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Interpretive Handbook

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Test 88897 :
B-Cell Lymphoma, FISH, Blood or Bone Marrow

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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 anomalies and variants of these anomalies have been associated with various kinds of lymphoma (see Table).

 

Common Chromosome Anomalies in B-Cell Lymphomas

Lymphoma Type

Chromosome Abnormality

FISH Probe

Burkitt (pediatric)

8q24.1 rearrangement

MYC

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

MYC/IGH

t(8;22)(q24.1;q11.2)

MYC/IGL

t(2;8)(p12;q24.1)

IGK/MYC

 

 

 

Mantle Cell

t(11;14)(q13;q32)

CCND1/IGH

12p13 rearrangement(1)

CCND2

17p deletion(2)

TP53/D17Z1

 

8q24.1 rearrangement(2)

MYC

 

 

 

Follicular

18q21 rearrangement(3)

BCL2

 

 

 

 

Diffuse large B-cell, Burkitt-like "double-hit"

 

 

 

 

8q24.1 rearrangement

MYC

    reflex: t(8;14)(q24.1;q32)

MYC/IGH

    reflex: t(8;22)(q24.1;q11.2)

MYC/IGL

    reflex: t(2;8)(p12;q24.1)

IGK/MYC

    reflex: 3q27 rearrangement

BCL6

    reflex: 18q21 rearrangement(3)

BCL2

 

 

 

MALT/ENMZL

18q21 rearrangement(4)

MALT1

   reflex: t(11;18)(q21;q21)

BIRC3/MALT1

   reflex: t(14;18)(q32;q21)

IGH /MALT1

 

 

 

Splenic marginal zone

7q deletion

D7Z1/7q32

17p deletion

TP53/D17Z1

Key:

1: CCND2 available upon request if IGH/CCND1 probe is normal

2: TP53 and MYC available for blastoid mantle cell lymphoma only

3: BCL2/IGH available upon request if BCL2 is disrupted

4: BIRC3/MALT1 and IGH/MALT1 available upon request if MALT1 is disrupted

 

Useful For Suggests clinical disorders or settings where the test may be helpful

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 neoplasms

Interpretation Provides information to assist in interpretation of the test results

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

 

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

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test is not approved by the FDA and it is best used as an adjunct to existing clinical and pathologic information.

 

Bone marrow is the preferred sample type for this FISH test. If bone marrow is not available, a blood specimen may be used if there malignant cells in the blood specimen (as verified by hematopathology).

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretive report will be provided.

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. WHO Classification of Tumour of Haematopoietic and Lymphoid Tissues. Edited by SH Swerdlow, E Campo, NL Harris. IARC, Lyon 2008, pp 185-187, 214-217, 220-226, 229-237, 262-278

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):1546-1553H636


Key