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1.6a - Flow Cytometry General Information

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Technical Director of Flow Cytometry
Dr. Hongbo Yu, MD 857-203-5898

BACL Flow Cytometry Laboratory Supervisors
West Roxbury Albert Filion 857-203-5942

Laboratory Telephones
West Roxbury 857-203-5942

West Roxbury Hours of Operation
Monday - Friday 6:00 AM to 3:00 PM
Weekends Closed
Holidays Closed


GENERAL INFORMATION
  1. Specimens sent from non-BACL sites are shipped via Quest courier and recorded on a LEDI manifest. The Flow Cytometry lab MUST BE NOTIFIED if a specimen is sent without being logged into LEDI. The date and time of collection must also be indicated if not logged into LEDI.
  2. Cutoff for specimen arrival in the Flow Cytometry laboratory is 12 noon on Friday and the day before a holiday.
  3. Peripheral blood, bone marrow, pleural effusion/ascites, bronchoalveolar lavage and CSF must be transported at room temperature. Lymph nodes will be transported with refrigerant pack (do not allow specimen to contact the pack). Blood preserved in Streck Cell Preservative reagent must be transported at 2-10°C. Streck Cyto-Chex BCT can be transported at room temperature, refrigerated is acceptable.
  4. Specimens should arrive within 24 hours of collection. Maximum stability of a flow cytometry specimen is 72 hours; however cell viability diminishes with time. Poor cell viability can limit the scope of testing. Blood preserved in Streck Cell preservative or Cyto-Chex BCT reagent has a stability of 7 days.
  5. Reflex Testing:  Flow Cytometry studies may  be added by pathologists after reviewing result from Hematology, Histology, or Cytology.
     

BAL CD4/CD8 (BRONCHOALVEOLAR LAVAGE ONLY)
Brief clinical history required. Panel= CD45, CD3+CD4+, CD3+CD8+,CD3, CD4/CD8 ratio. Transport at room temperature. Refrigeration is allowed. BAL samples should be placed in RPMI, if possiblie.

FULL LYMPHOCYTE ENUMERATION (BLOOD ONLY)
WBC and differential (performed on a concurrently collected EDTA tube) must accompany the specimen. Panel = Total T cells (CD3+), T helper (CD3+CD4+), T suppressor (CD3+CD8+), CD4/CD8 ratio, total B cells (CD19+) and NK (CD16+CD56+CD3-). Relative and absolute counts will be reported. Transport at room temperature. Refrigerate if aliquoted into Streck vial.

CD4/CD8 COUNT (BLOOD ONLY)
WBC and differential (performed on a concurrently collected EDTA tube) must accompany the specimen. Panel = Total T cells (CD3+), T helper (CD3+CD4+), T suppressor (CD3+CD8+) and CD4/CD8 ratio. Relative and absolute counts will be reported. Transport at room temperature unless in Streck Cell preservative. Refigerate if aliquoted into Streck vial.

FLOW: SPECIALTY ASSAY (SUSPECT LEUKEMIA, LYMPHOMA, DYSPLASIA, PLASMA CELL DYSCRASIA, CYTOPENIA, LYMPHOPROLIFERATIVE DISORDER)
Order as Flow: Specialty Assay and place r/o diagnosis in comments. Panel is customized based on patient clinical history, smear review by pathologist, and previous flow cytometric analysis performed at the BHS lab (if applicable).
WBC and differential (performed on a concurrently collected EDTA tube) must accompany the specimen. Panel = WBC, percent lymph, abs lymph, gate corrected and markers assayed. Yellow (ACD) or Lavender top tubes are acceptable. Transport at room temperature. Do NOT use Streck vial.

SPECIMENS
  1. Peripheral blood collected in ACD solution A tube (yellow top), 8.5 mL. WBC with differential (performed on a concurrently collected EDTA tube) must accompany the specimen. Include CBC histogram if available. Also submit 2 unstained smears prepared from the EDTA tube. If the EDTA tube is not needed by the sending site, please include with the other materials submitted. Transport at room temperature.
  2. Bone marrow collected in sodium heparin (green top) tube is preferred. Include history and 2 aspirate smears made from EDTA tube. Transport at room temperature.
  3. Fluids (not blood or bone marrow) can be collected in several ways. The volume to be submitted, the estimated cell concentration and the probability of clot formation are all factors. They are usually submitted without anticoagulant. If excessive fibrin may produce clumping (ascites, pleural) collect in ACD, EDTA or heparin tube. Include history and 2 wedge smears or cytospins. It is recommended that fluid samples be placed in RPMI. Transport at room temperature. Refrigeration is also allowed.
  4. Lymph node biopsies are examined by a surgical pathologist. If lymphoma is suspected, 2 air dried touch slides are made and should reflect the major cell distribution seen in the biopsy specimen. The specimen for flow cytometry should be placed in nutrient media (ex: RPMI-1640) and minced to maximize cell contact with the media. Under NO circumstances should this piece be fixed. If an additional piece is sent to the West Roxbury histology lab for analysis, please package the 2 separately. Lymph nodes will be transported with refrigerant pack (do not allow specimen to contact the pack).
  5. Fine needle aspirates (FNA) are most often referred to the flow cytometry lab after examination by cytology staff/pathologist. If lymphoma is suspected, aspirate should be place in nutrient media (ex. RPMI-1640). Include history and 2 cytospins. Transport at room temperature. Refrigeration is also allowed.


Test Code
Flow Cytometry



Last Updated: July 28, 2021


The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.