TABLE 17-8.

Ancillary Diagnostic Testing in Lymphoma and Leukemia

Presenting Complaint	Best Site to Test	Best Test(s) to Use
Lymphoma, confirmed, need phenotype	Lymph node	Flow cytometry, IHC, ICC
Lymphoma, suspect, equivocal cytology/histology	Lymph node or involved organ	PARR
Lymphocytosis or leukemia	Peripheral blood	Flow cytometry, ICC
Rare suspicious cells in the peripheral blood, no lymphocytosis	Peripheral blood	PARR
Splenomegaly, equivocal cytology/histology	Spleen	PARR
Mass or aspirate with cells of unclear origin	Mass	IHC, ICC, Flow cytometry if cellular; PARR if not
Lymphocyte rich effusion	Effusion fluid	Flow cytometry, IHC, ICC

IHC, Immunohistochemistry; ICC, immunocytochemistry; PARR, PCR for antigen receptor rearrangements.