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HelpTest ID: TLPF T-Cell Lymphoma, FISH, Varies
Useful For
Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various T-cell lymphomas
Tracking known chromosome abnormalities and response to therapy in patients with T-cell lymphoma
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 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.
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal T-cells are available for FISH testing. If the result does not identify a sufficient clonal T-cell population, this FISH test order will be canceled and no charges will be incurred.
If FISH testing proceeds, probes will be performed based on the lymphoma subtype suspected/identified utilizing the table located in Clinical Information.
If the patient is being tracked for known abnormalities, indicate which probes should be used.
The following probe sets are available within the T-cell lymphoma FISH profile:
14q32.1 rearrangement, TCL1A
/i(7q)/ -7/7q-, D7S486/D7Z1
+8, D8Z2/MYC
If T-cell prolymphocytic leukemia/lymphoma (T-PLL) is indicated, TCL1A rearrangement is performed, with reflex to the TRAD FISH probe if TCL1A is negative,
See Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm in Special Instructions.
Special Instructions
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
T-cell Lymphoma, FISH, B/BMSpecimen Type
VariesAdvisory Information
This assay detects chromosome abnormalities observed in the blood or bone marrow of patients with T-cell lymphoma.
-For testing paraffin-embedded tissue samples from patients with T-cell lymphoma, see TLYM / T-Cell Lymphoma, FISH, Tissue.
-For patients with T-cell acute lymphoblastic leukemia/lymphoma, order TALLF / T-Cell Acute Lymphoblastic Leukemia [T-ALL], FISH, Varies.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. Provide a reason for referral with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.
2. A pathology or flow cytometry report may be requested by the Genomics Laboratory to optimize testing and aid in interpretation of results.
Specimen Required
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Bone marrow
Container/Tube: Green top (sodium heparin)
Specimen Volume: 1-2 mL
Collection Instructions: Invert several times to mix bone marrow.
Acceptable:
Specimen Type: Blood
Container/Tube: Green top (sodium heparin)
Specimen Volume: 7-10 mL
Collection Instructions: Invert several times to mix blood.
Specimen Minimum Volume
Blood: 2 mL
Bone Marrow: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Clinical Information
T-cell neoplasms are relatively uncommon, accounting for approximately 12% of all non-Hodgkin lymphomas. There are several subtypes of T-cell neoplasms: T-cell acute lymphoblastic leukemia (T-ALL), T-cell prolymphocytic leukemia (T-PLL), T-cell large granular lymphocytic leukemia (T-LGL), anaplastic large cell lymphoma (ALCL), peripheral T-cell lymphoma, and various other cutaneous, nodal, and extranodal lymphoma subtypes.
There are a few common chromosome abnormalities associated with specific T-cell lymphoma subtypes evaluated by this FISH test, as follows:
|
Common Chromosome Abnormalities in T-cell Lymphomas |
||
|
Lymphoma Subtype |
Chromosome Abnormality |
FISH Probe |
|
T-cell prolymphocytic leukemia/lymphoma (T-PLL) |
inv(14)(q11q32) and t(14;14)(q11;q32) |
5'/3'TCL1A |
|
Reflex: 14q11.2 rearrangement |
5'/3'TRAD |
|
|
Hepatosplenic T-cell lymphoma |
Isochromosome 7q |
D7S486/D7Z1 |
|
Trisomy 8 |
D8Z2/MYC |
|
These probes have diagnostic relevance and can also be used to track response to therapy.
Reference Values
An interpretive report will be provided.
Interpretation
A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for any given probe.
Detection of an abnormal clone supports a diagnosis of a T-cell lymphoma. The specific abnormality detected may help subtype the neoplasm.
The absence of an abnormal clone does not rule out the presence of neoplastic disorder.
Clinical Reference
1. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Edited by SH Swerdlow, et al. IARC, Lyon 2017
2. Gesk S, Martin-Subero JI, Harder L, et al: Molecular cytogenetic detection of chromosomal breakpoints in T-cell receptor gene loci. Leukemia 2003;17:738-745
3. Chin M, Mugishima H, Takamura M, et al: Hemophagocytic syndrome and hepatosplenic (gamma)(delta) T-cell lymphoma with isochromosome 7q and 8 trisomy. J Pediatr Hematol Oncol 2004;26(6):375-378
Day(s) and Time(s) Performed
Specimens processed Monday through Sunday.
Results reported Monday through Friday, 8 a.m.-5 p.m.
Analytic Time
7 daysTest 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
88271x2, 88291-DNA probe, each (first probe set), Interpretation and report
88271x2-DNA probe, each; each additional probe set (if appropriate)
88271x1-DNA probe, each; coverage for sets containing 3 probes (if appropriate)
88271x2-DNA probe, each; coverage for sets containing 4 probes (if appropriate)
88271x3-DNA probe, each; coverage for sets containing 5 probes (if appropriate)
88274 w/modifier 52-Interphase in situ hybridization, <25 cells, each probe set (if appropriate)
88274-Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)
88275-Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TLPF | T-cell Lymphoma, FISH, B/BM | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 52009 | Result Summary | 50397-9 |
| 52011 | Interpretation | 69965-2 |
| 52010 | Result Table | 93356-4 |
| 54566 | Result | 62356-1 |
| CG719 | Reason for Referral | 42349-1 |
| CG720 | Specimen | 31208-2 |
| 52012 | Source | 31208-2 |
| 52013 | Method | 49549-9 |
| 55118 | Additional Information | 48767-8 |
| 53849 | Disclaimer | 62364-5 |
| 52014 | Released By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
mml-lymphoid-disorders