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Test Code TLBLF T-Lymphoblastic Leukemia/Lymphoma, FISH, Tissue


Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


A reason for referral and pathology report are required in order for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Tissue

Container/Tube: Formalin-fixed, paraffin-embedded tumor tissue block

 

Specimen Type: Slides

Specimen Volume: 19 Consecutive, unstained, 5 micron-thick sections placed on positively charged slides and 1 hematoxylin and eosin-stained slide


Secondary ID

65413

Useful For

Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with T-cell lymphoblastic leukemia or lymphoma

Reflex Tests

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

Testing Algorithm

This test may be ordered in 2 distinct ways allowing different combinations of probes to be utilized based on the clinical question, including the standard (diagnostic) T-lymphoblastic leukemia/lymphoma (TLBL) fluorescence in situ hybridization (FISH) panel and the individual TLBL FISH probes (per client request).

 

The specific TLBL FISH panel or probes requested must be noted on the request form or in the reason for referral. If no specific panel or FISH probes are indicated, the standard (diagnostic) panel will be performed.

 

The standard (diagnostic) panel includes testing for the following abnormalities, using the FISH probes listed:

1p33 rearrangements, TAL1/STIL(SIL)

t(5;14)(q35;q32), TLX3(HOX11L2)/BCL11B

7q34 rearrangements, TRB(TCR beta)

9p-, CDKN2A(p16)/D9Z1

t(9;22)(q34;q11.2), ABL1 amplification, ABL1(ABL)/BCR

t(10;11)(p12;q14), MLLT10(AF10)/PICALM

11q23 rearrangements, MLL

14q11.2 rearrangements, TRAD (TCR alpha delta)

17p-, TP53/D17Z1

 

When an MLL rearrangement is identified, reflex testing will be performed with 1 or more dual-fusion (D-FISH) probe sets in an attempt to identify the translocation partner.

Probes include:

t(4;11)(q21;q23), AFF1(AF4)/MLL

t(6;11)(q27;q23), MLLT4(AF6)/MLL

t(9;11)(p22;q23), MLLT3(AF9)/MLL

t(10;11)(p12;q23), MLLT10(AF10)/MLL

t(11;19)(q23;p13.1), MLL/ELL

t(11;19)(q23;p13.3), MLL/MLLT1(ENL)

 

When a TRB(TCR beta) rearrangement is identified, reflex testing will be performed with the D-FISH probe set t(7;10)(q34;q24), TRB(TCR beta)/TLX1(HOX11) in an attempt to identify the translocation partner.

 

When a TRAD (TCR alpha delta) rearrangement is identified, reflex testing will be performed with the D-FISH probe set t(10;14)(q24;q11.2), TLX1(HOX11)/TRAD(TCR alpha delta) in an attempt to identify the translocation partner.

 

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.

 

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.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

T-Lymphoblastic Leuk/Lymph, FISH,Ts

Specimen Type

Tissue

Specimen Minimum Volume

Formalin-fixed paraffin-embedded tissue block or for each probe set ordered, 9 unstained consecutive tissue sections cut at 5 microns and placed on positively charged microscope slides. Include 1 hematoxylin and eosin (H and E) stained slide.

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.

Day(s) Performed

Monday through Friday

Report Available

7 to 10 days

Performing Laboratory

Mayo Clinic 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 US Food and Drug Administration.

CPT Code Information

88271 x 2, 88291-DNA probe, each (first probe set), Interpretation and report

88271 x 2-DNA probe, each; each additional probe set (if appropriate)

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

88271 x 2-DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271 x 3-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
TLBLF T-Lymphoblastic Leuk/Lymph, FISH,Ts In Process

 

Result ID Test Result Name Result LOINC Value
113467 Result Summary 50397-9
113468 Interpretation 69965-2
113626 Result Table 93356-4
113469 Result 62356-1
GC005 Reason for Referral 42349-1
113470 Specimen 31208-2
113471 Source 31208-2
113472 Tissue ID 80398-1
113473 Method 85069-3
113474 Additional Information 48767-8
113475 Disclaimer 62364-5
113476 Released By 18771-6

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Hematopathology/Cytogenetics Test Request (T726)

-Children's Oncology Group Test Request (T829)