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Test ID MSTF Myeloid Sarcoma, FISH, Tissue

Useful For

Supporting the diagnosis of myeloid sarcoma when coordinated with a surgical pathology consultation

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_I099 Interphases, 25-99 No, (Bill Only) No
_I300 Interphases, >=100 No, (Bill Only) No
_IL25 Interphases, <25 No, (Bill Only) No
_PADD Probe, +1 No, (Bill Only) No
_PB02 Probe, +2 No, (Bill Only) No
_PB03 Probe, +3 No, (Bill Only) No
_PBCT Probe, +2 No, (Bill Only) No

Testing Algorithm

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

 

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes 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. See Method Description for specific details.

 

The test panel includes analysis for the disease-associated abnormalities using the probes listed below:

t(8;21), [M2], RUNX1T1/RUNX1
t(11q23;var), [M0-M7], MLL (KMT2A)
inv(16), [M4, Eos], MYH11/CBFB
t(15;17), [M3], PML/RARA
t(9;22), BCR/ABL1

 

If the patient is being treated for known abnormalities, indicate which probes should be used.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

Myeloid Sarcoma, FISH, Ts

Specimen Type

Tissue


Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


A reason for referral and pathology report are required in order for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports.



Specimen Required


Specimen Type: Tissue

Preferred: 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: Slides

Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.


Specimen Minimum Volume

For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.
Include 1 hematoxylin and eosin (H and E)-stained slide.

Specimen Stability Information

Specimen Type Temperature Time Special Container
Tissue Ambient (preferred)
  Refrigerated 

Reference Values

An interpretive 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.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were 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

88291

88271 x 2 (if appropriate)

88271 x 2 (if appropriate)

88271 (if appropriate)

88271 x 2 (if appropriate)

88271 x 3 (if appropriate)

88274 w/modifier 52 (if appropriate)

88274 (if appropriate)

88275 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MSTF Myeloid Sarcoma, FISH, Ts In Process

 

Result ID Test Result Name Result LOINC Value
52084 Result Summary 50397-9
52086 Interpretation 69965-2
52085 Result Table 36908-2
54576 Result 62356-1
CG735 Reason for Referral 42349-1
CG736 Specimen 31208-2
52087 Source 31208-2
52088 Tissue ID 80398-1
52089 Method 49549-9
55121 Additional Information 48767-8
53839 Disclaimer 62364-5
52090 Released By 18771-6

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.