Morphologic Evaluation
(Hematopathology Consultation)
Clinical Use
| • | Diagnose and classify benign and malignant hematological disorders (listed below) |
| • | Monitor effectiveness of therapy |
| • | Predict relapse |
| • | Detect progression |
Clinical Background
The diagnosis and classification of hematologic disorders, including leukemias and lymphomas, depends on a multiparameter approach, integrating morphologic evaluation with ancillary studies such as cytochemistry, immunohistochemistry, flow cytometry, cytogenetic, and molecular analyses. The hematopathology group at Quest Diagnostics Nichols Institute offers a comprehensive panel of immunohistological and chemical stains, flow cytometry, cytogenetic, and molecular studies that may help resolve difficult cases. Thorough evaluation of samples (bone marrow, lymph nodes, peripheral blood, other lymphoid tissues) is carried out by highly qualified hematopathologists and cytogeneticists.
Method
Along with the clinical history and laboratory data, bone marrow aspirate smears and H&E-stained bone marrow biopsy and clot sections are reviewed by a highly qualified hematopathologist. A preliminary diagnostic report is then issued, and the results are often discussed with the referring physician or pathologist by telephone. If additional studies (such as immunohistochemical stains) are felt necessary, but have not been requested by the referring physician or pathologist, we will consult with the referring physician/pathologist before performing such studies. (Additional tests are performed at an additional charge.) The case will be reviewed again when the ancillary studies are completed, and a final report will then be issued.
Specimen Requirements
Each specimen should be submitted with a requisition form along with the patient's name, social security number, brief clinical history or relevant laboratory results, and differential diagnosis. The name and the telephone number of the referring physician should be supplied. Any or all of the following materials may be submitted:
| • | Air-dried bone marrow aspirate smears or touch imprints (preferably 4 or more slides), unstained or stained with a Romanowsky stain, for morphologic review |
| • | Bone marrow aspirate material in a heparin-containing (green-top) tube for flow cytometry and cytogenetic studies |
| • | Bone marrow aspirate material in a lavender top, EDTA-containing tube, for flow cytometry and molecular studies and CBC (if results not submitted with the specimen) |
| • | Bone marrow trephine biopsy in a formalin container for morphologic review |
| • | Bone marrow clot in a formalin container for morphologic review |
| • | Peripheral blood smears |
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