Mature B, T & NK Cell Neoplasms Panel

  • Tech Only CPT
  • Tech Pro CPT 88184, 88189, 88185x24
  • PowerPath Code FL CHP
  • Schedule Monday - Friday (Weekends by arrangement for clinically urgent Flow diagnostics)
  • Turn Around Time 1 Day
  • Disease State Leukemia, Lymphoma
  • Methodology Flow Cytometry

Specimen Requirements

Container Type:Bone Marrow or Peripheral Blood in Heparin or EDTA. Tissue in RPMI or Sterile container with saline solution. Body Fluids in RPMI or Sterile container.

Preferred Volume: Bone Marrow or Peripheral Blood: 1.0 - 5.0ml.
Tissue: 1cm (greatest dimension) in 2ml of RPMI.
Body Fluids: 1.0-5.0ml.

Clinical Significance

This panel is designed to characterized lymphoproliferative disorders, which usually are comprised of mature B or T cells. The lymphoma panel is analyzed using a combination of light scatter and lineage-associated gating, rather than CD45-dependent gating, to identify the cell populations of interest. Surface CD19 expression is used to identify B cells, and surface CD3 to identify T cells. With very rare exceptions, demonstration of a monoclonal population with restricted κ or λ immunoglobulin light chain expression is diagnostic of B cell malignancies. The specific immunophenotype of a clonal B-cell population is further evaluated to arrive at a diagnosis, or provide a differential diagnosis. Cytoplasmic light chain expression may be evaluated to confirm clonality in B cell neoplasms showing aberrant loss of surface immunoglobulins. For T- cell or NK cell malignancies, there is no convenient clonal marker that can be demonstrated by cell-surface marker studies, although in many cases the identification of an abnormal T cell or NK cell phenotype is strong evidence for a malignancy. To further characterize an abnormal T cell population, the T cell receptor panel can be added. T-cell receptor (TCR) is a complex of integral membrane proteins that participates in the activation of T-Cells in response to the presentation of antigen. The TCR is composed of two different protein chains. In 95% of T cells, this consists of an alpha (α) and beta (β) chain that express the CD3 antigen while 5% of T cells is consists of gamma and delta (γ/δ) chains. When necessary, clonality can be further assessed by performing IgH or T-cell receptor gene rearrangement studies by PCR.

Required Patient Info

1. Requisition form with the patient’s name, DOB, DOC and recent treatments.
2. CBC report for Peripheral Blood

Storage and Transportation

Bone Marrow and Peripheral Blood: 48-72hrs transport at room temperature.
Tissue and Body Fluids: 24hrs. Transport refrigerated.

Cause for Rejection

Specimens without 2 (two) patient identifiers.Incorrect anticoagulant or lack of anticoagulant, frozen or incorrectly stored specimens (i.e. excessive heat or cold), severely hemolyzed specimens (minimal hemolysis will be evaluated on a case-by-case basis), broken or leaking tubes,specimens received with needles affixed, submitted in fixative - no fixative is acceptable!, specimen age: >72 hours for peripheral blood and >5 days for bone marrow *see note below, clotted specimens (small clots are acceptable-others evaluated on a case-by-case basis), contamination (bacterial, fungal, drug interaction, chylous, etc.), incorrectly labeled specimens or insufficient transport media for tissues and FNA’s.

*Note: Peripheral blood specimens >72-hours old are reported on a case-by-case basis and must be approved by the pathologist reviewing the case. Bone marrow specimens >5-days old are reported on a case-by-base basis and must be approved by the pathologist reviewing the case.

Retention

1 week

Comments

These tests were developed and the performance characteristics determined by CellNetix Pathology and Laboratories. They have not been cleared or approved by the US Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. This laboratory is certified under CLIA-88 and is qualified to perform high complexity clinical testing. Prognostic and predictive testing should be interpreted in the context of additional clinical and/or histopathological findings.