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• October 2018: Changes to ASPIGG, GAL3, HV6ABS, LIDO, & PROPA Testing

  Several upcoming changes to our test directory will affect multiple tests. Please refer to the information below for details.

• QuantiFERON-TB Gold Plus (QTB-Plus) 4-Tube Assay

  Effective September 12, CCL will convert to the QuantiFERON-TB Gold Plus (QTB-Plus) 4-Tube Assay for Mycobacterium tuberculosis testing.

• August 2018: Changes to ADRENL & RICKGM Testing

  Effective September 10, Rickettsia Antibodies IgG & IgM (RICKGM) will be discontinued. Adrenal Antibody (ADRENL) will have several changes.

• Pathology Insights – Lung Granulomas Caused by Fungal Infection with Sanjay Mukhopadhyay, MD

  Not all lung nodules are malignant. In this video, Dr. Mukhopadhyay compares two cases of lung granulomas caused by fungal infection.

• MGMT Pyrosequencing Methylation Assay for Glioblastoma

  Recent studies confirm the presence of MGMT promoter methylation corresponds to a likelihood that tumor cells would respond to temozolomide.

• June 2018: Changes to Cyanide, Blood (CYANID) Testing

  Effective August 15, 2018, Cyanide, Blood (CYANID) will implement changes affecting transport temperature, reference ranges, and more.

• Pathology Insights – Lung Cancer or Metastasis to Lung? with Sanjay Mukhopadhyay, MD

  Can metastases to the lung occur from cancers that were treated several years ago? Dr. Mukhopadhyay discusses.

• BCR / ABL p210 Quantitative RT-PCR Assay

  Modern therapy for chronic myloid leukemia has resulted in effective therapeutic options for patients and a need for effective monitoring.

• April 2018: Changes to Chemistry Tests

  Effective April 17, 2018, there will be changes to the build, reference ranges, and special/clinical information to several chemistry tests.

• Pathology Insights – Basics of Thymic Pathology with Sanjay Mukhopadhyay, MD

  What are the differences between normal thymic tissue and thymoma? Learn the basics in this brief overview with Sanjay Mukhopadhyay, MD.

• April 2018: Upcoming Test Changes

  Beginning in April 2018, there will be several test changes, discontinuations, and additions. Questions? Please contact Client Services.

• Pathology Insights – Challenging Cutaneous Spindle Cell Tumors with Steven Billings, MD

  Steven Billings, MD covers a set of challenging cutaneous spindle cell tumors, emphasizing a practical approach and key histologic features.

• Heparin Anti Xa Assay (HEPASY), PTT Incubated Mixing Study (PTTIM)

  Updates to Heparin Anti Xa Assay (HEPASY), PTT Incubated Mixing Study (PTTIM) testing are effective as of February 22, 2018.

• FLT3 Mutation Detection by PCR (FLT3MD)

  Effective February 5, 2018, FLT3 Mutation Detection by PCR (FLT3MD) testing will no longer accept specimens in a lithium heparin tube.

• February 2018: Polio Testing Update

  Effective on March 12, 2018, Poliovirus (Types 1, 3) Antibodies, IFA (POLIO) will be discontinued. We suggest ordering Polio Neutralization.

• December 2017: Changes to Chemistry Testing Go-Live Dates

  Due to unforeseen circumstances, the go-live dates for the following tests will be delayed until the indicated date.

• Pathology Insights – Atypical Epithelial Cells with Sanjay Mukhopadhyay, MD

  Sanjay Mukhopadhyay, MD discusses another unusual case of interstitial lung disease involving atypical epithelial cells.

• November 2017: Changes to Vitamin B12 (B12) Testing

  Effective December 7, 2017, Vitamin B12 (B12) Testing will include changes to ambient specimen stability and reference ranges.

• January 2018: Changes to Allergen Testing

  Effective January 4, 2018, changes to individual allergen and panel specimen volume, collection container, and stability will go into effect.

• Pathology Insights – Nonspecific Interstitial Pneumonia (NSIP) with Sanjay Mukhopadhyay, MD

  Sanjay Mukhopadhyay, MD explains the differences between Usual Interstitial Pneumonia and Nonspecific Interstitial Pneumonia.

• Pathology Insights – Issues With Esophageal Biopsies with John Goldblum, MD

  In this episode, Dr. John Goldblum, Chair of Anatomic Pathology at Cleveland Clinic, discusses cases focused on Barrett's esophagus.

• Pathology Insights – Smoking-Related Interstitial Fibrosis with Sanjay Mukhopadhyay, MD

  Sanjay Mukhopadhyay, MD presents a case of a relatively recent form of interstitial fibrosis known as Smoking-Related Interstitial Fibrosis.

• Chromogranin A (CHROMA)

  Due to reagent shortage, Chromogranin A testing was recently discontinued. CCL will send testing to a different lab using a different assay.

• August 2017: Changes to Citrate, Urine 24 Hour (UCITD)

  Effective October 2, 2017, Citrate, Urine 24 Hour (UCITD) will incorporate changes affecting specimen stability and reference ranges.

• Whole Genome Single Nucleotide Polymorphism Microarray Testing

  Analysis of single nucleotide polymorphism data provides information about allelic imbalances associated with the absence of heterozygosity.

• Pathology Insights – Orthopaedic Pathology: Osteoblastic Lesions with Scott Kilpatrick, MD

  Scott Kilpatrick, MD, Director of Orthopaedic Pathology, discusses osteoblastic lesions, which can be challenging to diagnose.

• Pathology Insights – Medical Kidney Pathology with Leal Herlitz, MD

  Dr. Leal Herlitz, Director of Medical Kidney Pathology, discusses an interesting renal pathology case received at Cleveland Clinic.

• Pathology Insights – Diagnosing Lung Cancer on Small Specimens with Jordan Reynolds, MD

  Dr. Jordan Reynolds discusses how pathologists at Cleveland Clinic diagnose lung cancer on small specimens.

• Pathology Insights – Well-Differentiated Lipomatous Tumors with John Goldblum, MD

  Dr. John Goldblum, Chair of Pathology at Cleveland Clinic, discusses one of the most common consults to the soft tissue pathology service.

• Detection and Typing of HSV-1 and HSV-2 in Cerebrospinal Fluid (CSF) by Polymerase Chain Reaction

  Rapid diagnosis of HSV meningitis/meningoencephalitis is important to direct therapy and minimize the suffering in affected patients.

• Chromosomal Single Nucleotide Polymorphism (SNP) Microarray for Hematology on Bone Marrow

  Cleveland Clinic Laboratories uses a cancer-specific microarray designed by the CCMC that targets associated genomic regions.

• Lipoprotein (a) in Serum

  Lipoprotein (a) in serum testing evaluates coronary artery disease risk associated with elevations of the atherogenic lipoprotein (a).

• Testing for Heparin-Induced Thrombocytopenia

  It is critical that HIT is recognized early so that patients can be alternatively anticoagulated and avoid further exposure to heparin.

• Stool Culture for Yersinia

  Yersinia enterocolitica can cause foodborne disease, but at a much lower incidence; consequently, most laboratories do not routinely look for this pathogen.

• OSOM® Trichomonas Rapid Test

  This FDA-approved, CLIA-waived test offers a simple, inexpensive option for the diagnosis of Trichomonas infection.

• Mixing Study, Incubated Activated Partial Thromboplastin Time (APTT)

  APTT is a commonly used test to investigate bleeding patients, monitor anticoagulant therapy, and screen patients before surgery.

• Legionella pneumophila by Real-Time PCR

  This test only detects L. pneumophila, as Legionella species other than L. pneumophila infrequently cause legionellosis.

• Hepatitis C Virus Genotyping

  Pre-treatment analysis of hepatitis C genotype determines the duration of therapy and predicts therapeutic response.

• Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in Urine, Endocervical, Vaginal, and Urethral Specimens

  Rapid and sensitive methods for laboratory diagnosis have been developed, making it reasonable to test for both agents simultaneously.

• Antiphospholipid Antibody Testing (Lupus Anticoagulant Testing)

  Antiphospholipid syndrome (APS) is the most common cause of acquired thrombophilia. Diagnosis of APS is made by clinicopathologic evaluation.

• CALR Mutation Detection

  Cleveland Clinic Laboratories offers a sensitive PCR assay for the detection of CALR mutations in blood, marrow, or FFPE tissues.

• MYD88 L265P Mutation Detection

  MYD88 L265P mutation testing is useful in the evaluation of small B-cell neoplasms, especially those with plasmacytic differentiation.

• ADAMTS13 Evaluation for Thrombotic Thrombocytopenic Purpura (TTP)

  Reduced or absent ADAMTS13 activity can trigger intravascular platelet aggregation causing signs of thrombotic thrombocytopenic purpura.

• Hypercoagulability / Thrombophilia Testing

  The Hypercoagulation Diagnostic Interpretive Panel evaluates congenital or acquired disorders associated with a hypercoagulable state.

• D-Dimer to Rule Out Venous Thromboembolism

  The D-dimer assay offers a rapid, non-invasive, inexpensive in vitro method to rule out venous thromboembolism, DVT, or pulmonary embolism.

• Collagen Binding Activity Assay for von Willebrand Disease

  Accurate diagnosis and classification are crucial because the biological activity of VWF determines hemorrhagic risk and clinical management.

• High-Sensitivity Flow Cytometry for Paroxysmal Nocturnal Hemoglobinuria

  This test may be useful to evaluate intravascular hemolysis, unexplained hemolysis, thrombosis with unusual features, or bone marrow failure.

• M. tuberculosis Complex versus Non-Tuberculous Mycobacteria by Polymerase Chain Reaction (PCR) on Smear-Positive Specimens

  The ability to rapidly and accurately distinguish M. tuberculosis from nontuberculous mycobacteria has significant clinical implications.

• Fecal Occult Blood Tests for Colorectal Cancer Screening

  There are two major reasons to detect occult blood in the stool: as a screen for colorectal cancer or to detect upper or lower GI bleeding.

• BK Polyomavirus by Real-Time PCR (Detection & Quantitation)

  BK Polyomavirus is associated with renal allograft infection, urethral stenosis, and hemorrhagic cystitis in bone marrow transplants.