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HelpOrder Code SLL Small Lymphocytic Lymphoma, FISH, Tissue
Ordering Guidance
This test does not include a pathology consultation. If a pathology consultation is requested, order PATHC / Pathology Consultation and the appropriate fluorescence in situ hybridization test (FISH) test will be added and performed at an additional charge.
Mayo Hematopathology Consultants are involved in both the preanalytic (tissue adequacy and probe selection, when applicable) and postanalytic (interpretation of FISH results in context of specific case, when applicable) phases.
This test is not appropriate for testing blood and bone marrow from patients with chronic lymphocytic leukemia. See CLLDF / Chronic Lymphocytic Leukemia (CLL), Diagnostic FISH, Varies or CLLMF / Chronic Lymphocytic Leukemia (CLL), Specified FISH, Varies.
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.
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 may be acceptable; provide fixation method used.
Acceptable
Specimen Type: Tissue slides
Slides:1 Hematoxylin and eosin-stained (H and E) stained and 10 unstained
Collection Instructions: Submit 1 slide stained with H and E and 10 consecutive, unstained, positively charged, unbaked slides with 5-micron-thick sections of the tumor tissue.
Useful For
Recurrent common chromosome abnormalities in patients with small lymphocytic lymphoma (SLL)
Distinguishing patients with 11;14 translocations who have mantle cell lymphoma (MCL) from patients who have SLL
Detecting patients with atypical SLL or other forms of B-cell lymphoma associated with translocations between IGH and BCL3
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| _PRAG | Probe, Each Additional (SLL) | No, (Bill Only) | 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 probes performed. No analysis charges will be incurred if an insufficient number of representative cells are available for analysis.
This test may be ordered in 2 distinct ways allowing different combinations of probes to be analyzed based on the clinical question, including the standard small lymphocytic lymphoma (SLL) FISH panel and the individual SLL FISH probes (per client request).
If the patient is being evaluated for known abnormalities, targeted probes must be listed in the probe request field. If no specific panel or FISH probes are indicated, the standard panel will be performed.
The standard SLL FISH panel includes testing for the following abnormalities, using the FISH probes listed:
6q-, D6Z1/MYB
11q-, D11Z1/ATM
+12, D12Z3/MDM2
13q-, D13S319/LAMP1
17p-, TP53/D17Z1
t(11;14), CCND1::IGH
When 3 IGH signals are identified suggesting an IGH rearrangement and no fusion with CCND1 is observed, additional testing with the t(14;19)(q32;q13) IGH::BCL3 FISH probe will be performed.
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
SLL, FISH, TissueSpecimen Type
TissueSpecimen Minimum Volume
Slides: 1 Hematoxylin and eosin-stained and 6 unstained
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.
Method Description
This test is performed using commercially available and laboratory-developed probes. Deletion of chromosomes 6q, 11q, 13q, and 17p, and trisomy of chromosome 12 are detected using enumeration strategy probes. A dual-color, dual-fusion (D-FISH) strategy probe set is used to detect CCND1::IGH rearrangements and, for reflex testing, to identify IGH::BCL3 rearrangements. Paraffin-embedded tissues are cut at 5 microns and mounted on positively charged glass slides. The selection of tissue and the identification of 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 engraving tool on the back of the unstained slide to be assayed. For each probe set, the probes are hybridized to the appropriate target areas and 2 technologists each analyze 50 interphase nuclei (100 total). All results are expressed as the percent abnormal nuclei.(Unpublished Mayo method)
Day(s) Performed
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
88377-if 1 probe set
88377 x 2-if 2 probe sets
88377 x 3-if 3 probe sets
88377 x 4-if 4 probe sets
88377 x 5-if 5 probe sets
88377 x 6-if 6 probe sets
88377 x 7-if 7 probe sets
88377 x 8-if 8 probe sets
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.