Integrated Oncology
 

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Flow Cytometry (Immunophenotyping by Flow)

Includes technical and professional components.

Characterization of hematopoietic cell populations, including leukemias and lymphomas using different cell surface and cytoplasmic antibodies. The technique allows for the lineage assignment of cells, maturational assessment of populations, detection of clonality, and detection of abnormal antigen expression of hematopoietic cells for diagnosis and monitoring of leukemia and lymphoma.

For additional antibodies, refer to our Antibody Library.


Comprehensive Leukemia/Lymphoma (for blood, bone marrow, spleen)

CPT Codes:

88184(1), 88185(23) (units of 88185 vary depending on the number of antibodies tested) and 88189(1)


CLL/SLL for Blood or Bone Marrow (includes ZAP 70, if indicated)

CPT Codes:

88184(1), 88185(17) (units of 88185 vary depending on the number of antibodies tested) and 88189(1)


Lymphoma - Tissue/Fluid (for fresh tissue, CSF or body fluid)

CPT Codes:

88184(1), 88185(18) (units of 88185 vary depending on the number of antibodies tested) and 88189(1)


Paroxysmal Nocturnal Hemoglobinuria (for blood only)
Note: Specimen most be processed within 72 hrs of being drawn

CPT Codes:

88184(1), 88185(7) (units of 88185 vary depending on the number of antibodies tested) and 88187(1)


Plasma Cell Dyscrasia - (Myeloma; for blood, bone marrow, spleen)

CPT Codes:

88184(1), 88185(16) (units of 88185 vary depending on the number of antibodies tested) and 88189(1)


 ZAP70 Expression – After CLL Diagnosis (for blood, bone marrow, fresh tissue or body fluid)

 

CPT Codes:

88184(1), 88185(3) (units of 88185 vary depending on the number of antibodies tested) and 88187(1)


Specimen Requirements:

  • A freshly prepared smear (blood or bone marrow) should accompany every case, for optimum interpretation of immunophenotypic results.
  • Internal studies have shown that ZAP-70 is a labile protein. Samples should be shipped on the day they are drawn.
  • For specimens not listed below, please contact our Client Services Department to determine if they may be acceptable.
  1. Peripheral Blood:
    • Peripheral blood can frequently yield diagnostic phenotypic data, even when automated and manual blood counts suggest that a circulating malignant cell population is a minority one, if present at all. Multi-parameter flow cytometric analysis/gating will focus the analysis on the population(s) of interest. The white blood count (WBC) is at best a rough guide to estimate circulating malignant cells. Generally, cells of interest are present in lower numbers in blood than in bone marrow, and collection volume must be adjusted accordingly.
    • 10-20 ml (minimum of 5 x 106 cell yield) in sodium heparin (green-top) tube; sodium heparin plus EDTA (lavendertop) tube for flow immunophenotyping. Cautionary Note: Lithium heparin also comes in a green-top collection tube. Do not collect in lithium heparin.
    • Provide smear and CBC results with specimen for flow immunophenotyping.
    • Refrigerate specimen. Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.
    • All specimens should be shipped to Integrated Oncology on the day of collection. Delay in shipping may compromise cell viability and results.
  2. Bone Marrow Aspirate:
    • If aspiration syringe requires internal pre-coating to prevent clotting, diluted citrate solution (coag. or blue- top tube) should be utilized. Do not send syringes. When collecting specimens to be used for immunophenotyping, pre-coating is recommended as imperceptible clots can compromise yield and interfere with optimal testing.
    • 2-3 ml aseptically aspirated (minimum of 5 x 106 cell yield) in sodium heparin (green-top) tube. Cautionary Note: Lithium heparin also comes in a green-top collection tubes. Do not collect in lithium heparin.
    • Provide bone marrow smear and CBC results with specimen for immunophenotyping.
    • Do not expose specimen to formalin or fixative fumes.
    • Refrigerate specimen. Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.
    • All specimens should be shipped to Integrated Oncology on the day of collection. Delay in shipping may compromise cell viability and results.
  3. Fresh Tissue Biopsy:
    • Two (2) pieces 0.2 cm x 0.2 cm x 0.2 cm (8-10 pieces preferred) in transport medium. Minimum of 5 X 106 cells. Do not use transport medium if it turns cloudy, yellow or is beyond the expiration date. Use only pink/orange color media.
    • Refrigerate specimen. Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.
    • All specimens should be shipped to Integrated Oncology on the day of excision. Delay in shipping may compromise cell viability and results.
  4. Body Fluids:
    • In order to ensure adequate cellularity for a comprehensive evaluation, a white blood count (WBC) should be performed on the specimen prior to sending for phenotyping. If the WBC and lymphocyte count are similar to that of the peripheral blood (5 x106 cells with 20 - 30% lymphocytes), 5-20 ml fluid will provide sufficient cells. The fluid volume should be adjusted upward proportionately if counts are lower.
    • Evacuated bottle or collection pouch.
    • 5-20 ml of fluid in 1:1 dilution of transport medium. Minimum of 5 X 106 cells. Do not use transport medium if it turns cloudy, yellow or is beyond the expiration date. Use only pink/orange color media.
    • Refrigerate specimen. Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.
    • All specimens should be shipped to Integrated Oncology on the day of collection. Delay in shipping may compromise cell viability and results.

Turnaround Time:

12-24 hours


Client Services: Oncology/Pathology   800-447-5816

Specimen Services/Pickup:  877-246-1226