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HelpOrder Code SZDIA Sezary Diagnostic Flow Cytometry, Blood
Useful For
Identifying immunophenotypically aberrant T-cell populations with restricted expression of T-cell receptor beta-chain constant in peripheral blood, to roughly assess the circulating tumor burden in cutaneous T-cell lymphomas
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FIRST | Flow Cytometry, Cell Surface, First | No | Yes |
| ADD1 | Flow Cytometry, Cell Surface, Addl | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FCIMS | Flow Cytometry Interp, 9-15 Markers | No | No |
| FCINS | Flow Cytometry Interp,16 or greater | No | No |
Testing Algorithm
This Sezary panel is ordered for patients with a clinical suspicion of Sezary syndrome or cutaneous T-cell lymphoma with peripheral blood involvement without a previously confirmed diagnosis. A Triage panel and Sezary panel will always be performed. This test is not indicated for monitoring peripheral blood involvement in patients with a diagnosis of Sezary syndrome or mycosis fungoides. For monitoring purposes, order SZMON / Sezary Monitoring Flow Cytometry, Blood.
The panel is charged based on number of markers tested (FIRST for first marker, ADD1 for each additional marker). In addition, reflex testing may occur to fully characterize a disease state or clarify any abnormalities from the screening test. Reflex tests will be performed at an additional charge for each marker tested (ADD1 if applicable).
The testing process begins with a triage panel to evaluate for and exclude monotypic B cells or increased numbers of blasts. The triage panel also includes antibodies to assess the number of CD3-positive T cells and CD16-positive/CD3-negative natural killer cells present. Additional reflex testing may occur to fully characterize a disease state per algorithmic approach or clarify any abnormalities from the screening test at an additional charge for each marker tested (ADD1 if applicable). For a comprehensive list of potential additional panels, refer to LCMS / Leukemia/Lymphoma Immunophenotyping, Flow Cytometry, Varies.
The Sezary panel will further evaluate the T cells for expression of CD2, CD4, CD5, CD7, CD8, CD26, and TRBC1.
Method Name
Immunophenotyping
Reporting Name
Sezary Diagnostic Flow Cytometry, BSpecimen Type
Whole bloodOrdering Guidance
This test is not indicated for monitoring patients with a diagnosis of Sezary syndrome. For monitoring purposes, order SZMON / Sezary Monitoring Flow Cytometry, Blood.
Specimen Required
Container/Tube:
Preferred: Yellow top (ACD solution A or B)
Acceptable: Lavender top (EDTA), green top (sodium heparin)
Specimen Volume: 6 mL
Collection Instructions:
1. Send whole blood specimen in original tube. Do not aliquot.
2. Label specimen as blood.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole blood | Ambient (preferred) | 4 days | |
| Refrigerated | 4 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
Reference Values
An interpretive report will be provided. This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic findings and, if available, morphologic features will be provided by a board-certified hematopathologist for every case.
Method Description
Flow cytometry immunophenotyping of peripheral blood is performed using the following antibodies:
-Triage Panel: CD3, CD10, CD16, CD19, CD34, CD45, and kappa and lambda immunoglobulin light chains.
-Sezary Panel: CD2, CD3, CD4, CD5, CD7, CD8, CD26, CD45, and TRBC1.(Shi M, Jevremovic D, Otteson GE, Timm MM, Olteanu H, Horna P. Single antibody detection of T-cell receptor alpha-beta clonality by flow cytometry rapidly identifies mature T-cell neoplasms and monotypic small CD8-positive subsets of uncertain significance. Cytometry B Clin Cytom. 2020;98[1]:99-107)
-Possible additional panels performed per algorithmic approach.
Day(s) Performed
Monday through Saturday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker x 1
88185-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each)
88188-Flow Cytometry Interpretation, 9 to15 markers (if appropriate)
88189-Flow Cytometry Interpretation, 16 or more markers (if appropriate)
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.