University of Iowa
Diagnostic Laboratories
(UIDL) Test Directory

319-384-7212 (local)
1-866-844-2522 (toll free)


Chronic Lymphocytic, Prolymphocytic, or Hairy Cell Leukemia

Order Form: Flow Cytometry Requisition
Specimen:
Various
Collection Medium:
Yellow top tube (ACD solution A)
Alternate
Collection Media:
Green top tube (Na Heparin), Lavender top tube (EDTA)
Minimum:
Adult
Peripheral Blood: 10 ml; Bone Marrow:  2-4 mL yellow top tube (ACD 
solution A)

Pediatric
Peripheral Blood:  2-5 mL; Bone Marrow:  2-5 mL lavender top tube 
(EDTA) or green top tube (Na Heparin).

Fluids and Tissue: Dispense sample into vial of RPMI-1640 tissue 
culture media.
Testing
Schedule:
0800-1630 Monday through Friday.
Analytic Time:
2 days
Reference Range:
Antibodies routinely included are: CD2, CD3, CD5, CD10, CD11c, CD14, 
CD19, CD20, CD22, CD23, CD25, CD38, CD45, CD103, CD138, FMC7, Heavy 
chains, Kappa and Lambda. Antibodies will also identify cases of 
Prolymphocytic and Hairy Cell Leukemia.

If clinical or morphologic features suggest a "T" or "NK" lymphocyte 
disorder, then the following additional antibody combinations are 
performed: CD3/CD4/CD8, CD7/CD5/HLA-DR, CD14/CD45, CD25/CD2/CD3, 
CD16/CD56/CD19, CD57/CD8/CD3, TCR alpha-beta/delta-gamma/CD3.

The pathologist will provide an interpretative report.
Comments:
Please state the clinical question to be answered on the requisition. 
Maintain the specimen at room temperature; do not refrigerate or 
incubate.

Please print, complete and submit the Advance Beneficiary Notice 
(ABN) along with the Flow Cytometry Requisition before shipping the 
specimen.
Methodology:
Flow Cytometry-Whole Blood Lysis
Sample
Processing:
Relevant clinical information must be submitted with specimen in order 
to provide correct interpretation of test results.
Specimen should be collected and packaged as close to shipping time as 
possible.
Sample
Storage:
Ambient or Room Temperature.
Transport
Instructions:
Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Ship at ambient temperature.
Recommend express mail or equivalent if not on courier service.
CPT Code:
88184, 88185(x20) technical; 88189 professional; T cell or NK cell 
disorder: 88184, 88185(x15) technical; 88188 professional
 
See Additional Information:
Flow Cytometry Consultation Overview

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Updated: 03/03/2009