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Test Mnemonic:
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FLOWPHENO
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Specimen Requirements:
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Collection:
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Peripheral blood: EDTA (Lavender-top tube) OR Sodium Heparin (Green-top tube).
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Bone Marrow aspirate: EDTA (Lavender-top tube) OR Sodium Heparin (Green-top tube).
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Lymph node or tissue biopsy: Placed in RPMI culture medium.
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Body fluid: Sterile container. If not performed the same day of collection transfer to RPMI culture medium.
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Fine Needle Aspirate (FNA): FNA collected in normal saline. If not performed the same day of collection transfer to RPMI culture medium.
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Minimum Volume:
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Peripheral blood: 4 ml
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Bone marrow aspirate: Depend on the cellularity of bone marrow; 1-2 ml of aspirate.
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Lymph node or tissue biopsy: There is no minimum volume. It is up to the discretion of the pathologist to proceed with the testing or not.
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Body fluid: it depends on the cellularity of the specimen, but a minimum of 10 ml is recommended.
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Fine Needle Aspirate (FNA): N/A. Cellularity of the FNA will determine the markers to be tested by pathologist.
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Storage/Transport:
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Peripheral blood: Samples are stored refrigerated (2-8°C).
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Bone marrow aspirate: Samples are stored at room temperature (18-22°C) OR refrigerated (2-8°C) is acceptable.
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Lymph node or tissue biopsy: Specimen in RPMI culture medium stored at 2-8°C.
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Body fluid: Stored at 2-8°C post collection.
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Fine Needle Aspirate (FNA): Process as soon as possible or add RPMI culture medium and store at 2-8°C.
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Specimen Preparation:
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Brief clinical history, provisional diagnosis and name/phone or beeper number of the provider should accompany the specimen or the order.
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Stability:
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Peripheral blood: Blood collected in EDTA is good up to 48 hours; while sodium heparin sample is good up to 72 hours.
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Bone marrow aspirate: Bone marrow collected in EDTA is good up to 48 hours; while sodium heparin sample is good up to 72 hours.
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Lymph node or tissue biopsy: Sample in RPMI stable up to 48 hours.
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Body fluid: Sample stable up to 48 hours.
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Fine Needle Aspirate (FNA): Samples in RPMI are stable up to 48 hours.
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Causes for Rejection:
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Sample Clotted.
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Sample QNS.
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Sample Hemolyzed.
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Unlabeled/mislabeled specimen.
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Specimen received on Saturday or Sunday (emergency cases on the weekend will be sent out to ARUP with the approval of the Hematopathology Director).
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Reference Range:
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By report (reports may vary based on instrumentation, patient age and sex)
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Turnaround Time:
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48-72 hours
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Methodology:
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Flow Cytometry
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Performed:
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Synonyms:
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Flow cytometry Immunophenotype
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Leukemia/Lymphoma Evaluation Panel
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Hematopoietic neoplasms monitoring
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Leukemia/Lymphoma immunophenotyping
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Clinical Indication:
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Flow cytometric leukemia and lymphoma testing may aid in identifying the tumor cell lineage for diagnostic and prognostic purposes. After review of the clinical history and morphology, a panel of markers is selected for each case by pathologist. In most cases the lineage can be identified as T-cell, B-cell, monocytic or myeloid and a diagnosis or differential diagnosis can be made.
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CPT 4 Code:
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88184 (first marker); 88185 (each additional marker)
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When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-10 code or its verbal equivalent.
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