Penn Medicine

How to Order a Test

Physicians at Penn Medicine

  • All inpatient orders require completion of a CPD Test Requisition Form.  Please submit the completed form with both blood and bone marrow specimens, or fax a copy of the requisition to 215-614-1988 or 215-898-9817 for all other requests.
  • All outpatient requests are available in EPIC as a special studies request on an APconsult orderable. After placing the order, a copy of the requisition must be printed and faxed to either 215-614-1988 or 215-898-9817. 
    • CPD Hematologic Malignancies Panel or
    • CPD Solid Tumor Sequencing Panel
  • For all requests, a qualified Pathologist will review the submitted or available material to ensure there is adequate tumor present.
  • Appropriate and adequate samples will be routed to the CPD for DNA extraction and NGS testing, with results to be returned within 14-21 days.

Physicians outside of Penn Medicine

Physicians outside the University of Pennsylvania Health Care System who are interested in the services of the CPD can contact the Laboratory directly.

Research Studies

Each of the panels is also available for order on research samples. Please contact the laboratory for additional information if you are interested in submitting samples for research analysis.

Common ICD-10 Codes

HEMATOLOGIC MALIGNANCY CODES
ICD-10 DIAGNOSIS
C95.00 ACUTE LEUKEMIA OF UNSPECIFIED CELL TYPE NOT HAVING ACHIEVED REMISSION
C91.00 ACUTE LYMPHOBLASTIC LEUKEMIA NOT HAVING ACHIEVED REMISSION
C92.50 ACUTE MYELOMONOCYTIC LEUKEMIA, NOT HAVING ACHIEVED REMISSION
C92.00 ACUTE MYELOBLASTIC LEUKEMIA, NOT HAVING ACHIEVED REMISSION
C92.40 ACUTE PROMYELOCYTIC LEUKEMIA, NOT HAVING ACHIEVED REMISSION
C91.10 CHRONIC LYMPHOCYTIC LEUKEMIA OF B-CELL TYPE NOT HAVING ACHIEVED REMISSION
C92.10 CHRONIC MYELOID LEUKEMIA, BCR/ABL-POSITIVE, NOT HAVING ACHIEVED REMISSION
C93.10 CHRONIC MYELOMONOCYTIC LEUKEMIA NOT HAVING ACHIEVED REMISSION
C85.80 OTHER SPECIFIED TYPES OF NON-HODGKIN LYMPHOMA, UNSPECIFIED SITE
C90.00 MULTIPLE MYELOMA NOT HAVING ACHIEVED REMISSION
SOLID TUMOR CODES
ICD-10 DIAGNOSIS
C34.90 MALIGNANT NEOPLASM OF UNSPECIFIED PART OF UNSPECIFIED BRONCHUS OR LUNG
C71.9 MALIGNANT NEOPLASM OF BRAIN, UNSPECIFIED
C43.9 MALIGNANT MELANOMA OF SKIN, UNSPECIFIED
C18.9 MALIGNANT NEOPLASM OF COLON, UNSPECIFIED
C50.919 MALIGNANT NEOPLASM OF UNSPECIFIED SITE OF UNSPECIFIED FEMALE BREAST
C25.9 MALIGNANT NEOPLASM OF PANCREAS, UNSPECIFIED
C73 MALIGNANT NEOPLASM OF THYROID GLAND

Specimen Requirements

  Bone Marrow Leukemic Blood Isolated Genomic DNA FFPE Tissue FNA Rinse
Hematologic Malignancies Panel X X X   X
Solid Tumor Sequencing Panel     X X X

CPD Hematologic Malignancies Panel (restricted to blood, bone marrow, isolated genomic DNA)

CPD Solid Tumor Sequencing Panel (optimized for formalin fixed paraffin embedded tissue)

Specimen Type: Bone Marrow

  • Requirements: 2-4 cc drawn in an EDTA (purple-top) tube.
  • Transport Conditions: Transport at ambient temperature (18-25°C/64-77°F) in an insulated container. Specimens should arrive in the laboratory within 48 hrs of collection. Do not freeze.

Specimen Type: Leukemic Blood

  • Requirements: 3-5 cc drawn in an EDTA (purple-top) tube. (White blood cell count > 10,000 cells/ml with at least 15% circulating blasts or malignant cells.)
  • Transport Conditions: Transport at ambient temperature (18-25°C/64-77°F) in an insulated container. Specimens should arrive in the laboratory within 48 hrs of collection. Do not freeze.

Specimen Type: Isolated Genomic DNA

  • Requirements: 20 μl at a minimum of 35 ng/μl determined by a fluorescent-based assay (i.e. Qubit, picogreen). All DNA received by the laboratory not meeting our quality control standards will not be tested.
  • Transport Conditions: Transport at ambient temperature (18-25°C/64-77°F) in an insulated container by overnight courier. Specimen should arrive in the laboratory within 48 hrs of collection.

Specimen Type: Formalin Fixed, paraffin embedded tissue

  • Requirements: Less than 50% tumor nuclei in sample:  10-15 unstained 5μm FFPE slides containing adequate amounts of tumor to be analyzed. Areas containing tumor must be marked on an adjacent H&E slide (outside cases). Greater than 50% tumor nuclei in sample: 6 to 9 rolls cut at 10 μm and placed in a 1.5 ml tube.  All samples must come with a corresponding H&E slide from the top and bottom of the sample.  Outside cases must include a copy of the surgical pathology report.  Specimens fixed or processed with alternative fixatives will result in DNA that fails QC and therefore will be rejected. Specimens containing less than 15% total tumor nuclei will also be rejected.
  • Transport Conditions: Transport at ambient temperature (18-25°C/64-77°F) in an insulated container by overnight courier. Do not heat or freeze.  Avoid direct exposure to light.

Specimen Type: Fine Needle Aspirate Rinse Material containing Malignancy (confirmed with on-site evaluation by Penn Medicine cytopathology or final interpretation)

  • Requirements: Minimum of 20 cc in PreservCyt vial prepared for potential molecular testing from Cytopathology sent within three weeks of original collection date. (Note, FNA cell blocks if adequate can be utilized longer than 3 weeks).
  • Transport Conditions: Transport at ambient temperature (18-25°C/64-77°F). Do not freeze. Specimens can only be used within three weeks of original collection date.

Specimen Type: Malignant Effusions, Liquid

  • Requirements: Minimum of 20 cc in PreservCyt vial prepared for potential molecular testing from Cytopathology sent within three weeks of original collection date. (Note, a malignant effusion cell block if adequate can be utilized longer than 3 weeks; follow formalin fixed, paraffin embedded tissue specimen type).
  • Transport Conditions: Transport at ambient temperature (18-25°C/64-77°F). Do not freeze. Specimens can only be used within three weeks of original collection date.

Cytopathology

For cytology samples, FNA rinses, body fluids, and cell blocks can be used. FNA rinses can yield better-quality DNA for the full solid tumor panel as well as quicker turnaround times. For any specimen type where a full solid tumor panel cannot be performed, the Penn Precision Panel (PPP) will be attempted as determined by CPD.

The PPP will test for 20 commonly mutated genes in many solid tumors even in samples of frequent low or poor quality DNA yield. This extremely targeted panel can be used to reflex samples that have insufficient DNA yield, to run on larger panels with as little as 250 picogram input DNA and can be performed on a range of cytology specimens, including FNA rinse specimens, as well as limited biopsy specimens. PPP results show the same rate of abnormal results as the larger, full panel with high-quality DNA.

References and Resources

*My Cancer Genome is a website managed by the Vanderbilt-Ingram Cancer Center which gives users up-to-date information on what mutations are present in cancers and the related therapeutic implications. This site also links to available clinical trials for mutations featured. Learn more at: http://www.mycancergenome.org/

Questions & Information:

Call 800-PENN-LAB