Test ID: 81107
JC Virus (JCV) Detection by In Situ Hybridization
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Confirming a clinical and histopathologic diagnosis of progressive multifocal leukoencephalopathy (PML); especially helpful when only a small piece of biopsy material is available
Method Name A short description of the method used to perform the test
In Situ Hybridization with Biotin-Labeled Probes
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
JC Virus In Situ Hybridization
JCV (JC Virus Detection by In Situ Hybridization)
John Cunningham Virus (JCV)
PML Virus (Progressive Multi-Focal Leukoence-Phalopathy)
IJCV
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Specimen Type: Formalin-fixed, paraffin-embedded tissue block; 4 glass "positively charged" slides with formalin-fixed, paraffin-embedded tissue
Container/Tube: Surgical Pathology Packaging Kit (Supply T554)
Specimen Volume: Tissue block or 4 slides
Collection Instructions: Attach the green pathology address label included in the kit to the outside of the transport container.
Additional Information:
1. A pathology/diagnostic report and a brief history are required.
2. One slide will be stained with hematoxylin-and-eosin and retained.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Tissue | Ambient | |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
JCV was isolated from brain tissue of a patient with progressive multifocal leukoencephalopathy (PML), a rare, demyelinating, fatal disorder of the central nervous system which occurs on a background of immune deficiency. PML occurs as an infrequent complication of a wide variety of conditions, including: lymphoproliferative disorders such as Hodgkin's disease, chronic lymphocytic leukemia, and lymphosarcoma; chronic diseases such as sarcoidosis and tuberculosis, and primary immunodeficiency diseases. PML has also been recognized as a frequent complication of the AIDS. Most cases of PML, not associated with AIDS, occur in middle age or later life, but the disease may occur in an immunocompromised individual of any age and has been recognized in young children with immunodeficiency diseases.
JCV also infects humans in childhood and is present in most of the world's population. It is the etiologic agent of PML. Clinically, signs and symptoms of asymmetric multifocal brain disease without signs of increased intracranial pressure in a person who is immunocompromised would suggest the diagnosis of PML. Computed tomographic scan or magnetic resonance imaging of the brain is effective in establishing the diagnosis of PML in a noninvasive manner. The unique histopathologic features of PML can be identified by light microscopy of a brain biopsy specimen. JCV can be cultivated in cell cultures, and serologic assays have have been developed, but nucleic acid detection methods are much more sensitive and rapid for making the laboratory diagnosis of PML using brain tissue.
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.
This test, when not accompanied by a pathology consultation request, will be answered as either positive or negative.
If additional interpretation/analysis is needed, please request 5439 Surgical Pathology Consultation along with this test.
Interpretation Provides information to assist in interpretation of the test results
"Positive for Polyomavirus (JC Virus)" indicates the presence of infection with JCV.
"Negative for Polyomavirus (JC Virus)" indicates the absence of cells infected with JCV.
A negative result is normal.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Prolonged formalin fixation may cause false-negative results. A few weeks appears to be the maximum time of fixation.
Submitted specimens will be screened by a pathologist to determine the acceptability of the specimen for the test.
Slides must be specially prepared, therefore, a paraffin-embedded, formalin-fixed tissue must also be submitted.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Aksamit AJ, Mourrain P, Sever JL, Major EO: Progressive multifocal leukoencephalopathy: investigation of three cases using in situ hybridization with JC virus biotinylated DNA probe. Ann Neurol 1985;18:490-496
2. Telenti A, Aksamit AJ Jr, Proper J, Smith TF: Detection of JC virus DNA by polymerase chain reaction in patients with progressive multifocal leukoencephalopathy. J Infect Dis 1990;162:858-861
3. Aksamit AJ Jr: Nonradioactive in situ hybridization in progressive multifocal leukoencephalopathy. Mayo Clin Proc 1993;68:899-910
Method Description Describes how the test is performed and provides a method-specific reference
The probes are labeled with digoxigenin and used in an in situ hybridization procedure with hybridization for 2 hours. After washing, the tissues are incubated with anti-digoxigenin antibody conjugated to alkaline phosphatase and the hybridization product is detected by reaction of the enzyme conjugate with the substrate 5-bromo-4-chloro-3-indolyl phosphate (BCIP) and concomitant reduction of nitroblue tetrazolium (NBT). Some bizarre, malignant-appearing astrocytes may stain with the JCV probe. These cells are infected by JCV in progressive multifocal leukoencephalopathy (PML). Morphologically, these cells have enlarged nuclei (25-60 nm), lobulated nuclei, multiple nuclei, nuclear hyperchromasia with a coarse chromatin pattern, and occasional frank mitosis. (Aksamit AJ, Mourrain P, Sever JL, Major EO: Progressive multifocal leukoencephalopathy: investigation of three cases using in situ hybridization with JC virus biotinylated DNA probe. Ann Neurol 1985;18:490-496)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; 9 a.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
88365
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 18894 | Accession Number | N/A |
| 18895 | Referring Pathologist/Physician | 46608-6 |
| 18896 | Ref Path/Phys Address | In Process |
| 18897 | Material: | In Process |
| 18969 | Tissue: | 31208-2 |
| 18898 | Interpretation: | In Process |
| 18970 | Comment: | 48767-8 |
| 18899 | SP Signing Pathologist: | N/A |
| 18900 | *Previous Report Follows* | N/A |
| 18901 | Addendum: | 35265-8 |
| 19222 | Addendum Comment: | 22638-1 |
| 18902 | Addendum Pathologist: | 19139-5 |
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