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Test Code SLL Small Lymphocytic Lymphoma, FISH, Tissue


Ordering Guidance


This test does not include a pathology consultation. If a pathology consultation is requested, order PATHC / Pathology Consultation and the appropriate fluorescence in situ hybridization test (FISH) test will be added and performed at an additional charge.

 

Mayo Hematopathology consultants are involved in both the preanalytic (tissue adequacy and probe selection, when applicable) and postanalytic (interpretation of FISH results in context of specific case, when applicable) phases.

 

This test is not appropriate for testing blood and bone marrow from patients with chronic lymphocytic leukemia. If a non-paraffin embedded bone marrow or blood sample is received for this test, the test will be canceled and automatically reordered by the laboratory as CLLDF / Chronic Lymphocytic Leukemia (CLL), Diagnostic FISH, Varies or CLLMF / Chronic Lymphocytic Leukemia (CLL), Specified FISH, Varies.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


1. A pathology report is required for testing to be performed. If not provided, appropriate testing and/or interpretation may be compromised or delayed. Acceptable pathology reports include working drafts, preliminary pathology, or surgical pathology reports.

2. The following information must be included in the report provided:

-Patient name

-Block number-must be on all blocks, slides, and paperwork

-Date of collection

-Tissue source

3. A reason for testing must be provided. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

4. A list of probes is required if select probes are necessary or if the patient is being tracked for known abnormalities. See Table in Clinical Information.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Tissue block

Collection Instructions:

1. Submit a formalin-fixed, paraffin-embedded tumor tissue block. Blocks prepared with alternative fixation methods will be attempted but are less favorable for successful results.

2. Provide fixation method used.

Additional Information:

1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).

2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.

 

Acceptable:

Specimen Type: Tissue slides

Slides: 1 Hematoxylin and eosin stained and 2 unstained for each probe set

Collection Instructions:

1. Include 1 hematoxylin and eosin-stained slide for the entire test order.

2. If individual probe sets are chosen: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.

3. If a complete small lymphocytic lymphoma (SLL) panel is ordered, submit 14 consecutive, unstained, 5 micron-thick sections placed on positively charged slides.


Useful For

Detecting, at diagnosis, recurrent common chromosome abnormalities in patients with small lymphocytic lymphoma (SLL) in paraffin-embedded tissue specimens

 

Distinguishing patients with 11;14 translocations who have mantle cell lymphoma from patients who have SLL

 

Detecting patients with atypical SLL with translocations between IGH and BCL3

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_PRAG Probe, Each Additional (SLL) No, (Bill Only) No

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

SLL, FISH, Tissue

Specimen Type

Tissue

Specimen Minimum Volume

See Specimen Required.

Specimen Stability Information

Specimen Type Temperature Time
Tissue Ambient (preferred)
  Refrigerated 

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Small lymphocytic lymphoma (SLL) is the nonleukemic form of chronic lymphocytic leukemia (CLL), one of the most common leukemias in adults. The most frequently seen cytogenetic abnormalities in SLL involve chromosomes 6, 11, 12, 13, and 17. These are detected and quantified using the SLL fluorescence in situ hybridization (FISH) panel.

 

Cytogenetics has proven to be a reliable predictor of outcome for patients with CLL. It is unknown if SLL has the same prognostic significance when these genetic abnormalities are observed.

 

This FISH test detects an abnormal clone in approximately 65% of patients with SLL. Patients with t(11;14)(q13;q32) associated with IGH::CCND1 fusion, have mantle cell lymphoma which can be distinguished from SLL and other B-cell lymphomas with this assay. Patients with t(14;19)(q32;q13.3) associated with IGH::BCL3 fusion, may have an atypical form of SLL or another B-cell lymphoma.

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Friday

Report Available

7 to 10 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

88377-if 1 probe set

88377 x 2-if 2 probe sets

88377 x 3-if 3 probe sets

88377 x 4-if 4 probe sets

88377 x 5-if 5 probe sets

88377 x 6-if 6 probe sets

88377 x 7-if 7 probe sets

88377 x 8-if 8 probe sets

Forms

If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.