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HelpTest Code TLPMF T-Cell Lymphoma, Specified FISH, Varies
Ordering Guidance
This test is intended for instances when limited T-cell lymphoma fluorescence in situ hybridization (FISH) probes are needed based on specific abnormalities or abnormalities identified in the diagnostic sample. The FISH probes to be analyzed must be specified on the ordering request. If targeted FISH probes are not included with this test order, test processing will be delayed and the test may be canceled and automatically reordered by the laboratory as TLPDF / T-Cell Lymphoma, Diagnostic FISH, Varies.
This test should only be ordered if the specimen 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 order will be canceled, and no charges will be incurred.
TCL1A and TRA break-apart probe sets are performed simultaneously and cannot be ordered independently.
This test should NOT be used to screen for residual T-cell lymphoma.
If a complete T-cell lymphoma panel is preferred, order TLPFD / T-Cell Lymphoma BM/BL Panel, Diagnostic, FISH, Varies.
This test should NOT be used to screen for residual T-cell lymphoma.
This assay detects chromosome abnormalities observed in blood or bone marrow specimens 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, order either TALAF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies or TALFP / Pediatric T-Lymphoblastic Leukemia/Lymphoma Panel, FISH, Varies,?depending on the age of the patient. For testing paraffin-embedded tissue samples from patients with T-cell lymphoblastic Lymphoma, see TLBLF / T-Lymphoblastic Leukemia/Lymphoma, FISH, Tissue.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. A list of probes requested for analysis is required. Probes available for this test are listed in the Testing Algorithm section.
2. 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.
3. 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 (sodium heparin) or lavender top (EDTA)
Specimen Volume: 2 to 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 (sodium 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 common chromosome abnormalities associated with specific T-cell lymphoma subtypes using client-specified probe set(s)
This test should not be used to screen for residual T-cell lymphoma
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 additional probe sets 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.
This test is performed using client-specified FISH probes and is not intended as a panel test. Specific probes or suspected T-cell lymphoma subtype must be listed in the probe request field. Reflex probes can be performed when appropriate if specified in the order request field.
When specified, any of the following probes for the following known subtypes of T-cell lymphoma will be performed:
i(7q) or isochromosome 7q, request probe D7Z1/D7S486
+8 or trisomy 8, request probe D8Z2/MYC
t(14q32.1;var) or TCL1A rearrangement, request probe TCL1A break-apart
t(14q11.2;var) or TRA rearrangement, request probe TRA break-apart
TCL1A and TRAD break-apart probe sets will be performed simultaneously and cannot be ordered independently.
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. The T-cell lymphoma subtype will be used by the laboratory to determine appropriate FISH probes, if determined and applicable.
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 see Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm.
Special Instructions
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
T-cell Lymphoma B/BM, Spec FISHSpecimen Type
VariesSpecimen Minimum Volume
Bone marrow: 1 mL; Whole blood: 2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| 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. Genetic abnormalities can assist diagnosis and have served as important prognostic markers in T-cell lymphomas. Fluorescence in situ hybridization (FISH) permits the detection of recurrent gene rearrangements associated with various chromosomal abnormalities in specific 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' TRA |
|
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.
The absence of an abnormal clone does not rule out the presence of lymphoma or another neoplastic disorder.
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.
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysSpecimen Retention Time
4 weeksPerforming 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
88271x2, 88275 x1, 88291x1- FISH Probe, Analysis, Interpretation; 1 probe set
88271x2, 88275 x1 - FISH Probe, Analysis; each additional probe set (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TLPMF | T-cell Lymphoma B/BM, Spec FISH | 101682-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 614348 | Result Summary | 50397-9 |
| 614349 | Interpretation | 69965-2 |
| 614350 | Result Table | 93356-4 |
| 614351 | Result | 62356-1 |
| GC141 | Reason for Referral | 42349-1 |
| GC142 | Probes Requested | 78040-3 |
| GC143 | Specimen | 31208-2 |
| 614352 | Source | 31208-2 |
| 614353 | Method | 85069-3 |
| 614354 | Additional Information | 48767-8 |
| 614355 | Disclaimer | 62364-5 |
| 614356 | Released By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.