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

Detecting an abnormal clone associated with the common chromosome anomalies seen in patients with B-cell lymphoma, specifically Burkitt, mantle cell, follicular, diffuse large B-cell, and MALT lymphoma

Individual probes can also be utilized to identify specific chromosome anomalies in patients with B-cell lymphoma and track the response to therapy.

Indicate which subtype of B-cell lymphoma is suspected as well as which anomalies need to be investigated from the following profile.

t(8;14), MYC/IGH

t(8q24.1;var), MYC

t(11;14), CCND1/IGH

t(11;18), BIRC3/MALT1

t(14;18), IGH/MALT1

t(14;18), IGH/BCL2

t(3q27;var), BCL6

t(8;22), MYC/IGL

If the patient is being tracked for known anomalies, indicate which anomalies need to be investigated.

The number of probes ordered will determine the price of the testing. When this test is ordered, a charge for 2 FISH probes and interpretation is included. If additional probes or the entire panel are ordered, additional probes charges will be added.

See Malignant Lymphoma, Guideline for Bone Marrow Staging Studies in Special Instructions

• Cytogenetics Hematologic FISH Panel Patient Information Sheet
• Malignant Lymphoma, Guideline for Bone Marrow Staging Studies

Fluorescence In Situ Hybridization (FISH)

Provide a reason for referral 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.

Forms:

1. Cytogenetics Hematologic FISH Panel Patient Information Sheet (Supply T603) in Special Instructions

2. If not ordering electronically, submit a Cytogenetics Hematologic Disorders Request Form (Supply T607) with the specimen.

Advise Express Mail or equivalent if not on courier service.

Submit only 1 of the following specimens:

Preferred:

Specimen Type: Blood

Container/Tube: Green top (sodium heparin)

Specimen Volume: 7-10 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.

Specimen Type: Bone marrow

Container/Tube: Green top (sodium heparin)

Specimen Volume: 1-2 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.

Acceptable:

Specimen Type: Touch prep or fresh tissue

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 1 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). 

An interpretive report will be provided.

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 the presence of neoplastic disorder.

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

1. 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

2. 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

3. 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

Anomalies involving BCL6, c-MYC, and IGL are detected using a break-apart FISH probe. If a MYC abnormality is detected, reflex testing will be performed to identify the translocation partner. Translocations involving fusion of CCND1 and IGH; BCL2 and IGH; MYC and IGH; BIRC3 and MALT1; IGH and MALT1; and MYC and IGL are detected using dual-color, dual-fusion (D-FISH) strategies. A total of 200 nuclei are scored for the break-apart probe set. For each D-FISH probe set, 500 interphase nuclei are scored and results for each abnormal probe(s) are expressed as percent abnormal nuclei.(Brockman SR, Paternoster SF, Ketterling RP, et al: New highly sensitive fluorescence in situ hybridization method to detect PML/RARA fusion in acute promyelocytic leukemia. Cancer Genet Cytogenet 2003;145:144-51)

Monday through Friday; 6 a.m.-9 p.m., Saturday, Sunday; 6 a.m.-4 p.m.

B-Cell Lymphoma, FISH, Blood or Bone Marrow

88271 x 2-DNA probe, each

88275 x 2-Interphase in situ hybridization

88291-Interpretation and report

One Additional FISH Probe

88271-DNA probe, each (if appropriate)

88275-Interphase in situ hybridization (if appropriate)

Two Additional FISH Probes

88271 x 2-DNA probe, each (if appropriate)

88275-Interphase in situ hybridization (if appropriate)

Three Additional FISH Probes

88271 x 3-DNA probe, each (if appropriate)

88275-Interphase in situ hybridization (if appropriate)

Four Additional FISH Probes

88271 x 4-DNA probe, each (if appropriate)

88275 x 2-Interphase in situ hybridization (if appropriate)

Five Additional FISH Probes

88271 x 5-DNA probe, each (if appropriate)

88275 x 2-Interphase in situ hybridization (if appropriate)

Six Additional FISH Probes

88271 x 6-DNA probe, each (if appropriate)

88275 x 3-Interphase in situ hybridization (if appropriate)

Seven Additional FISH Probes

88271 x 7-DNA probe, each (if appropriate)

88275 x 3-Interphase in situ hybridization (if appropriate)

Eight Additional FISH Probes

88271 x 8-DNA probe, each (if appropriate)

88275 x 4-Interphase in situ hybridization (if appropriate)

Nine Additional FISH Probes

88271 x 9-DNA probe, each (if appropriate)

88275 x 4-Interphase in situ hybridization (if appropriate)

Ten Additional FISH Probes

88271 x 10-DNA probe, each (if appropriate)

88275 x 5-Interphase in situ hybridization (if appropriate)

Eleven Additional FISH Probes

88271 x 11-DNA probe, each (if appropriate)

88275 x 5-Interphase in situ hybridization (if appropriate)

Twelve Additional FISH Probes

88271 x 12-DNA probe, each (if appropriate)

88275 x 6-Interphase in situ hybridization (if appropriate)

Thirteen Additional FISH Probes

88271 x 13-DNA probe, each (if appropriate)

88275 x 6-Interphase in situ hybridization (if appropriate)

Fourteen Additional FISH Probes

88271 x 14-DNA probe, each (if appropriate)

88275 x 7-Interphase in situ hybridization (if appropriate)

Fifteen Additional FISH Probes

88271 x 15-DNA probe, each (if appropriate)

88275 x 7-Interphase in situ hybridization (if appropriate)

Sixteen Additional FISH Probes

88271 x 16-DNA probe, each (if appropriate)

88275 x 8-Interphase in situ hybridization (if appropriate)

Seventeen Additional FISH Probes

88271 x 17-DNA probe, each (if appropriate)

88275 x 8-Interphase in situ hybridization (if appropriate)

Eighteen Additional FISH Probes

88271 x 18-DNA probe, each (if appropriate)

88275 x 9-Interphase in situ hybridization (if appropriate)

Nineteen Additional FISH Probes

88271 x 19-DNA probe, each (if appropriate)

88275 x 9-Interphase in situ hybridization (if appropriate)

Twenty Additional FISH Probes

88271 x 20-DNA probe, each (if appropriate)

88275 x 10-Interphase in situ hybridization (if appropriate)

Twenty One Additional FISH Probes

88271 x21-DNA probe, each (if appropriate)

88275 x10-Interphase in situ hybridization (if appropriate)

Twenty Two Additional FISH Probes

88271 x22-DNA probe, each (if appropriate)

88275 x11-Interphase in situ hybridization (if appropriate)

Twenty Three Additional FISH Probes

88271 x23-DNA probe, each (if appropriate)

88275 x11-Interphase in situ hybridization (if appropriate)

Twenty Four Additional FISH Probes

88271 x24-DNA probe, each (if appropriate)

88275 x12-Interphase in situ hybridization (if appropriate)

Twenty Five Additional FISH Probes

88271 x25-DNA probe, each (if appropriate)

88275 x12-Interphase in situ hybridization (if appropriate)

Twenty Six Additional FISH Probes

88271 x26-DNA probe, each (if appropriate)

88275 x13-Interphase in situ hybridization (if appropriate)

Twenty Seven Additional FISH Probes

88271 x27-DNA probe, each (if appropriate)

88275 x13-Interphase in situ hybridization (if appropriate)

Twenty Eight Additional FISH Probes

88271 x28-DNA probe, each (if appropriate)

88275 x14-Interphase in situ hybridization (if appropriate)

Twenty Nine Additional FISH Probes

88271 x29-DNA probe, each (if appropriate)

88275 x14-Interphase in situ hybridization (if appropriate)

Thirty Additional FISH Probes

88271 x30-DNA probe, each (if appropriate)

88275 x15-Interphase in situ hybridization (if appropriate)