Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

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assessment of blood smears, bone marrow smears, and tissue sections remains the cornerstone of
lymphoma and leukemia diagnosis and classification, immunophenotyping is a very valuable and
important complementary tool. Immunophenotyping hematopoietic specimens can help resolve many
differential diagnostic problems posed by the clinical or morphologic features.
Useful For: Evaluating lymphocytoses of undetermined etiology Identifying B- and T-cell
lymphoproliferative disorders involving blood and bone marrow Distinguishing acute lymphoblastic
leukemia (ALL) from acute myeloid leukemia (AML) Immunologic subtyping of ALL Distinguishing
reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma Distinguishing between
malignant lymphoma and acute leukemia Phenotypic subclassification of B- and T-cell chronic
lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and
hairy cell leukemia Recognizing AML with minimal morphologic or cytochemical evidence of
differentiation Recognizing monoclonal plasma cells
Interpretation: Report will include a morphologic description, a summary of the procedure, the
percent positivity of selected antigens, and an interpretive conclusion based on the correlation of the
clinical history with the morphologic features and immunophenotypic results.
Reference Values:
When performed, an interpretive report will be provided.
This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic
findings and correlation with the morphologic features will be provided by a Hematopathologist.
Clinical References: 1. Hanson CA, Kurtin PJ, Katzman JA, et al: Immunophenotypic analysis of
peripheral blood and bone marrow in the staging of B-cell malignant lymphoma. Blood
1999;94:3889-3896 2. Hanson CA: Acute leukemias and myelodysplastic syndromes. In Clinical
Laboratory Medicine. Edited by KD McClatchey. Baltimore, MD, Williams & Wilkins, Inc, 1994, pp
939-969 3. Morice WG, Leibson PJ, Tefferi A: Natural killer cells and the syndrome of chronic natural
killer cell lymphocytosis. Leuk Lymphoma 2001;41(3-4):277-284 4. Langerak, van Den Beemd,
Wolvers-Tettero, et al: Molecular and flow cytometric analysis of the Vbeta repertoire for clonality
assessment in mature TCR alpha beta T-cell proliferations. Blood 2001;98(1):165-173
Hematopathology Consultation
Clinical Information: Diagnostic hematopathology has become an increasingly complex
subspecialty, particularly with neoplastic disorders of blood and bone marrow. The clinical, therapeutic,
and prognostic features of these disorders are often distinctive, while the pathologic features are quite
subtle, requiring the application of ancillary studies (eg, cytochemistry, immunohistochemistry, flow
cytometric immunophenotyping, cytogenetics, and molecular genetics) to establish a diagnosis.
Furthermore, these ancillary studies are expensive, labor intensive, and are most efficiently utilized and
interpreted in the context of the morphologic features. It is the Division of Hematopathology's goal to
provide the highest possible level of diagnostic consultative service, trying to balance optimal patient
care with a cost-conscious approach to solving difficult diagnostic problems. All blood and bone
marrow studies are available within the context of a hematopathology consultation. Requests for
specific ancillary tests, including enzyme cytochemical stains, immunocytochemistry (slide
immunophenotyping), and immunohistochemistry are not available through Mayo Medical Laboratories
as individually ordered tests, but rather in association with a consultation. If the Mayo consultant would
approach the diagnosis in a different way than the referring physician, then the Mayo consultant will
call the referring physician to discuss the case prior to performing any additional studies. Referring
physicians are welcome to suggest which specific ancillary studies should be performed, but before they
are done, a morphologic review by one of the Mayo consulting staff hematopathologists will confirm
the diagnostic problem presented by the morphologic differential diagnosis. The following algorithms
are available in Special Instructions: -Myeloproliferative Neoplasm: A Diagnostic Approach to Bone
Marrow Evaluation -Myeloproliferative Neoplasm: A Diagnostic Approach to Peripheral Blood
Evaluation -Laboratory Approach to the Diagnosis of Amyloidosis
Useful For: Obtaining a rapid, expert second opinion on specimens referred by the primary
pathologist Obtaining special studies not available locally Note: If the need for special studies is
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