPMI, or equivalent).
2. Send intact specimen (do not mince)
3. Specimen cannot be fixed.
Specimen Stability Information: Ambient 4 days/Refrigerated 4 days
Specimen Minimum Volume
1 mm(3)
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Tissue | Refrigerated (preferred) | |
| Ambient | ||
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Saturday
Clinical Information
Cellular immunophenotyping, characterizing cells by using antibodies directed against cell surface markers, is generally regarded as a fundamental element in establishing a diagnosis of tissue involvement by hematolymphoid malignancies, when used in conjunction with morphologic assessment. It is also an essential component in subclassification of hematolymphoid malignancies when present.
Report Available
1 to 4 daysReject Due To
| Fixed, paraffin-embedded, or minced tissue |
Reject |
| Dry tissue without transport medium |
Reject |
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)
88187-Flow Cytometry Interpretation, 2 to 8 Markers (if appropriate)
88188-Flow Cytometry Interpretation, 9 to 15 Markers (if appropriate)
88189-Flow Cytometry Interpretation, 16 or More Markers (if appropriate)
Method Name
Immunophenotyping
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FIRST | Flow Cytometry, Cell Surface, First | No, (Bill Only) | Yes |
| ADD1 | Flow Cytometry, Cell Surface, Addl | No, (Bill Only) | Yes |
Forms
1. Hematopathology Patient Information (T676)
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.