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Test ID: TCGRV T-Cell Receptor Gene Rearrangement, PCR, Varies

Reporting Name

T Cell Receptor Gene Rearrange, V

Useful For

Determining whether a T-cell population is polyclonal or monoclonal using body fluid or tissue specimens

Specimen Type

Varies


Shipping Instructions


Body fluid or spinal fluid specimens must arrive within 4 days (96 hours) of collection.



Specimen Required


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

 

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

 

Specimen Type: Tissue slides

Container/Tube: Unstained tissue slides

Specimen Volume: 10 slides

Specimen Stability: Ambient

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 5 to 10 mL

Specimen Stability Information: Ambient/Refrigerated

 

Specimen Type: Extracted DNA

Container/Tube: 1.5- to 2-mL tube with indication of volume and concentration of DNA

Specimen Volume: Entire specimen

Collection Instructions:

1. Label specimen as extracted DNA and source of specimen

2. Indicate volume and concentration of DNA on label

Specimen Stability Information: Refrigerated/Ambient


Specimen Minimum Volume

Body fluid or Spinal fluid: 1 mL
Tissue: 50 mg
Extracted DNA: 50 microliters at 20 ng/mcL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reference Values

An interpretive report will be provided.

Positive, negative, or indeterminate for a clonal T-cell population

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

81340-TCB (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s), using amplification methodology (eg, PCR)

81342-TCG (T cell receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TCGRV T Cell Receptor Gene Rearrange, V In Process

 

Result ID Test Result Name Result LOINC Value
19936 Final Diagnosis: 22637-3
MP016 Specimen: 31208-2
608953 Signing Pathologist 19139-5

Clinical Information

The T-cell receptor (TCR) genes (alpha, beta, delta, and gamma) are comprised of numerous, discontinuous coding segments that somatically rearrange to produce heterodimeric cell surface TCR, either alpha/beta (90%-95% of T cells) or gamma/delta (5%-10% of T cells). With rare exceptions (eg, some neoplastic B-lymphoid proliferations), other cell types retain the germline configuration of the TCR genes without rearrangement.

 

The marked diversity of somatic TCR-gene rearrangements is important for normal immune functions but also serves as a valuable marker to distinguish abnormal T-cell proliferations from reactive processes. A monoclonal expansion of a T-cell population will result in the predominance of a single TCR-gene rearrangement pattern. In contrast, reactive T-cell expansions are polyclonal (or multiclonal), with no single clonotypic population predominating in the population of T cells. These distributive differences in both TCR sequence and genomic rearrangement fragment sizes can be detected by molecular techniques (ie, polymerase chain reaction) and used to determine if a population of T cells shows monoclonal or polyclonal features.

Interpretation

An interpretive report will be provided.

 

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

 

In the appropriate clinicopathologic setting, a monoclonal result is associated with a neoplastic proliferation of T cells (see Cautions).

Clinical Reference

1. Liu H, Bench AJ, Bacon CM, et al: A practical strategy for the routine use of BIOMED-2 PCR assays for detection of B- and T-cell clonality in diagnostic haematopathology. Br J Haematol. 2007 Jul;138(1):31-43

2. van Krieken JHJM, Langerak AW, Macintyre EA, et al: Improved reliability of lymphoma diagnostics via PCR-based clonality testing: report of the BIOMED-2 Concerted Action BHM4-CT98-3936. Leukemia. 2007 Feb;21(2):201-206

3. Bruggermann M, White H, Gaulard P, et al: Powerful strategy for polymerase chain reaction-based clonality assessment in T-cell malignancies Report of the BIOMED-2 Concerted Action BHM4 CT98-3936. Leukemia. 2007 Feb;21(2):215-221

4. Langerak AW, Groenen PJTA, Bruggemann M, et al: EuroClonality/BIOMED-2 guidelines for interpretation and reporting of Ig/TCR clonality testing in suspected lymphoproliferations. Leukemia. 2012 Oct;26(10):2159-2171. doi: 10.1038/leu.2012.246

Analytic Time

7 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-myeloproliferative-neoplasm, mml-lymphoid-disorders