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Test Code LAB8643 Amyloid Protein Identification, Paraffin, Mass Spectrometry

Additional Codes

AMPIP,


Ordering Guidance


This test should only be ordered on patients for whom a primary diagnosis has already been established. If a patient does not have a primary diagnosis, order PATHC / Pathology Consultation or refer to the Pathology Consultation Ordering Algorithm.

 

If a pathology consultation is desired in addition to this test, order PATHC / Pathology Consultation alone and send the required paperwork with specimen. Indicate that amyloid protein identification is desired. If needed, this test will be added by the reviewing pathologist and will be reported with the consultation. For more information see PATHC / Pathology Consultation.



Shipping Instructions


Attach the green pathology address label included in the kit to the outside of the transport container.



Necessary Information


1. Preliminary pathology report and history are required.

2. Include performed Congo red slide

3. A brief explanatory note or consultative letter is also recommended.



Specimen Required


Specimen Type: Formalin-fixed or B5-fixed paraffin-embedded tissue block

Collection Instructions:

1. Do not send fixed tissue slides for testing. Testing can only be done on paraffin-embedded tissue blocks.

2. If Congo red stain has already been performed, send Congo red stained slide along with the tissue block.


Secondary ID

620247

Useful For

Definitive identification of amyloid proteins

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
MLCPC Microdissection, Laser Capture No, (Bill Only) No
MSPTC Mass Spectrometry No, (Bill Only) No

Testing Algorithm

In all cases with adequate tissue, an initial Congo red stain is performed before mass spectrometry testing to confirm positivity, and the pattern of amyloid deposition can be considered when interpreting mass spectrometry results.

 

In some instances, per pathologist discretion, a different initial Congo red stain may be performed using SS2PC / Special Stain, Group II, Other (Bill Only).

-If the stain is negative for amyloid, then this test will not be performed, and only the SS2PC will be charged.

-If the stain is positive for amyloid, this test will be performed, and the SS2PC billing charge will be credited.

 

A pathology consultation is typically not required. If the amyloid subtyping results do not fit the clinical findings, PATHC / Pathology Consultation may be added if appropriate, upon client approval.

 

For more information see Amyloidosis: Laboratory Approach to Diagnosis.

Method Name

Histological Stain/Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Specimen Type

AMYLOID
Medical University of South Carolina Note:

    On-campus collections: Send in  Pathology Packaging Kit (T554), Ambient
 
Off-campus collections: Centrifuge and aliquot within ___ minutes/hours.  N/A
Specimen to be stored/transported at Ambient temp. 

Specimen Stability Information

Specimen Type Temperature Time Special Container
AMYLOID Ambient (preferred)
  Refrigerated 

Reject Due To

Fixed tissue slides
Wet/frozen tissue
Cytological smears
Nonformalin fixed tissue
Nonparaffin embedded tissue		 Reject

Interpretation

An interpretation will be provided.

Method Description

Affected areas are removed from paraffin-embedded tissues by laser microdissection. Protein digestion is performed, followed by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)

Day(s) Performed

Monday through Friday

Report Available

7 to 15 days

Specimen Retention Time

Submitted block: Not retained; Congo red-stained slides performed at Mayo Clinic: Indefinitely

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

88313

82542 (if appropriate)

88380 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
AMPIP Amyloid Protein ID, Par, LC MS/MS 101405-9

 

Result ID Test Result Name Result LOINC Value
71185 Interpretation 50595-8
71186 Participated in the Interpretation No LOINC Needed
71187 Report electronically signed by 19139-5
71189 Material Received 81178-6
71592 Disclaimer 62364-5
72109 Case Number 80398-1

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Cardiovascular Test Request (T724)

-Hematopathology/Cytogenetics Test Request (T726)

-Renal Diagnostics Test Request (T830)

Reference Values

An interpretive report will be provided.