Test ID BCGRV Immunoglobulin Gene Rearrangement, Varies
Useful For
Determining whether a B-cell or plasma cell population is polyclonal or monoclonal
Identifying neoplastic cells as having B-cell or plasma cell differentiation
Monitoring for a persistent neoplasm by detecting an immunoglobulin gene rearrangement profile similar to that from a previous neoplastic specimen
Special Instructions
Method Name
Genomic DNA Extracted Followed by Polymerase Chain Reaction (PCR)
(PCR is used pursuant to a license agreement with Roche Molecular Systems, Inc. and InvivoScribe Technologies)
Reporting Name
Immunoglobulin Gene Rearrange, VSpecimen Type
VariesForms:
1. Hematopathology Patient Information Sheet (Supply T676) in Special Instructions
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request Form (T726) with the specimen
(http://www.mayomedicallaboratories.com/it-mmfiles/hematopathology-request-form.pdf)
Body fluid or spinal fluid must arrive within 96 hours of collection.
Submit only 1 of the following specimens:
Specimen Type: Body fluid
Container/Tube: Sterile container
Specimen Volume: At least 5 mL
Collection Instructions:
1. If the volume is large, pellet cells prior to sending.
2. Send less volume at ambient temperature or as a frozen cell pellet.
Specimen Stability Information:
Body Fluid: Ambient/Refrigerated/Frozen
Cell Pellet: Frozen
Specimen Type: Paraffin-embedded bone marrow aspirate clot
Container/Tube: Paraffin block
Specimen Stability Information: Ambient/Refrigerated
Specimen Type: Frozen tissue
Container/Tube: Plastic container
Specimen Volume: 100 mg
Collection Instructions: Freeze tissue within 1 hour of collection.
Specimen Stability Information: Frozen
Specimen Type: Paraffin-embedded tissue
Container/Tube: Paraffin block
Specimen Stability Information: Ambient/Refrigerated
Specimen Type: Spinal fluid
Container/Tube: Sterile vial
Specimen Volume: 5-10 mL
Specimen Stability Information: Ambient/Refrigerated
Specimen Type: Extracted DNA from blood or bone marrow
Container/Tube: 1.5- to 2-mL tube with indication of volume and concentration of DNA
Specimen Volume: Entire specimen
Collection Instructions: Label specimen as extracted DNA from blood or bone marrow
Specimen Stability Information: Refrigerated/Ambient
Specimen Minimum Volume
Body Fluid or Spinal Fluid: 1 mL/Tissue: 50 mg/Extracted DNA from Blood or Bone Marrow: 50 microliter at 20 ng/microliter
Specimen Stability Information
Specimen Type | Temperature | Time |
---|---|---|
Varies | Varies |
Clinical Information
The immunoglobulin (Ig) genes (heavy, kappa, and lambda) are comprised of numerous, discontinuous coding segments. As B cells develop, the segments are rearranged such that each mature B cell and plasma cell has a unique rearrangement profile. Other cell types usually retain the nonrearranged gene structures. Clonal expansion of any B cell or plasma cell will result in a population of cells that all contain an identical Ig gene rearrangement profile.
Reactive B-cell or plasma cell expansions are polyclonal, with each clone containing relatively few cells and no single clone predominating. Conversely, neoplastic clones are generally large such that the clonal cells are the predominant B cells or plasma cells present.
In the appropriate clinical and pathologic setting, detection of a prominent Ig gene rearrangement profile may be equated to the presence of a neoplastic B-cell or plasma cell clone.
Reference Values
An interpretive report will be provided.
Cautions
This test is neither 100% sensitive nor 100% specific.
False-negative results may occur if the immunoglobulin (Ig) gene has numerous point mutations introduced during expansion in a follicle center (somatic hypermutation) such that none of the PCR primers will bind. False-negatives will also occur if the clonal cells have not rearranged the Ig genes being evaluated or are present below the sensitivity level of the assay (sensitivity is quite variable but the assay requires that at least 1%-5% of the nucleated cells present be clonal). False-positive results are rare but may occur if a predominant clone (or small number of clones) is produced or sampled from a polyclonal expansion.
The test does not provide information regarding:
-The differentiation of the clonal cell population (neoplastic cells other than B cells or plasma cells may occasionally have Ig gene rearrangements)
-Whether a prominent clone is physiologic or neoplastic
Day(s) Performed
Monday through Friday
Report Available
7 daysPerforming Laboratory

Test Classification
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
81261-IGH (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas B-cell), gene rearrangement analysis to detect abnormal clonal populations; amplified methodology (eg. polymerase chain reaction)
81264-IGK (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell) gene rearrangement analysis, evaluation to detect abnormal clonal populations