Test ID 60506 Cutaneous Anaplastic Large Cell Lymphoma, 6p25.3 (IRF4) Rearrangement, FISH, Tissue
Reporting NameIRF4, 6p25.3, FISH
Providing potential prognostic information in patients with documented systemic anaplastic lymphoma kinase-negative anaplastic large cell lymphoma
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.
Fluorescence In Situ Hybridization (FISH)
Performing LaboratoryMayo Medical Laboratories in Rochester
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.
Forms: If not ordering electronically, submit a Hematopathology/Molecular Oncology Request Form (Supply T241) with the specimen.
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.
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
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.
Test ClassificationThis 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.
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|
|20390||Ref Path/Phys Address||74221-3|
|20400||SP Signing Pathologist:||N/A|
|20401||*Previous Report Follows*||N/A|