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HelpTest ID BLYMF B-Cell Lymphoma, FISH, Tissue
Useful For
Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various B-cell lymphomas
Tracking known chromosome abnormalities and response to therapy in patients with B-cell lymphomas
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| _PBCT | Probe, +2 | No, (Bill Only) | No |
| _PADD | Probe, +1 | No, (Bill Only) | No |
| _PB02 | Probe, +2 | No, (Bill Only) | No |
| _PB03 | Probe, +3 | No, (Bill Only) | No |
| _IL25 | Interphases, <25 | No, (Bill Only) | No |
| _I099 | Interphases, 25-99 | No, (Bill Only) | No |
| _I300 | Interphases, ≥100 | No, (Bill Only) | No |
Testing Algorithm
This test does not include a pathology consultation. If a pathology consultation is requested, 70012 / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the pre-analytic (tissue adequacy and probe selection, when applicable) and post-analytic (interpretation of FISH results in context of specific case, when applicable) phases.
This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.
Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in the table: Common Chromosome Abnormalities in B-cell Lymphomas in Clinical Information.
If the patient is being tracked for known abnormalities, indicate which probes should be used.
This assay detects chromosome abnormalities observed in paraffin-embedded tissue samples of patients with B-cell lymphoma. For testing the blood and bone marrow from patients with B-cell lymphoma, see BLPF / B-Cell Lymphoma, FISH, Blood or Bone Marrow.
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
B-cell Lymphoma, FISH, TsSpecimen Type
TissueProvide a reason for referral with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.
Forms: 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)
Advise Express Mail or equivalent if not on courier service.
Submit only 1 of the following specimens:
Specimen Type: Lymph node
Preferred: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.
Acceptable: Slides
Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.
Specimen Type: Solid tumor
Preferred: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.
Acceptable: Slides
Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.
Specimen Minimum Volume
For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides. Include 1 hematoxylin and eosin-stained- (H&E) stained slide.
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Tissue | Ambient (preferred) | |
| Refrigerated | ||
Clinical Information
Mature B-cell lymphoma can be low grade, intermediate grade, or high grade, and the prognosis and clinical course are highly variable. Genetic abnormalities have emerged as one of the most important prognostic markers in B-cell lymphomas and can aid in diagnosis. Several chromosome abnormalities and variants of these abnormalities have been associated with various lymphoma subtypes (see table). Conventional chromosome studies cannot be employed on paraffin-embedded tissue, and molecular genetic analyses are often problematic in the study of lymphomas. FISH permits the detection of abnormal gene associated with various chromosome translocations and inversions in B-cell lymphoma (see table).
|
Common Chromosome Abnormalities in B-cell Lymphomas |
||
|
Lymphoma Type |
Chromosome Abnormality |
FISH Probe |
|
Burkitt (pediatric, ≤18 years old) |
8q24.1 rearrangement |
5’/3’ MYC |
|
t(2;8)(p12;q24.1) |
IGK/MYC |
|
|
t(8;14)(q24.1;q32) |
MYC/IGH |
|
|
t(8;22)(q24.1;q11.2) |
MYC/IGL |
|
|
3q27 rearrangement |
3’/5’ BCL6 |
|
|
18q21 rearrangement |
3’/5’ BCL2 |
|
|
Diffuse large B-cell, Burkitt-like "double-hit" |
8q24.1 rearrangement |
5’/3’ MYC |
|
Reflex: t(2;8)(p12;q24.1) |
IGK/MYC |
|
|
Reflex: t(8;14)(q24.1;q32) |
MYC/IGH |
|
|
Reflex: t(8;22)(q24.1;q11.2) |
MYC/IGL |
|
|
Reflex: 3q27 rearrangement |
3’/5’ BCL6 |
|
|
Reflex: 18q21 rearrangement |
3’/5’ BCL2 |
|
|
Follicular |
18q21 rearrangement |
3’/5’ BCL2 |
|
3q27 rearrangement |
3’/5’ BCL6 |
|
|
Mantle Cell |
t(11;14)(q13;q32) |
CCND1/IGH |
|
Blastoid subtype only: deletion of 17p |
TP53/D17Z1 |
|
|
Blastoid subtype only: 8q24.1 rearrangement |
5’/3’ MYC |
|
|
MALT |
18q21 rearrangement |
5’/3’ MALT1 |
|
Splenic Marginal Zone |
Deletion of 7q |
D7Z1/7q32 |
|
Deletion of 17p |
TP53/D17Z1 |
|
Reference Values
An interpretive report will be provided.
Cautions
This test is not approved by the U.S. Food and Drug Administration and it is best used as an adjunct to existing clinical and pathologic information.
Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays.
Paraffin-embedded tissues that have been decalcified are generally unsuccessful for FISH analysis. The pathologist reviewing the hematoxylin and eosin-stained slide may find it necessary to cancel testing.
This test is not appropriate for testing blood or bone marrow samples from patients with B-cell lymphoma, see BLPF / B-Cell Lymphoma, FISH, Blood or Bone Marrow.
Day(s) Performed
Samples processed Monday through Sunday. Results reported Monday through Friday, 8 a.m.-5 p.m. CT.
Report Available
4 daysPerforming Laboratory
Mayo Medical Laboratories in Rochester
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
88271x2, 88291 – DNA probe, each (first probe set), Interpretation and report
88271x2 – DNA probe, each; each additional probe set (if appropriate)
88271x1 – DNA probe, each; coverage for sets containing 3 probes (if appropriate)
88271x2 – DNA probe, each; coverage for sets containing 4 probes (if appropriate)
88271x3 – DNA probe, each; coverage for sets containing 5 probes (if appropriate)
88274 w/modifier 52 – Interphase in situ hybridization, <25 cells, each probe set (if appropriate)
88274 – Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)
88275 – Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)