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HelpTest Code MSTF Myeloid Sarcoma, FISH, Tissue
Useful For
Supporting the diagnosis of myeloid sarcoma when coordinated with a surgical pathology consultation
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 does not include a pathology consult. If a pathology consultation is requested, PATHC / Pathology Consultation should be ordered, and the appropriate fluorescence in situ hybridization (FISH) test will be performed at an additional charge.
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.
The test panel includes analysis for the disease-associated abnormalities using the probes listed below:
t(8;21), [M2], RUNX1T1/RUNX1
t(11q23;var), [M0-M7], MLL (KMT2A)
inv(16), [M4, Eos], MYH11/CBFB
t(15;17), [M3], PML/RARA
t(9;22), BCR/ABL1
If the patient is being treated for known abnormalities, indicate which probes should be used.
Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
Myeloid Sarcoma, FISH, TsSpecimen Type
TissueShipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
A reason for referral and pathology report are required in order for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports.
Specimen Required
Specimen Type: Tissue
Preferred: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.
Acceptable: Slides
Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.
Specimen Minimum Volume
For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.
Include 1 hematoxylin and eosin (H and E)-stained slide.
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Tissue | Ambient (preferred) | ||
| Refrigerated | |||
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test 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 US Food and Drug Administration.CPT Code Information
88291
88271 x 2 (if appropriate)
88271 x 2 (if appropriate)
88271 (if appropriate)
88271 x 2 (if appropriate)
88271 x 3 (if appropriate)
88274 w/modifier 52 (if appropriate)
88274 (if appropriate)
88275 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MSTF | Myeloid Sarcoma, FISH, Ts | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 52084 | Result Summary | 50397-9 |
| 52086 | Interpretation | 69965-2 |
| 52085 | Result Table | 93356-4 |
| 54576 | Result | 62356-1 |
| CG735 | Reason for Referral | 42349-1 |
| CG736 | Specimen | 31208-2 |
| 52087 | Source | 31208-2 |
| 52088 | Tissue ID | 80398-1 |
| 52089 | Method | 85069-3 |
| 55121 | Additional Information | 48767-8 |
| 53839 | Disclaimer | 62364-5 |
| 52090 | Released By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.