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Test Code Flow LLI Leukemia/Lymphoma Immunophenotyping

Useful For

Please see the Flow Cytometry Flow Chart for ordering instructions
Evaluating lymphocytosis/leukocytosis 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

Patient Preparation

No special patient preparation required

Collection Method

  • Venous collection
  • Bone Marrow Aspirate
  • Fine Needle Aspirate
  • Tissue Biopsy
  • Lumbar Puncture
  • Thoracentesis
  • Paracentesis

Minimum Volume

Blood 4 mL
Other specimens Dependent on cellularity

Container

Purple (EDTA)

Preferred Specimen

  • Whole blood
  • Bone marrow in Na Heparin
  • CSF neat
  • Tissue RPMI
  • Fluid added EDTA
  • FNA RPMI

Acceptable Specimens

  • Venous collection: Purple, Pink (EDTA)
  • Bone Marrow Aspirate: Dark Green (Na Heparin)
  • CSF
  • Pleural Fluid
  • Other fluid, ascites, etc
  • Fine Needle Aspirate and Tissue collections in RPMI

Critical Value

As determined by pathologist

Reasons for Rejection



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Hemolysis Threshold
 N/A
Icterus Threshold
 N/A
Lipemia Threshold
 N/A
Other
 QNS, contaminated, improperly labled, improper specimen type, specimen clotted, specimens that have added fixative

Specimen Stability



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Ambient
 96 hours
Refrigerated (4°C to 8°C)
 96 hours
Frozen(-40°C to 0°C)
 N/A

Performance Information



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Days and Time Performed
 Monday – Friday 9AM – 5PM
Saturday 8AM – 12PM
Expected Turn Around Time
 72 hours
Stat Availabilty
 On-Call service available for Acute cases
Performing Bench
 Flow Cytometry
Methodology/Method Description
 BD FACSCanto II – Immunophenotyping. The triage panel is initially performed to evaluate for monotypic B cells by kappa and lambda light chain expression, increased numbers of blast cells by CD34 and CD45 expression along with side scatter gating, and increased plasma cells by CD45 expression and side scatter gating. The triage panel also includes antibodies to assess the number of CD3-positive T cells and CD16-positive/CD3-negative natural killer (NK) cells present. This triage panel also determines if there is an increase in the number of T cells that aberrantly coexpress CD16, an immunophenotypic feature of T-cell granular lymphocytic leukemia. This panel, together with the provided clinical history and morphologic review, is used to determine what, if any, additional testing is needed for disease diagnosis or classification. If additional testing is required, it will be added per the algorithm to fully characterize a disease state with a charge per unique antibody tested.

Special Handling

DO NOT FIX.
CSF specimens collected after hours should have an equal volume of
RPMI added.
CSF, fluids, fine needle aspirates, and tissue containers should be placed in the Flow Cytometry refrigerator.

CPT Codes

88184; 88185 (units vary)

Reflex Testing

This panel, together with the provided clinical history and morphologic review, is used to determine what, if any, additional testing is needed for disease diagnosis or classification. If additional testing is required, it will be added per the algorithm to fully characterize a disease state with a charge per unique antibody tested. If no abnormalities are detected by the initial panel, no further flow cytometric assessment will be performed unless otherwise indicated by specific features of the clinical presentation or prior laboratory results.