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HelpTest Code TLBLF T-Cell Lymphoblastic Leukemia/Lymphoma, FISH, Tissue
Ordering Guidance
This test does not include a pathology consultation. If a pathology consultation is requested, order PATHC / Pathology Consultation, and appropriate testing will be added at the discretion of the pathologist and performed at an additional charge.
Mayo Clinic Hematopathology consultants are involved in the pre-analytic phase (tissue adequacy and probe selection, when applicable).
This test is not appropriate for testing blood and bone marrow from patients with T-lymphoblastic leukemia/lymphoma (T-LBL). If a non-paraffin embedded bone marrow or blood specimen is received for this test, the test will be canceled and automatically reordered by the laboratory as 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.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. A pathology report is required for testing to be performed. If not provided, appropriate testing and/or interpretation may be compromised or delayed. Acceptable pathology reports include working drafts, preliminary pathology, or surgical pathology reports.
2. The following information must be included in the report provided:
-Patient name
-Block number - must be on all blocks, slides, and paperwork
-Date of collection
-Tissue source
3. 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.
4. A list of probes is required if select probes are necessary or if the patient is being tracked for known abnormalities. See Table in Clinical Information.
Specimen Required
Submit only 1 of the following specimens:
Preferred
Specimen Type: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded tumor tissue block. Blocks prepared with alternative fixation methods will be attempted but are less favorable for successful results; provide fixation method used.
Additional Information:
1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).
2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.
Acceptable
Specimen Type: Tissue slides
Slides: 1 Hematoxylin and eosin stained and 2 unstained for each probe set
Collection Instructions:
1. Include 1 hematoxylin and eosin-stained slide for the entire test order.
2. If individual probe sets are chosen: For each probe set ordered, submit 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.
3. If a complete T-lymphoblastic leukemia/lymphoma (TLBL) panel is ordered: submit 16 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.
Useful For
Detecting, at diagnosis, recurrent common chromosome abnormalities associated with T-cell acute lymphoblastic leukemia/lymphoma (T-ALL) in paraffin-embedded tissue specimens
Monitoring response to therapy by tracking known chromosome abnormalities in patients with T-ALL/T-lymphoblastic 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 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 all reflex or 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 may be ordered in 2 distinct ways allowing different combinations of probes to be analyzed based on the clinical question.
1. Standard (diagnostic) T-lymphoblastic leukemia/lymphoma (TLBL) FISH panel
2. Individual TLBL FISH probes chosen, per client request, from probes listed below
If individual TLBL FISH probes are needed, the specific probes requested must be noted on the request form or in the reason for referral. If no 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 rearrangement or STIL deletion, request probe TAL1/STIL
t(5;14)(q35;q32) or TLX3::BCL11B fusion, request probe TLX3/BCL11B
t(7q34;var) or 7q34 rearrangement, request probe TRB break-apart
t(9;22) or ABL1 amplification, request probe ABL1/BCR
t(10;11)(p12;q14) or MLLT10::PICALM fusion, request probe MLLT10/PICALM
t(11q23;var) or 11q23 rearrangement, request probe KMT2A break-apart
t(14q11.2;var) or 14q11.2 rearrangement, request probe TRA break-apart
In the following situations, additional (reflex) testing may be performed at the laboratory's discretion and may be influenced by other FISH testing.
When a TRB (TCR beta) rearrangement is identified, the dual-fusion FISH (D-FISH) probe set for t(7;10)(q34;q24) TRB::TLX1 fusion may be used in an attempt to identify the translocation partner. To request this probe specifically, request probe TRB/TLX1.
When a KMT2A rearrangement is identified, 1 or more D-FISH probe sets may be used in an attempt to identify the translocation partner. Reflex testing is performed for the following abnormalities:
t(4;11)(q21;q23) or KMT2A::AFF1 fusion, request probe AFF1/KMT2A
t(6;11)(q27;q23) or KMT2A::AFDN fusion, request probe AFDN/KMT2A
t(9;11)(p22;q23) or KMT2A::MLLT3 fusion, request probe MLLT3/KMT2A
t(10;11)(p12;q23) or KMT2A::MLLT10 fusion, request probe MLLT10/KMT2A
t(11;19)(q23;p13.1) or KMT2A::MLLT1 fusion, request probe KMT2A/ELL
t(11;19)(q23;p13.3) or KMT2A::ELL fusion, request probe KMT2A/MLLT1
When a TRA rearrangement is identified, the D-FISH probe set for t(10;14)(q24;q11.2) TRA::TLX1 fusion may be used in an attempt to identify the translocation partner. To request this probe specifically, request probe TLX1/TRA.
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,TsSpecimen Type
TissueSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| 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 daysPerforming 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
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 | 101663-3 |
| 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: