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Flow Cytometry Studies - BAL

Mnemonic

ATTN FLOW – FLOW CYTOMETRY STUDIES-BAL

Synonym

ATTN FLOW - Flow Cytometry Studies - BAL - F LYMREQ - BAL Lymphoma Protocol - BAL R/O Lymphoma - BAL: CD4/CD8 Ratio

Guidelines

CD4:CD8 Ratio:  This test is designed for enumerating the percent of T-Cell lymphocyte subsets in BAL. The CD4/CD8 ratio is calculated by dividing the CD4 percent by the CD8 percent.

Lymphoma Protocol is designed to aid in the diagnosis and subcategorization of suspected or known lymphoma or chronic lymphoid leukemia.

Specimen Collection Requirements

Collect

15.0 -30.0 mL BAL fluid in sterile container.

Handling

Maintain specimens at ambient temperature (20-25°C), avoid temperature extremes and do not centrifuge. Call Client Services ASAP at (503) 413-1234 or Toll Free (877) 270-5566 to arrange for PRIORITY pickup.

Specimen should be received within 24 hours of collection for optimal cell viability

For complete collection and handling guidelines see Cytogenetics/Flow Cytometry/FISH Specimens for Leukemia, Lymphoma and Other Oncology Referrals

Preferred Volume

15.0 mL BAL fluid in sterile container.

Minimum Volume

5.0 mL BAL fluid in sterile container.

Transport

Ambient (20-25°C)

Rejection Criteria

Grossly mucoid, full of bacteria, frozen or fixed specimens.

 

Specimen rejection: ONLY by Flow Cytometry personnel after consultation with the Hematopathologist.

Stability

Stability (collection to initiation of testing): Ambient (20°-25°C): 24 hours; Refrigerated: Acceptable 24 hours; Frozen: Unacceptable; Fixed: Unacceptable

Testing Information

Note

Flow cytometric leukemia and lymphoma analysis may aid in identifying the tumor lineage for diagnostic and prognostic purposes. After review of the clinical history and morphology, a panel of markers is selected for each case by a board-certified pathologist. In most cases, the lineage can be identified as T-cell, B-cell, or myeloid and a diagnosis or differential diagnosis can be made. 

Available Markers*:

T-cell:
CD2, CD3, CD4, CD5, CD7, CD8, Cytoplasmic CD3
B-cell:
CD10, CD19, CD20, CD22, CD23, CD103, Kappa, Lambda, Cytoplasmic Kappa, Cytoplasmic Lambda


*Not all markers will be reported in all cases.
Requests for specific markers to be run must be listed on manual requisition or by footnote for electronic orders. We do not offer individual marker identification separately outside of the markers in this panel.

A comprehensive flow cytometric Leukemia/Lymphoma assessment of BAL, 4-14 or more markers; At the discretion of the pathologist, limited-cellularity samples will be triaged, and an appropriate number of markers will be run due to the irreplaceable nature of these samples. Limited-cellularity samples typically include a minimum number of markers (e.g., 4-14 markers).

The report will include a pathologist interpretation and a marker interpretation range corresponding to CPT codes of 2-8 markers, 9-15 markers, and 16+ markers interpreted. Charges apply per marker.

 

Remarks: A minimum of 10,000 viable cells is required for flow cytometry phenotyping of samples containing a very limited number of markers (may also be called antibodies or antigens). For low-count specimens, supplying clinical and diagnostic
information is especially important to help ensure that the most appropriate marker combinations are evaluated before the specimen is depleted of cells.


Provide specimen source, clinical history, differential diagnosis, and any relevant pathology reports.


Follow up: If previous leukemia/lymphoma phenotyping was performed at another lab, the outside flow cytometry report and histograms (if possible) should accompany the specimen.

Performed

Monday-Friday (0800-1630)

Reported

Monday-Friday except holidays, 24-48 hours from receipt in Flow Lab

Method

Flow Cytometry

Reference Values

Reference Values

Interpretation provided

CPT Codes

88184, 88185, 88189

Last Updated: Friday, January 15, 2021 01:46:36 AM


Client Services: 503-413-1234