At Cleveland Clinic Laboratories, our pathologists were among the first in the United States to routinely use molecular tests in the clinical setting, making our team among the most experienced in the country in clinical applications and interpretation of molecular testing.
Cleveland Clinic Laboratories features an expansive menu of tests that range from commercially-available, moderately-complex assays to esoteric and highly-complex molecular diagnostic tests. With every test result, the department is focused on delivering personalized, world-class service and total customer satisfaction.
Although Cleveland Clinic Laboratories offer some of the most complex assays available, we never lose sight of the big picture: that each specimen represents a patient’s life and the results of each test performed will profoundly impact that patient, in some instances changing the entire course of therapy.
Sections
Our subspecialties within molecular pathology include:
Operational Cores
Molecular Pathology achieves efficiencies by operating a number of core laboratories around key technologies. The operational cores consist of:
- Materials handling core
- Extraction core
- Rapid-cycle and traditional polymerase chain reaction (PCR) core
- Commercial assays core
- Cytogenetic core
- Fluorescence in situ hybridization (FISH) core
- Sequencing core
- Microarray core
- Methylation and epigenetics core
This core concept provides us the opportunity to integrate continuous improvement tools to optimize laboratory productivity, which in turn translates into better turnaround time for patient results. Although a high degree of efficiency is a goal of each core, a keen eye is maintained on quality metrics and quality improvement initiatives are ongoing.
The outcome of this unique structure, which engages individuals with subspecialty pathology expertise, molecular technical experts, and skilled administrative and technical personnel, is maximum throughput for superior customer service coupled with the confidence of having every test performed, handled and reported by some of the finest experts in the field.
Cytogenetics
Cytogenetic studies are available for peripheral blood, bone marrow and tissue investigations. Specimens must contain sufficient numbers of viable cells capable of mitosis. The type of anticoagulant, the freshness of the samples and the cellularity are all important variables.
Please provide sufficient clinical information to define the appropriate culture conditions. A variety of mitogens are available. For example, special mitogens for myeloid cells (GM-CSF) or for B-lymphocytes (phorbol ester) will be used if the working diagnosis of myelodysplasia or chronic lymphocytic leukemia accompanies the specimen. Each specimen will be cultured under at least two different culture systems to maximize metaphase recovery. Please see the Test Directory for specimen submission guidelines and Specimen Handling for specimen preparation and shipping guidelines.
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Molecular Genetic Pathology
Molecular Genetic Pathology performs a variety of analyses that assess for an array of germline disorders.
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Molecular Hematopathology
Molecular Hematopathology provides comprehensive molecular testing for patients with benign and malignant disorders of the lymph nodes, peripheral blood, and bone marrow. Our state of the art diagnostic techniques assist in establishing a diagnosis, predicting prognosis, and/or guiding the choice of therapy in a wide range of hematologic diseases.
Testing performed includes clonality studies for lymphoproliferative disorders, mutational analysis for acute myeloid leukemias, minimal residual disease monitoring and mutation analysis in chronic myeloid leukemia, mutation testing for myeloproliferative neoplasms, and thalassemia/hemoglobinopathy testing. Numerous fluorescence in situ hybridization assays are available to detect molecular cytogenetic abnormalities associated with myeloid and lymphoid neoplasms.
Results of molecular testing are correlated with the corresponding morphologic findings where appropriate, and an integrated interpretation is provided. Our pathologists also provide expert assistance in test selection and interpretation of unusual findings.
In addition to their excellence in clinical service, faculty have research interests in a wide variety of hematolymphoid disorders. The faculty also participates in a variety of cooperative groups, multinational consortiums, and national level continuing education programs.
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Molecular Oncologic Pathology
Molecular Oncologic Pathology provides state of the art molecular testing for solid tumor malignancies. Molecular test results are interpreted in the context of conventional morphologic and immunophenotypic features, and integrated into the clinical service and teaching of each pathology subspecialty. Molecular techniques used include testing that utilizes nucleic acid derivatives, and cell based testing that utilizes fluorescent in situ hybridization assays.
The instrumentation and expertise of Molecular Oncologic Pathology currently provide molecular testing results for multiple solid tumor subspecialties, including:
- Microsatellite Stability Analysis
- Gastrointestinal pathology
- Gynecological pathology
- Mutational Analysis
- Gastrointestinal pathology
- Head & Neck pathology
- Dermatopathology
- Transcription Mediated Amplification/Hybridization Protection Analysis
- DNA Hypermethylation Analysis
- Fluoroescence In Situ Hybridization
- Breast pathology
- Urological pathology
- Neuropathology
- Dermatopathology
- Soft Tissue Tumor pathology
- Pulmonary pathology
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Molecular Microbiology
Molecular Microbiology is responsible for the molecular detection and characterization of infectious agents.
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