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Test Code TLYMF T-Cell Lymphoma, FISH, Tissue

Useful For

Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various T-cell lymphomas

 

Tracking known chromosome abnormalities and response to therapy in patients with T-cell lymphomas

Reflex Tests

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

Testing Algorithm

This test does not include a pathology consultation. If a pathology consultation is requested, PATHC / Pathology Consultation should be ordered and the appropriate FISH test will be ordered 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 FISH results in context of specific case, when applicable) phases.

 

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.

 

Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in the Clinical Information.

 

If the patient is being tracked for known abnormalities, indicate which probes should be used.

 

Panel includes testing for the following abnormalities using the probes listed:

14q32.1 rearrangement, TCL1A

-7/7q-/i(7q), D7S486/D7Z1

+8, D8Z2/MYC

2p23.2 rearrangement, ALK

 

This assay detects chromosome abnormalities observed in paraffin-embedded tissue samples of patients with T-cell lymphoma. For testing the blood and bone marrow from patients with T-cell lymphoma, see TLPF / T-Cell Lymphoma, FISH, Blood or Bone Marrow.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

T-cell Lymphoma, FISH, Ts

Specimen Type

Tissue


Advisory Information


This test is not appropriate for testing blood or bone marrow samples from patients with T-cell lymphoma, see TLPF / T-Cell Lymphoma, FISH, Blood or Bone Marrow.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


Provide a reason for referral and pathology report 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:

 

Specimen Type: Lymph node

Preferred: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used

Acceptable: Slides

Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.

 

Specimen Type: Solid tumor

Preferred: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.

Acceptable: Slides

Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.


Specimen Minimum Volume

For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides. Include 1 hematoxylin and eosin-stained slide.

Specimen Stability Information

Specimen Type Temperature Time
Tissue Ambient (preferred)
  Refrigerated 

Reject Due To

No specimen should be rejected.

Clinical Information

T-cell malignancies account for approximately 12% of all non-Hodgkin lymphomas. There are several subtypes of T-cell neoplasms: T-cell acute lymphoblastic leukemia (T-ALL), T-cell prolymphocytic leukemia (T-PLL), T-cell large granular lymphocytic leukemia (T-LGL), anaplastic large cell lymphoma (ALCL), peripheral T-cell lymphoma, and various other cutaneous, nodal, and extrandodal lymphoma subtypes. The 2 most prevalent lymphoma subtypes are unspecified peripheral T-cell lymphoma (3.7%) and ALCL (2.4%).

 

A few common chromosome abnormalities are associated with specific T-cell lymphoma subtypes, including:

-inv(14)(q11q32) and t(14;14)(q11;q32) involving the T-cell leukemia/lymphoma 1 gene (TCL1A) at 14q32

-Translocations involving the ALK gene at 2p23 in ALCL

-Isochromosome 7q and trisomy 8 in hepatosplenic T-cell lymphoma

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 subtype the neoplasm.

 

The absence of an abnormal clone does not rule out the presence of a neoplastic disorder.

Cautions

This test is not approved by the U.S. Food and Drug Administration and it is best used as an adjunct to existing clinical and pathologic information.

 

Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays.

 

Paraffin-embedded tissues that have been decalcified are generally unsuccessful for FISH analysis. The pathologist reviewing the hematoxylin and eosin-stained slide may find it necessary to cancel testing.

Supportive Data

Each probe was independently tested on a set of formalin-fixed, paraffin-embedded tissue specimens from patients diagnosed with a T-cell lymphoma and noncancerous lymph node specimens. Normal cutoffs were calculated based on the results from 25 normal specimens. For each probe set, a series of chromosomally abnormal specimens were evaluated to confirm each probe set detected the anomaly it was designed to detect.

Clinical Reference

1. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Edited by ES Jaffe, NL Harris, H Stein, JW Vardiman. Lyon, IARC Press, 2001

2. Gesk S, Martin-Subero JI, Harder L, et al: Molecular cytogenetic detection of chromosomal breakpoints in T-cell receptor gene loci. Leukemia 2003;17:738-745

3. Chin M, Mugishima H, Takamura M, et al: Hemophagocytic syndrome and hepatosplenic (gamma)(delta) T-cell lymphoma with isochromosome 7q and 8 trisomy. J Pediatr Hematol Oncol 2004;26(6):375-378

4. Graux C, Cools J, Michaux L, et al: Cytogenetics and molecular genetics of T-cell acute lymphoblastic leukemia: from thymocyte to lymphoblast. Leukemia 2006;20:1496-1510

5. Cayuela JM, Madani A, Sanhes L, et al: Multiple tumor-suppressor gene 1 inactivation is the most frequent genetic in T-cell lymphoblastic leukemia. Blood 1996;87:3180-3186

Method Description

This test is performed using commercially available and laboratory-developed probes. Rearrangements involving ALK or TCL1A are detected using a dual-color break-apart (BAP) strategy probe. Trisomy of chromosome 8 and isochromosome 7q are detected using enumeration strategy probes. Formalin-fixed, paraffin-embedded tissues are cut at 5 microns and mounted on positively charged glass slides. The selection of tissue and the target areas on the hematoxylin and eosin (H and E)-stained slide is performed by a pathologist. Using the H and E-stained slide as a reference, target areas are etched with a diamond-tipped etcher on the back of the unstained slide to be assayed. The probe set is hybridized to the appropriate target areas and 2 technologists each analyze 100 interphase nuclei (200 total) with the results expressed as the percent abnormal nuclei.(Unpublished Mayo method)

Day(s) and Time(s) Performed

Samples processed Monday through Sunday. Results reported Monday through Friday 8 a.m.-5 p.m.

Analytic Time

7 days

Specimen Retention Time

Slides and H and E used for analysis are retained by the lab indefinitely. Client provided paraffin blocks and extra unstained slides (if provided) will be returned after testing is complete.

Performing Laboratory

Mayo Medical 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 U.S. Food and Drug Administration.

CPT Code Information

88271x2, 88291 – DNA probe, each (first probe set), Interpretation and report

88271x2 – DNA probe, each; each additional probe set (if appropriate)

88271x1 – DNA probe, each; coverage for sets containing 3 probes (if appropriate)

88271x2 – DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271x3 – 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
TLYMF T-cell Lymphoma, FISH, Ts In Process

 

Result ID Test Result Name Result LOINC Value
52139 Result Summary 50397-9
52141 Interpretation In Process
52140 Result Table No LOINC Needed
54583 Result In Process
CG743 Reason for Referral 42349-1
52142 Specimen In Process
52143 Source 31208-2
52144 Tissue ID No LOINC Needed
52145 Method 49549-9
55025 Additional Information 48767-8
53832 Disclaimer 62364-5
52146 Released By No LOINC Needed

Forms

If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request Form (T726) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/hematopathology-request-form.pdf)