Hematopathology
Hematopathology Overview
Align With Evolving Disease Classifications
Our hematopathology team provides expert interpretation of bone marrow biopsies, peripheral blood smears, lymph node specimens, and hematologic malignancies. Led by board-certified hematopathologists, the team brings both academic rigor and practical experience to every case.
Interpretations are clinically correlated with ancillary studies—including flow cytometry, immunohistochemistry, molecular diagnostics, FISH, and cytogenetics—ensuring a comprehensive and integrated diagnosis. We collaborate closely with oncologists, hematologists, interventional radiologists, and hospital partners to deliver timely, actionable results.
Our internal peer-review process allows for rapid second opinions and case discussions, helping to maintain diagnostic accuracy and align with evolving disease classifications. When needed, preliminary reads can be provided urgently, without sacrificing quality or completeness.
Meet the Experts
Pathology Specialists
Our pathologists are readily available for direct phone consultations, providing timely, accessible answers to your clinical questions.
Hematopathology
Collection Guide
Detailed instructions for collecting bone marrow biopsies and flow cytometry specimens (peripheral blood, tissue, body fluids, fine needle aspirations).
Test Menu
Flow Cytometry
Specimen types: Peripheral blood, Bone marrow, Solid tissues, Body fluids
Services: Technical Component, Professional Services, Global Services, and Consultations
On the Cutting Edge of Patient-Focused Lab Services
Accurate Results. Reliable Partnership.
Sagis is a full-service pathology and laboratory testing provider, partnering with physicians, clinics, and health systems to deliver accurate, timelyresults. Our board-certified pathologists, laboratory experts, and responsive client services team work together to support better clinical decision-making and patient care.
Whether you need pathology interpretations, toxicology testing, or specialized lab services, Sagis offers the expertise, technology, and personalized service that help elevate your standard of care.
We are here to help
Frequently
asked questions
If your question isn’t addressed below, please contact us
About Hematopathology
What is hematopathology?
Hematopathology is a subspecialty of pathology focused on diagnosing diseases of the blood, bone marrow, lymph nodes, and lymphoid tissue. Our hematopathologists examine specimens microscopically and integrate ancillary studies, such as flow cytometry, immunohistochemistry, molecular diagnostics, FISH, and cytogenetics, to diagnose hematologic malignancies and other blood disorders.
What conditions does Sagis diagnose through hematopathology?
Our hematopathologists evaluate a wide range of hematologic diseases, including leukemias, lymphomas, myeloproliferative neoplasms, myelodysplastic syndromes, plasma cell dyscrasias such as multiple myeloma, and other bone marrow and peripheral blood disorders. We also provide diagnostic support for solid tissue and body fluid specimens when hematologic involvement is suspected.
What types of specimens does Sagis accept for hematopathology?
Sagis accepts peripheral blood, bone marrow aspirates and biopsies, lymph node specimens, solid tissues, and body fluids. Each specimen type has specific collection and transport requirements. Please refer to our Hematopathology Specimen Collection Guide for guidance.
Flow Cytometry
What is flow cytometry and when is it used?
Flow cytometry is an advanced laboratory technique used to characterize cell populations based on their surface and intracellular markers. In hematopathology, it plays a critical role in diagnosing and classifying leukemias, lymphomas, and other hematologic malignancies. It is also used to monitor minimal residual disease and evaluate immune function.
What specimen types are accepted for flow cytometry?
Sagis accepts peripheral blood, bone marrow, solid tissues, fine needle aspirations, and body fluids for flow cytometry testing.Â
What flow cytometry services does Sagis offer?
Sagis provides global services (technical component and professional interpretation) and consultation services for flow cytometry. Our board-certified hematopathologists interpret results in their clinical context and integrate the findings with histologic, molecular, and cytogenetic data to deliver a complete, clinically correlated diagnosis.
Bone Marrow Evaluation
What is included in a bone marrow evaluation at Sagis?
A complete bone marrow evaluation at Sagis includes morphologic review of the aspirate and peripheral blood smears, clot, and trephine core biopsy. Ancillary studies, such as flow cytometry, immunohistochemistry, FISH, cytogenetics, and molecular testing, are performed as clinically indicated, and the results are integrated into a single, comprehensive diagnostic report.
How much bone marrow aspirate is needed for a complete evaluation?
At least 10 mL of total bone marrow aspirate is preferred. Place at least 2 mL of bone marrow aspirate in each of: 2 purple top tubes, 2 green top tubes, with the remainder allowed to clot and placed in formalin. If the aspirate volume is limited, please prioritize at least 2 mL in each of: 1 purple top tube, 1 one green top tube, with the remainder allowed to clot and placed in formalin.
What should I do if a dry tap occurs during bone marrow collection?
If no aspirate is obtained, please obtain an additional 2 cm biopsy core and place it in a container with RPMI media or saline, not formalin. Make a total of 10 touch prep slides for possible FISH studies. Peripheral blood in both a purple top and a green top tube should also be submitted. Notify Sagis immediately so our team can triage the specimen appropriately.Â
Are touch prep slides required for bone marrow biopsies?
At least 2 touch prep slides are recommended for all bone marrow biopsies. If a dry tap occurs, 10 touch prep slides are recommended for possible FISH studies. Slides must be completely air-dried before packaging and should be labeled with two patient identifiers and the specimen type (touch prep or aspirate).
Ancillary Testing
Does Sagis offer molecular diagnostics and FISH testing for hematologic cases?
Yes. When clinically indicated, Sagis coordinates molecular diagnostics, including PCR and next-generation sequencing (NGS), as well as cytogenetics and FISH testing to evaluate for chromosomal abnormalities. These studies are integrated with morphology and flow cytometry findings to deliver a complete, clinically correlated diagnosis.
Does Sagis perform immunohistochemistry in-house?
Yes. Sagis maintains a state-of-the-art, in-house immunohistochemistry laboratory. When immunohistochemical staining is required to characterize a hematologic diagnosis, studies are performed on-site and interpreted by our board-certified hematopathologists as part of the overall diagnostic workup.
How are ancillary study results incorporated into the final report?
All ancillary study results (flow cytometry, immunohistochemistry, FISH, cytogenetics, and molecular) are clinically correlated and integrated into a single, comprehensive diagnostic report. Our hematopathologists synthesize findings across modalities to provide a unified interpretation that supports clinical decision making.
Working with Sagis
What makes Sagis different from other hematopathology laboratories?
Sagis is physician-owned and subspecialty-focused. Our board-certified hematopathologists bring academic rigor and hands-on experience to every case. At Sagis we operate collaboratively, and cases are discussed internally when needed before a final report is issued. Referring physicians have direct access to our pathologists for consultations, second opinions, and preliminary reads when urgency requires it.
Can I reach a hematopathologist directly to discuss a case?
Yes. Direct access to our hematopathologists is a core part of how we work. Whether you need to discuss a case before collection, review a finalized report, or request a second opinion, our team is available by phone for one-on-one consultations. This access is included as part of your service with Sagis.
Does Sagis offer second opinions on hematopathology cases?
Yes. We provide second-opinion consultations on outside cases, including complex hematologic malignancies, ambiguous bone marrow findings, and difficult lymphoma classifications. If you have a case that warrants expert review, we welcome the opportunity to evaluate it.
Can Sagis provide urgent or preliminary reads on hematopathology cases?
Yes. When clinical urgency requires it, our team can provide preliminary reads without sacrificing diagnostic quality or completeness. Contact our local sales rep to discuss expedited turnaround for time-sensitive cases.
Who does Sagis collaborate with for hematopathology cases?
Our hematopathology team works closely with oncologists, hematologists, interventional radiologists, and hospital partners to ensure coordinated, integrated care. We communicate critical or unexpected findings directly and remain available for ongoing case discussions as treatment plans evolve.
How do I set up service to submit hematopathology specimens to Sagis?
Setting up service is straightforward. Contact your local sales representative to establish your account by finding your territory rep using our Find My Sales Rep Map or by submitting our Become A New Client form. Once your account is active, specimen supplies, requisition forms, and courier services can be ordered through your rep or via our Supplies & Requests portal.
Reports & Results
How will I receive hematopathology results?
Sagis supports electronic reporting compatible with most EMR systems. Results are also accessible through our secure online portal as soon as reports are finalized. Critical or unexpected findings are communicated directly and promptly to the ordering provider.
How long does it take to receive hematopathology results?
Turnaround time varies based on the complexity of the case and the ancillary studies required. Straightforward cases may be reported within 24 to 48 hours of specimen receipt. Cases requiring flow cytometry, immunohistochemistry, FISH, cytogenetics, and/or molecular testing may take additional time. Contact our team for estimates on specific case types or if urgent turnaround is needed.
Accreditation & Quality
Is Sagis accredited for hematopathology testing?
Yes. Sagis is a CAP- and CLIA-accredited medical diagnostic laboratory based in Houston, Texas. We also hold a Clinical Laboratory Permit from the New York State Department of Health. These accreditations reflect a rigorous commitment to quality, accuracy, and consistency across all laboratory testing and reporting, including hematopathology and flow cytometry services.
How does Sagis ensure diagnostic accuracy for hematopathology cases?
Sagis maintains an internal peer-review process that allows for rapid second opinions and collaborative case discussions prior to final sign-out. This process supports diagnostic accuracy and ensures alignment with current disease classifications. Our hematopathologists also integrate findings across multiple ancillary modalities to provide a complete and clinically meaningful interpretation.