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Test ID: BCGBM Immunoglobulin Gene Rearrangement, PCR, Bone Marrow

Reporting Name

Immunoglobulin Gene Rearrange, BM

Useful For

Determining whether a B-cell or plasma cell population is polyclonal or monoclonal in bone marrow specimens

 

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 a previous neoplastic specimen

Specimen Type

Bone Marrow


Shipping Instructions


Specimen must arrive within 7 days (168 hours) of collection.



Specimen Required


Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 2 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Send specimen in original tube. Do not aliquot.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Bone Marrow Ambient (preferred) 7 days
  Refrigerated  7 days

Reference Values

An interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Friday

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 population(s); 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 population(s)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BCGBM Immunoglobulin Gene Rearrange, BM 61113-7

 

Result ID Test Result Name Result LOINC Value
19894 Final Diagnosis: 34574-4
608949 Signing Pathologist 19139-5

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 or plasma cell has a unique rearrangement profile. Other cell types usually retain the unrearranged gene structures. Clonal expansion of any B cell or plasma cell will result in a population of cells that all contain identical Ig gene rearrangement profiles.

 

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.

Interpretation

An interpretive report will be provided.

 

Results will be characterized as positive, negative, or indeterminate for a clonal B-cell population.

 

The interpretation of the presence or absence of a predominant immunoglobulin (Ig) gene rearrangement profile is sometimes subjective. These results must always be interpreted in the context of other clinicopathologic information to determine the significance of the result.

 

The detection of a clonal Ig gene rearrangement by this test is not synonymous with the presence of a B-cell or plasma cell neoplasm.

Clinical Reference

1. van Dongen JJ, Wolvers-Tettero IL: Analysis of immunoglobulin and T-cell receptor genes. Part II: Possibilities and limitations in the diagnosis and management of lymphoproliferative diseases and related disorders. Clin Chim Acta. 1991 Apr;198(1-2):93-174

2. Coad JE, Olson DJ, Lander TA, McGlennen RC: Molecular assessment of clonality in lymphoproliferative disorders: I. Immunoglobulin gene rearrangements. Mol Diagn. 1996 December;1(4):335-355

3. Kokovic I, Novakovic BJ, Novakovic S: Diagnostic value of immunoglobulin k light chain gene rearrangement analysis in B-cell lymphomas. Int J Oncol. 2015 Mar;46(3):953-962. doi: 10.3892/ijo.2014.2790

Analytic Time

5 days

Method Name

Polymerase Chain Reaction (PCR)

Forms

1. Hematopathology Patient Information (T676) in Special Instructions

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.

Mayo Clinic Laboratories | Hematology Catalog Additional Information:

mml-lymphoid-disorders