T-cell and NK-cell non-Hodgkin lymphomas (NHL) represent a small portion of the lymphomas diagnosed in the U.S.
Epidemiology
WHO Classification of Mature T- and NK-cell Neoplasms (2008)
Risk Factors
Clinical Presentation of Selected Lymphoma Subtypes (based on WHO classification)
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 in evaluation of lymphoma |
| Test name: Hepatic Function Panel |
| ARUP #: 0020416 |
| Methodology: Refer to individual components. |
| Use: Initial test in evaluation of lymphoma May provide prognostic information |
| Test name: Lactate Dehydrogenase, Serum or Plasma |
| ARUP #: 0020006 |
| Methodology: Quantitative Enzymatic |
| Use: Initial test in evaluation of lymphoma May provide prognostic information |
| Test name: Uric Acid, Serum or Plasma |
| ARUP #: 0020026 |
| Methodology: Quantitative Spectrophotometry |
| Use: Initial test in evaluation of lymphoma May provide prognostic information |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Whole Blood) |
| ARUP #: 0096299 |
| Methodology: Flow Cytometry |
| Use: Use for whole blood specimens to identify tumor cell populations, aid in selection of appropriate therapy and assessment of clinical behavior and prognosis T-cell antigens include CD1, CD2, CD3, CD4, CD5, CD7, CD8, TCR alpha-beta, TCR gamma-delta, cytoplasmic CD3, CD26 Other antigens include CD11c, CD16, CD25, CD30, CD34, CD38, CD41, CD42b, CD45, CD56, CD57, CD61, HLA-DR, glycophorin, TdT, bcl-2 |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Bone Marrow) |
| ARUP #: 0095244 |
| Methodology: Flow Cytometry |
| Use: Use for bone marrow specimens to identify neoplastic populations, aid in selection of appropriate therapy and assessment of clinical behavior and prognosis T-cell antigens include CD1, CD2, CD3, CD4, CD5, CD7, CD8, TCR alpha-beta, TCR gamma-delta, cytoplasmic CD3 Other antigens include CD11c, CD16, CD25, CD30, CD34, CD38, CD41, CD42b, CD45, CD56, CD57, CD61, HLA-DR, glycophorin, TdT, bcl-2 |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Miscellaneous) |
| ARUP #: 0095243 |
| Methodology: Flow Cytometry |
| Use: Use for fluid and tissues to identify tumor cell populations, aid in selection of appropriate therapy and assessment of clinical behavior and prognosis T-cell antigens include CD1, CD2, CD3, CD4, CD5, CD7, CD8, TCR alpha-beta, TCR gamma-delta, cytoplasmic CD3 B-cell antigens include CD10, CD19, CD20, CD22, CD23, CD103, kappa, lambda, FMC7, cytoplasmic kappa, cytoplasmic lambda Myelo/mono antigens include CD11b, CD13, CD14 (Mo2), CD14 (MY4), CD15, CD33, CD64, CD117, myeloperoxidase Other antigens include CD11c, CD16, CD25, CD30, CD34, CD38, CD41, CD42b, CD45, CD56, CD57, CD61, HLA-DR, glycophorin, TdT, bcl-2 |
| Test name: T-Cell Clonality by Flow Cytometry Analysis of TCR V-Beta |
| ARUP #: 0093199 |
| Methodology: Flow Cytometry |
| Use: Aid in further characterization of phenotypically abnormal T-cell populations identified by flow cytometry and determine whether monoclonality is present based on expression of T-cell antigen receptor beta chain variable regions (TCR V-Beta) |
| Test name: T-Cell Clonality Screening Assay by PCR, Fluid |
| ARUP #: 0055567 |
| Methodology: Polymerase Chain Reaction/Fragment Analysis |
| Use: Aid in identification and diagnosis of T-cell lymphomas |
| Limitations: "Not detected" result does not entirely exclude the presence of a T-cell receptor gamma rearrangement (or monoclonal T-cell population) in the sample "Not detected" PCR screening result should be terminally analyzed by restriction fragment Southern blot hybridization (RF-SBH) to definitively exclude T-cell monoclonality |
| Test name: T-Cell Clonality Screening Assay by PCR, Tissue |
| ARUP #: 0055568 |
| Methodology: Polymerase Chain Reaction/Fragment Analysis |
| Use: Aid in identification and diagnosis of T-cell lymphomas |
| Limitations: "Not detected" result does not entirely exclude the presence of a T-cell receptor gamma gene rearrangement (or monoclonal T-cell population) in the sample "Not detected" PCR screening result should be terminally analyzed by RF-SBH to definitively exclude T-cell monoclonality |
| Test name: T-Cell Clonality Assessment by Restriction Fragment-Southern Blot Hybridization, Tissue |
| ARUP #: 0055594 |
| Methodology: Restriction Fragment Southern Blot Hybridization |
| Use: Aid in identification and diagnosis of T-cell lymphomas Definitive confirmation of negative PCR T-cell clonality screening test Fixed tissue sample required |
| Test name: T-Cell Clonality Assessment by Restriction Fragment-Southern Blot Hybridization, Fluid |
| ARUP #: 0055596 |
| Methodology: Restriction Fragment Southern Blot Hybridization |
| Use: Aid in identification and diagnosis of T-cell lymphomas Definitely confirms negative PCR T-cell clonality |
| Limitations: Negative result does not entirely exclude the presence of a T-cell receptor gene rearrangement (or monoclonal T-cell population) in the sample |
| Test name: Human T-Lymphotropic Virus Types I/II Antibodies with Reflex to HTLV I/II Confirmation |
| ARUP #: 0051164 |
| Methodology: Qualitative Enzyme Immunoassay/Qualitative Western Blot |
| Use: Aid in diagnosis of adult T-cell leukemia/lymphoma |
| Test name: Epstein-Barr Virus Antibody to Early D Antigen (EA-D), IgG |
| ARUP #: 0050225 |
| Methodology: Semi-Quantitative Chemiluminescent Immunoassay |
| Use: Aid in diagnosis of NK-cell nasal-type lymphomas |
| Test name: CD2 by Immunohistochemistry |
| ARUP #: 2003505 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD1a by Immunohistochemistry |
| ARUP #: 2003502 |
| Methodology: Immunohistochemistry |
| Use: Aid in identifying some T-cell lymphoblastic lymphomas and leukemias Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD3 by Immunohistochemistry |
| ARUP #: 2003508 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD4 by Immunohistochemistry |
| ARUP #: 2003511 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD5 by Immunohistochemistry |
| ARUP #: 2003514 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD7 by Immunohistochemistry |
| ARUP #: 2003517 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD8 by Immunohistochemistry |
| ARUP #: 2003520 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD10 (CALLA) by Immunohistochemistry |
| ARUP #: 2003523 |
| Methodology: Immunohistochemistry |
| Use: Aid in identifying lymphoblastic lymphoma, Burkitt lymphoma, follicular lymphoma and CML; aids in differential diagnosis of small B-cell lymphomas and subtyping of lymphoblastic leukemias; helpful in angioimmunoblastic T-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD15, Leu M1 by Immunohistochemistry |
| ARUP #: 2003529 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD19 by Immunohistochemistry |
| ARUP #: 2005114 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic differential diagnosis of T/NK-cell leukemia/lymphoma 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 histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD23 by Immunohistochemistry |
| ARUP #: 2003541 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD25 by Immunohistochemistry |
| ARUP #: 2003544 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas 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 in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD34, QBEnd/10 by Immunohistochemistry |
| ARUP #: 2003556 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD43, L60 (Leu 22) by Immunohistochemistry |
| ARUP #: 2003568 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD56 (NCAM) by Immunohistochemistry |
| ARUP #: 2003589 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: CD57 by Immunohistochemistry |
| ARUP #: 2003592 |
| Methodology: Immunohistochemistry |
| Use: Aid in identifying NK lymphocyte-mediated cytotoxicity, NK and T-cell subset tumors and neural tissue neoplasms Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Ki-67, MIB-1, by Immunohistochemistry |
| ARUP #: 2004519 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas 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 in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: BF-1 by Immunohistochemistry |
| ARUP #: 2003466 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Muc-1 by Immunohistochemistry |
| ARUP #: 2004002 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: T-cell Intracytoplasmic Antigen (TIA-1) by Immunohistochemistry |
| ARUP #: 2004148 |
| Methodology: Immunohistochemistry |
| Use: Aid in differentiating T-cell leukemias and lymphomas from B-cell leukemias and lymphomas |
| Test name: TdT by Immunohistochemistry |
| ARUP #: 2004142 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of T/NK-cell lymphomas Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: B-Cell and T-Cell Clonality Assessment by PCR, Fluid |
| ARUP #: 0055610 |
| Methodology: Polymerase Chain Reaction |
| Comments: A “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: A “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: |
| Test name: B-Cell and T-Cell Comprehensive Clonality Assessment, Fluid |
| ARUP #: 0055612 |
| Methodology: Polymerase Chain Reaction/Restriction Fragment Southern Blot Hybridization |
| Comments: 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: Panel includes B-cell and T-cell screening assays and clonality assessment by restriction fragment southern blot hybridization testing |
| Test name: T-Cell Clonality Screening Assay by PCR, Paraffin |
| ARUP #: 0055631 |
| Methodology: Polymerase Chain Reaction/Fragment Analysis |
| Comments: |
| Test name: CD20, L26 by Immunohistochemistry |
| ARUP #: 2003532 |
| Methodology: Immunohistochemistry |
| Comments: |
| Test name: BCL-2 by Immunohistochemistry |
| ARUP #: 2004513 |
| Methodology: Immunohistochemistry |
| Comments: |