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Test ID: BLPF B-Cell Lymphoma, FISH, Varies

Useful For

Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various B-cell lymphomas using blood or bone marrow specimens

 

Tracking known chromosome abnormalities and response to therapy in patients with B-cell neoplasms

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 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.

 

When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal B-cells are available for FISH testing. If the result does not identify a sufficient clonal B-cell population, this FISH test order will be canceled and no charges will be incurred.

 

If FISH testing proceeds, probes will be performed based on the lymphoma subtype suspected/identified utilizing the table "Common Chromosome Abnormalities in B-cell Lymphomas" located in Clinical Information.

 

If the patient is being tracked for known abnormalities, indicate which probes should be used.

 

The following probe sets are available within this B-cell lymphoma FISH profile:

-8q24.1 rearrangement, MYC

-t(8;14), MYC/IGH

-18q21 rearrangement, BCL2

-3q27 rearrangement, BCL6

-t(11;14), CCND1/IGH

-17p deletion, TP53/D17Z1

-7q deletion, D7Z1/7q32

-18q21 rearrangement, MALT1

 

Marginal zone lymphoma (MZL) can be evaluated via probes for specific subtypes, as follows: mucosa-associated lymphoid tissue (MALT) lymphoma or extra-nodal marginal zone lymphoma (ENMZL) using the MALT1 rearrangement probe and splenic marginal zone lymphoma using probes for 7q deletion and 17p deletion. If no MZL subtype is provided, we will evaluate using probes for MALT1, 7q deletion and 17p deletion.

 

See Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm in Special Instructions.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

B-cell Lymphoma, FISH, B/BM

Specimen Type

Varies


Advisory Information


This assay detects chromosome abnormalities observed in the blood or bone marrow of patients with B-cell lymphoma. If a formalin-fixed, paraffin-embedded specimen is submitted, the test will be cancelled and BLYM / B-Cell Lymphoma, FISH, Tissue will be added and performed as the appropriate test.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


1. Provide a reason for testing 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.

2. A pathology or flow cytometry report may be requested by the Genomics Laboratory to optimize testing and aid in interpretation of results.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Bone marrow

Container/Tube: Green top (sodium heparin)

Specimen Volume: 1-2 mL

Collection Instructions: Invert several times to mix bone marrow.

 

Acceptable:

Specimen Type: Blood

Container/Tube: Green top (sodium heparin)

Specimen Volume: 7-10 mL

Collection Instructions: Invert several times to mix blood.

 

Specimen Type: Touch prep or fresh tissue


Specimen Minimum Volume

Blood: 2 mL
Bone Marrow: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)
  Refrigerated 

Clinical Information

Lymphoid neoplasms are known to be complex and the prognosis and clinical course of patients with lymphoma is highly variable. Genetic abnormalities have emerged as one of the most reliable criteria for categorizing lymphomas. Several chromosome abnormalities and variants of these abnormalities have been associated with various kinds of 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,
"double-hit" or
"triple hit"

8q24.1 rearrangement

5'/3' MYC

t(8;14)(q24.1;q32)

MYC/IGH

----Reflex: t(2;8)(p12;q24.1)

IGK/MYC

----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

----Reflex: 11q13 rearrangement

5'/3' CCND1

Blastoid subtype only: deletion of 17p

TP53/D17Z1

Blastoid subtype only: 8q24.1 rearrangement

5'/3' MYC

Blastoid subtype only: t(8;14)(q24.1;q32)

MYC/IGH

Marginal Zone Lymphoma

18q21 rearrangement

5'/3' MALT1

Deletion of 7q

D7Z1/7q32

Deletion of 17p

TP53/D17Z1

Reference Values

An interpretive report will be provided.

Interpretation

A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for any given probe.

 

Detection of an abnormal clone supports a diagnosis of a B-cell neoplasm; the specific abnormality detected may help subtype the neoplasm

 

The absence of an abnormal clone does not rule out the presence of neoplastic disorder.

Clinical Reference

1. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Edited by SH Swerdlow, et al. IARC, Lyon 2017.

2. Remstein ED, Kurtin PJ, Buno I, et al: Diagnostic utility of fluorescence in situ hybridization in mantle-cell lymphoma. Br J Haematol 2000 Sep;110(4):856-862

3. Remstein ED, Kurtin PJ, James CD, et al: Mucosa-associated lymphoid tissue lymphomas with t(11;18) (q21;q21) and mucosa-associated lymphoid tissue lymphomas with aneuploidy develop along different pathogenetic pathways. Am J Pathol 2002 Jul;161(1):63-71

4. Remstein ED, Dogan A, Einerson RR, et al: The incidence and anatomic site specificity of chromosomal translocations in primary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) in North America. Am J Surg Pathol 2006 Dec;30(12):1546-1553

Day(s) and Time(s) Performed

Specimens are processed Monday through Sunday.

Results reported Monday through Friday; 8 a.m. to 5 p.m.

Analytic Time

7 days

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)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BLPF B-cell Lymphoma, FISH, B/BM In Process

 

Result ID Test Result Name Result LOINC Value
51900 Result Summary 50397-9
51902 Interpretation 69965-2
51901 Result Table 93356-4
54546 Result 62356-1
CG684 Reason for Referral 42349-1
CG685 Specimen 31208-2
51903 Source 31208-2
51904 Method 49549-9
54455 Additional Information 48767-8
53867 Disclaimer 62364-5
51905 Released by 18771-6

Forms

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