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B-cell non-Hodgkin lymphomas (NHL) represent a heterogenous group of malignancies of the lymphoid system.
Tests generally appear in the order most useful for common clinical situations
| Test name: CBC with Platelet Count & Automated Differential |
| ARUP #: 0040003 |
| Methodology: Automated Cell Count with Flow Cell Differential |
| Use: Initial test to evaluate lymphoma May provide prognostic information |
| Test name: Hepatic Function Panel |
| ARUP #: 0020416 |
| Methodology: Refer to individual components. |
| Use: Initial test to evaluate lymphoma May provide prognostic information |
| Test name: Lactate Dehydrogenase, Serum or Plasma |
| ARUP #: 0020006 |
| Methodology: Quantitative Enzymatic |
| Use: Initial test to evaluate lymphoma May provide prognostic information |
| Test name: Uric Acid, Serum or Plasma |
| ARUP #: 0020026 |
| Methodology: Quantitative Spectrophotometry |
| Use: Initial test to evaluate lymphoma May provide prognostic information |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Whole Blood) |
| ARUP #: 0096299 |
| Methodology: Flow Cytometry |
| Use: Identify specific phenotypes associated with B-cell NHL; establish tumor lineage to aid in selection of appropriate therapy, assessment of clinical behavior and prognosis Available antigens for B-cell: CD10, CD19, CD20, CD22, CD23, CD103, kappa, lambda, FMC7, cytoplasmic kappa, cytoplasmic lambda |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Bone Marrow) |
| ARUP #: 0095244 |
| Methodology: Flow Cytometry |
| Use: Identify specific phenotypes associated with B-cell NHL; establish tumor lineage to aid in selection of appropriate therapy, assessment of clinical behavior and prognosis Available antigens for B-cell: CD10, CD19, CD20, CD22, CD23, CD103, kappa, lambda, FMC7, cytoplasmic kappa, cytoplasmic lambda |
| Test name: IGH-BCL2 (BCL-2/JH) Translocation, t(14;18) by PCR, Fluid |
| ARUP #: 0055616 |
| Methodology: Polymerase Chain Reaction |
| Use: Identify characteristic translocation of most follicular lymphomas and many diffuse large B-cell lymphomas (DLBCL) Detect a majority of BCL2/JH rearrangements |
| Test name: IGH-BCL2 (BCL-2/JH) Translocation, t(14;18) by PCR, Tissue |
| ARUP #: 0055619 |
| Methodology: Polymerase Chain Reaction |
| Use: Identify characteristic translocation of most follicular lymphomas and many DLCBL Detect a majority of BCL2/JH rearrangements |
| Limitations: Some breakpoints occurring at distant loci will not be identified |
| Test name: Acute Lymphocytic Leukemia (ALL) Panel by FISH, Pediatric |
| ARUP #: 2002719 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Identify presence of genetic abnormalities characteristic of pediatric B-cell ALL; should be performed in conjunction with routine cytogenetic analysis Helpful for diagnosis, prognosis and monitoring disease progression and response to therapy Probes include ETV6-RUNX1, BCR-ABL, E2A, CEP4, CEP10, CEP17, MLL |
| Test name: Acute Lymphocytic Leukemia (ALL) Panel by FISH, Adult |
| ARUP #: 2002647 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Identify presence of genetic abnormalities characteristic of adult B-cell ALL; should be performed in conjunction with routine cytogenetic analysis Helpful for diagnosis, prognosis and in monitoring disease progression and response to therapy Probes include BCR-ABL1, MLL, E2A, IGH, MYC |
| Test name: IGH-BCL2 Fusion, t(14;18) by FISH |
| ARUP #: 2001536 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Determine presence of BCL2-IGH, t(14;18) [bcl-2/JH] chromosomal translocation in NHL in paraffin-embedded tissues to support diagnosis of follicular lymphoma |
| Test name: IGH-MYC Fusion t(8;14) by FISH |
| ARUP #: 2001538 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Determine presence of MYC translocations in Burkitt lymphoma (BL) and other NHL in paraffin-embedded tissues |
| Test name: MYC (8q24) Gene Rearrangement by FISH |
| ARUP #: 2002345 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Diagnose BL Presence of t(8q;24) rearrangement strongly supports diagnosis of BL |
| Test name: Lymphoma (Aggressive) Panel by FISH |
| ARUP #: 2002650 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Identify dual- or triple-hit lymphomas; provides prognostic information for patients with B-cell lymphomas with features intermediate between DLBCL and BL Probes in this panel include MYC, BCL6, and IGH-BCL2 Fresh tissue sample required |
| Limitations: Detects only specific aberrations in chromosomes of interest for diagnosis and prognosis Chromosome alterations outside regions complementary to these probes will not be detected |
| Test name: Chromosome FISH, Interphase |
| ARUP #: 2002298 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Detect translocation recurrent in some NHL Fresh tissue sample required Indicate names of probes needed for testing |
| Test name: IGH-CCND1 (BCL-1/JH) Translocation, t(11;14) by PCR, Tissue |
| ARUP #: 0055564 |
| Methodology: Polymerase Chain Reaction |
| Use: Determine presence of IGH-CCND1 t(11;14)(q13; q32) in fixed tissue to support the diagnosis of mantle cell lymphoma |
| Test name: IgVH Mutation Analysis by Sequencing |
| ARUP #: 0040227 |
| Methodology: Polymerase Chain Reaction/Sequencing |
| Use: Determine CLL prognosis Results should always be correlated with morphologic and clinical information |
| Limitations: Assay designed for individuals with a confirmed diagnosis of CLL; for these individuals testing will include sequencing; all other diagnoses will terminate after amplification and will not have the sequencing component |
| Test name: ZAP-70 Analysis by Flow Cytometry |
| ARUP #: 0092392 |
| Methodology: Flow Cytometry |
| Use: Determine CLL prognosis Results should always be correlated with morphologic and clinical information |
| Test name: Chromosome FISH, CLL Panel |
| ARUP #: 2002295 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Determine CLL prognosis; specific genomic abnormalities tested include ATM deletion, 13q deletion, trisomy 12, TP53 deletion |
| Test name: IGH-CCND1 Fusion, t(11;14) by FISH |
| ARUP #: 0049381 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Identify characteristic IGH-CCND1 t(11;14) translocation of mantle cell lymphomas Fixed tissue sample required |
| Test name: IGH-CCND1 (BCL-1/JH) Translocation, t(11;14) by PCR, Fluid |
| ARUP #: 0055557 |
| Methodology: Polymerase Chain Reaction |
| Use: Identify characteristic IGH-CCND1 t(11;14) translocation of mantle cell lymphomas |
| Test name: IGH-BCL2 (BCL-2/JH) Translocation, t(14;18) by PCR, Paraffin |
| ARUP #: 0055625 |
| Methodology: Polymerase Chain Reaction |
| Use: Identify characteristic translocation of most follicular lymphomas and many DLBCL Fixed tissue sample required |
| Test name: Cyclin D1, SP4 by Immunohistochemistry |
| ARUP #: 2003842 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Pax-5 by Immunohistochemistry |
| ARUP #: 2004082 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Ki-67 Tissue Assay, Paraffin |
| ARUP #: 0049270 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: MUM1/IRF4 by Immunohistochemistry |
| ARUP #: 2003975 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Herpes Virus 8 by Immunohistochemistry |
| ARUP #: 2003932 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of multicentric Castleman disease, angioimmunoblastic lymphadenopathies, and Kaposi sarcoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Anaplastic Lymphoma Kinase 1 (ALK-1) by Immunohistochemistry |
| ARUP #: 2003439 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD3 by Immunohistochemistry |
| ARUP #: 2003508 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD5 by Immunohistochemistry |
| ARUP #: 2003514 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD10 (CALLA) by Immunohistochemistry |
| ARUP #: 2003523 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of lymphoblastic lymphoma, BL, follicular lymphoma, and CML Aid differential diagnosis of small B-cell lymphomas and subtyping of lymphoblastic leukemias Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD19 by Immunohistochemistry |
| ARUP #: 2005114 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell leukemia/lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD20, L26 by Immunohistochemistry |
| ARUP #: 2003532 |
| Methodology: Immunohistochemistry |
| Use: Aid in identifying common acute lymphoblastic leukemia, pre-B ALL, CLL, prolymphocytic leukemia, hairy cell leukemia, lymphoma cell leukemia, B-cell lymphomas, including BL, Waldenstrom, and immunoblastic B-cell Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD21 (Dendritic Cell) by Immunohistochemistry |
| ARUP #: 2003535 |
| Methodology: Immunohistochemistry |
| Use: Aid in identifying B-cell CLL, follicular lymphoma, low-grade MALT-type B-cell lymphoma, primary salivary gland and gastric lymphoma, T-cell and histiocyte-rich B-cell lymphoma, angioimmunoblastic T-cell lymphoma, nodular lymphocyte-predominant Hodgkin lymphoma, follicular dendritic sarcoma and some Reed-Sternberg cells not expressing other B- or T-cell-associated markers Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD23 by Immunohistochemistry |
| ARUP #: 2003541 |
| Methodology: Immunohistochemistry |
| Use: Aid in differentiating small lymphocytic lymphoma (+) and mantle cell lymphoma (-) Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD25 by Immunohistochemistry |
| ARUP #: 2003544 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD30 (Ki-1) by Immunohistochemistry |
| ARUP #: 2003547 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD79A by Immunohistochemistry |
| ARUP #: 2003800 |
| Methodology: Immunohistochemistry |
| Use: Aid in identifying acute leukemia of precursor B-cell type, B-cell lymphomas and some myelomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD138 (Syndecan-1) by Immunohistochemistry |
| ARUP #: 2003812 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: BCL-2 by Immunohistochemistry |
| ARUP #: 2004513 |
| Methodology: Immunohistochemistry |
| Use: Aids in identifying colorectal adenomas, carcinomas; distinguishes follicular lymphoma from reactive follicles Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: BCL-6 by Immunohistochemistry |
| ARUP #: 2003457 |
| Methodology: Immunohistochemistry |
| Use: Aid in identifying large cell lymphomas, BL, and Hodgkin lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Kappa Light Chains by Immunohistochemistry |
| ARUP #: 2003981 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Lambda Light Chains by Immunohistochemistry |
| ARUP #: 2003984 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Tartrate-Resistant Acid Phosphatase (TRAP) by Immunohistochemistry |
| ARUP #: 2004160 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: TdT by Immunohistochemistry |
| ARUP #: 2004142 |
| Methodology: Immunohistochemistry |
| Use: Aid histologic diagnosis of B-cell lymphoma Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: B-Cell CD20 Expression |
| ARUP #: 0092099 |
| Methodology: Flow Cytometry |
| Comments: |
| Test name: B-Cell Clonality Screening Assay by PCR, Fluid |
| ARUP #: 0055552 |
| Methodology: Polymerase Chain Reaction |
| Comments: For confirmation, order B-Cell Clonality Assessment by Restriction Fragment Souther Blot Hybridization, Fluid |
| Test name: B-Cell Clonality Screening Assay by PCR, Paraffin |
| ARUP #: 0055626 |
| Methodology: Polymerase Chain Reaction |
| Comments: |
| Test name: B-Cell Clonality Screening Assay by PCR, Tissue |
| ARUP #: 0055556 |
| Methodology: Polymerase Chain Reaction |
| Comments: For confirmation, order B-Cell Clonality Assessment by Restriction Fragment Souther Blot Hybridization, Tissue |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Miscellaneous) |
| ARUP #: 0095243 |
| Methodology: Flow Cytometry |
| Comments: |
| Test name: B-Cell Clonality Assessment by Restriction Fragment Southern Blot Hybridization, Fluid |
| ARUP #: 0055592 |
| Methodology: Restriction Fragment Southern Blot Hybridization |
| Comments: |
| Test name: B-Cell Clonality Assessment by Restriction Fragment-Southern Blot Hybridization, Tissue |
| ARUP #: 0055590 |
| Methodology: Restriction Fragment Southern Blot Hybridization |
| Comments: |
| Test name: Chromosome Analysis, Bone Marrow |
| ARUP #: 2002292 |
| Methodology: Giemsa-Band Analysis |
| Comments: Identify neoplastic populations in marrow |
| Test name: B-Cell and T-Cell Clonality Assessment by PCR, Fluid |
| ARUP #: 0055610 |
| Methodology: Polymerase Chain Reaction |
| Comments: “Not detected” result does not entirely exclude the presence of a monoclonal population in the sample Further confirmation of PCR results may be determined by restriction fragment Southern blot hybridization; this test is not automatically performed unless stipulated |
| Test name: B-Cell and T-Cell Clonality Assessment by PCR, Tissue |
| ARUP #: 0055611 |
| Methodology: Polymerase Chain Reaction |
| Comments: Use B-cell tests listed above for known B-cell disease “Not detected” result does not entirely exclude the presence of a monoclonal population in the sample Further confirmation of PCR results may be determined by restriction fragment Southern blot hybridization; this test is not automatically performed unless stipulated |
| Test name: B-Cell and T-Cell Clonality Assessment by PCR, Paraffin |
| ARUP #: 0055627 |
| Methodology: Polymerase Chain Reaction |
| Comments: Use B-cell tests listed above for known B-cell disease |
| Test name: B-Cell and T-Cell Comprehensive Clonality Assessment, Fluid |
| ARUP #: 0055612 |
| Methodology: Polymerase Chain Reaction/Restriction Fragment Southern Blot Hybridization |
| Comments: Use B-cell tests listed above for known B-cell disease Panel includes B-cell and T-cell screening assays and clonality assessment by restriction fragment southern blot hybridization testing |
| Test name: B-Cell and T-Cell Comprehensive Clonality Assessment, Tissue |
| ARUP #: 0055613 |
| Methodology: Polymerase Chain Reaction/Restriction Fragment Southern Blot Hybridization |
| Comments: Use B-cell tests listed above for known B-cell disease Panel includes B-cell and T-cell screening assays and clonality assessment by restriction fragment southern blot hybridization testing |
| Test name: B Cell Specific Octamer Binding Protein-1 (BOB-1) by Immunohistochemistry |
| ARUP #: 2003442 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: Caspase-3 by Immunohistochemistry |
| ARUP #: 2003496 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: CD15, Leu M1 by Immunohistochemistry |
| ARUP #: 2003529 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: CD43, L60 (Leu 22) by Immunohistochemistry |
| ARUP #: 2003568 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: CD45 by Immunohistochemistry |
| ARUP #: 2003574 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: Hairy Cell Leukemia, DBA.44 by Immunohistochemistry |
| ARUP #: 2003860 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: Octamer Transcription Factor-2 (Oct 2) by Immunohistochemistry |
| ARUP #: 2004061 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: Hepatitis B Virus Core Antibodies (Total) |
| ARUP #: 0020091 |
| Methodology: Qualitative Chemiluminescent Immunoassay |
| Comments: Identify HBV status if considering rituximab therapy |
| Test name: Hepatitis B Virus Surface Antigen, Confirmation |
| ARUP #: 0020128 |
| Methodology: Chemiluminescent Immunoassay |
| Comments: Identify HBV status if considering rituximab therapy |
| Test name: Hepatitis C Virus Antibody by CIA |
| ARUP #: 2002483 |
| Methodology: Qualitative Chemiluminescent Immunoassay |
| Comments: Identify HCV status of at-risk patients if considering rituximab therapy |
| Test name: Cytomegalovirus, Quantitative PCR |
| ARUP #: 0051813 |
| Methodology: Quantitative Polymerase Chain Reaction |
| Comments: Follow patients with history of CMV for reactivation during alemtuzumab therapy |
| Test name: Human Immunodeficiency Virus Types 1 and 2 (HIV-1, HIV-2) Antibodies with Reflex to Human Immunodeficiency Virus Type 1 (HIV-1) Antibody Confirmation by Western Blot |
| ARUP #: 2005377 |
| Methodology: Qualitative Chemiluminescent Immunoassay/Qualitative Western Blot |
| Comments: Use for at-risk patients |