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Orderable Name SLL Small Lymphocytic Lymphoma, FISH, Tissue


Ordering Guidance


This test does not include a pathology consultation. If a pathology consultation is requested, order PATHC / Pathology Consultation and the appropriate fluorescence in situ hybridization test (FISH) test will be added and performed at an additional charge.

 

Mayo Hematopathology consultants are involved in both the preanalytic (tissue adequacy and probe selection, when applicable) and postanalytic (interpretation of FISH results in context of specific case, when applicable) phases.

 

This test is not appropriate for testing blood and bone marrow from patients with chronic lymphocytic leukemia. If a non-paraffin embedded bone marrow or blood sample is received for this test, the test will be canceled and automatically reordered by the laboratory as CLLDF / Chronic Lymphocytic Leukemia (CLL), Diagnostic FISH, Varies or CLLMF / Chronic Lymphocytic Leukemia (CLL), Specified FISH, Varies.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


1. A pathology report is required for testing to be performed. If not provided, appropriate testing and/or interpretation may be compromised or delayed. Acceptable pathology reports include working drafts, preliminary pathology, or surgical pathology reports.

2. The following information must be included in the report provided:

-Patient name

-Block number-must be on all blocks, slides, and paperwork

-Date of collection

-Tissue source

3. A reason for testing must be provided. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

4. A list of probes is required if select probes are necessary or if the patient is being tracked for known abnormalities. See Table in Clinical Information.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Tissue block

Collection Instructions:

1. Submit a formalin-fixed, paraffin-embedded tumor tissue block. Blocks prepared with alternative fixation methods will be attempted but are less favorable for successful results.

2. Provide fixation method used.

Additional Information:

1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).

2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.

 

Acceptable:

Specimen Type: Tissue slides

Slides: 1 Hematoxylin and eosin stained and 2 unstained for each probe set

Collection Instructions:

1. Include 1 hematoxylin and eosin-stained slide for the entire test order.

2. If individual probe sets are chosen: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.

3. If a complete small lymphocytic lymphoma (SLL) panel is ordered, submit 14 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.


Useful For

Detecting, at diagnosis, recurrent common chromosome abnormalities in patients with small lymphocytic lymphoma (SLL) in paraffin-embedded tissue specimens

 

Distinguishing patients with 11;14 translocations who have mantle cell lymphoma from patients who have SLL

 

Detecting patients with atypical SLL with translocations between IGH and BCL3

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_PRAG Probe, Each Additional (SLL) No, (Bill Only) No

Testing Algorithm

This test includes a charge for the probe application, analysis, and professional interpretation of results for one probe set (2 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets 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.

 

This test may be ordered in 2 distinct ways allowing different combinations of probes to be analyzed based on the clinical question.

1. Standard (diagnostic) small lymphocytic lymphoma (SLL) FISH panel

2. Individual SLL FISH probes chosen, per client request, from probes listed below

 

If individual SLL FISH probes are needed, the specific probes requested must be noted on the request form or in the reason for referral. If no FISH probes are indicated, the standard (diagnostic) panel will be performed.

 

The standard (diagnostic) SLL FISH panel includes testing for the following abnormalities using the FISH probes listed:

6q-, D6Z1/MYB probe set

11q-, D11Z1/ATM probe set

+12, D12Z3/MDM2 probe set

13q-, D13S319/LAMP1 probe set

17p-, TP53/D17Z1 probe set

t(11;14)(q13;q32) or IGH::CCND1 fusion, CCND1/IGH probe set

 

Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes used will have the results included within the final report and will be performed at an additional charge. In the following situations, additional (reflex) testing may be performed at the laboratory's discretion and may be influenced by available karyotype results or other FISH testing.

 

In the absence of IGH::CCND1 fusion, when an extra IGH signal is identified, testing using the IGH/BCL3 probe set may be performed to identify a potential IGH::BCL3 fusion, t(14;19)(q32;q13).

 

In the absence of IGH::CCND1 fusion, when an extra or atypical CCND1 signal is identified, testing using the CCND1 break-apart probe set may be performed to identify a potential variant translocation involving CCND1, t(11;var)(q13;?).

Method Name

Fluorescence In Situ Hybridization (FISH)

Specimen Type

Tissue

Specimen Minimum Volume

See Specimen Required.

Specimen Stability Information

Specimen Type Temperature Time
Tissue Ambient (preferred)
  Refrigerated 

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Friday

Report Available

7 to 10 days

CPT Code Information

88377-if 1 probe set

88377 x 2-if 2 probe sets

88377 x 3-if 3 probe sets

88377 x 4-if 4 probe sets

88377 x 5-if 5 probe sets

88377 x 6-if 6 probe sets

88377 x 7-if 7 probe sets

88377 x 8-if 8 probe sets

Forms

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