University of Iowa
Diagnostic Laboratories
(UIDL) Test Directory

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


Lymphoma Panel
Order Form: Flow Cytometry Requisition
Specimen:
Peripheral Blood, Bone Marrow, Fresh Lymph Node, Fine Needle Aspirate, or Body Fluids NOS
Alternate
Collection Media:
Green top tube (Na Heparin)
Minimum:
Adult and Pediatric; Peripheral Blood: 10ml; yellow top tube.

Adult and Pediatric; Bone Marrow or Body Fluid; 2-5ml; Green top tube 
(Na Heparin) or heparinized syringe (use approximately 1000 units).

Fluids and Tissue: Dispense sample into vial of RPMI-160 tissue culture 
media. RPMI-1640 minimizes cell death in such specimens, especially if 
processing cannot be done within 48 hours of collection.
Testing
Schedule:
0800-1630 Monday through Friday.
Analytic Time:
2 days
Reference Range:
Antibodies routinely included are: (CD2, CD3, CD4, CD5, CD8, CD10, 
CD14, CD19, CD20, CD23, CD45, Kappa, Lambda

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, CD25/CD2/CD3, CD16/CD56/CD19, 
CD57/CD8/CD3, TCR alpha-beta/delta-gamma/CD3.

The pathologist will provide an interpretative report.
Comments:
Please print, complete and submit the Advance Beneficiary Notice 
(ABN) along with the Flow Cytometry Requisition before shipping the 
specimen.

Please state the clinical question to be answered on the requisition. 
Maintain the specimen at room temperature; do not refrigerate or 
incubate.

CPT Codes Technical:     88184 x1 and 88185 x12
CPT Codes Professional:  88188 - 26
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:
See comments
 
See Additional Information:
Flow Cytometry Consultation Overview

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Updated: 11/03/2005