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Test ID 60506 Cutaneous Anaplastic Large Cell Lymphoma, 6p25.3 (IRF4) Rearrangement, FISH, Tissue

Useful For

Providing potential prognostic information in patients with documented systemic anaplastic lymphoma kinase-negative anaplastic large cell lymphoma

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

IRF4, 6p25.3, FISH

Specimen Type


Specimen Required

Provide a pathology report with each tissue specimen. The laboratory will not reject a specimen that arrives without this information, but will hold the specimen until a pathology report is received.


Submit only 1 of the following specimens:


Specimen Type: Lymph node

Preferred: Tissue block               

Collection Instructions: Formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Include 1 hematoxylin and eosin (H and E)-stained slide.


Acceptable: Slides

Collection Instructions: For each probe set ordered, 2 unstained consecutive tissue sections cut at 5 microns and placed on positively charged microscope slides. Include 1 H and E-stained slide.

Specimen Minimum Volume

Formalin-fixed paraffin-embedded tissue block or 2 consecutive unstained 5-micron thick sections placed on positive-charged microscope slides and 1 hematoxylin and eosin-stained slide.

Specimen Stability Information

Specimen Type Temperature Time
Tissue Ambient (preferred)

Reference Values

An interpretative report will be provided.

Day(s) and Time(s) Performed

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

Performing Laboratory

Mayo Medical Laboratories in Rochester

CPT Code Information

88271 x 2-DNA probe, each

88275-Interphase in situ hybridization, 100 to 300 cells

88291-Interpretation and report

LOINC Code Information

Result ID Reporting Name LOINC Code
20388 Accession Number N/A
20389 Referring Pathologist/Physician 46608-6
20390 Ref Path/Phys Address 74221-3
20391 Material: N/A
20392 Specimen: 31208-2
20393 Microscopic Description: N/A
20394 Special Studies: N/A
20395 Final Diagnosis: 34574-4
20396 Comment: 22638-1
20397 Revision Description: N/A
20398 Signing Pathologist: 19139-5
20399 Special Procedures: N/A
20400 SP Signing Pathologist: N/A
20401 *Previous Report Follows* N/A
20402 Addendum: 35265-8
20403 Addendum Comment: 22638-1
20404 Addendum Pathologist: 19139-5

Test Classification

This test was developed and its performance characteristics 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.

Testing Algorithm

This test does not include a pathology consultation. If a pathology consultation is requested, 70012 / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge.