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25628 B-Cell Lymphoma Tissue, FISH (BLYM)

B-Cell Lymphoma Tissue, FISH (BLYM)
Test Code: BLYMFSO
Synonyms/Keywords

​BLYM
BCL2 (18q21) rearrangement
BCL6 (3q27) rearrangement
Burkitt lymphoma
Burkitt-like lymphoma
CCND2
Diffuse Large Cell Lymphoma/"Double Hit"
Follicular lymphoma
Large BCL with IRF4 rearranged
MALT (18q21) rearrangement
MALT lymphoma
Mantle Cell Lymphoma (MCL)
MYC (8q24.1) rearrangement
MYC/Kappa
MYC/Lambda
Splenic Marginal Zone Lymphoma
t(11;14) (q13;q32) - CCND1/IGH
t(11;18) (q21;q21) - BIRC3/MALT1
t(14;18) (q32;q21) - IGH/MALT1
t(14;18)(q32;q21) - IGH/BCL2
t(2;8)(p12;q24) - IGK/MYC
t(8;14) (q24.1;q32) - MYC/IGH
t(8;22) (q24.1;q11.2) - MYC/IGL
IRF4
DUSP22
TNFRSF14
1p36

TI BLYMFSO

Test Components

This test does not include a pathology consultation. If a pathology consultation is desired, PATHC / Pathology Consultation should be ordered and the appropriate fluorescence in situ hybridization (FISH) test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the pre-analytic (tissue adequacy and probe selection, when applicable) and post-analytic (interpretation of FISH results in context of specific case, when applicable) phases.

This assay detects chromosome abnormalities observed in paraffin-embedded tissue samples of patients with B-cell lymphoma. If a blood or bone marrow specimen is submitted, the test will be canceled and BLPMF / B-Cell Lymphoma, Specified FISH, Varies will be added and performed as the appropriate test.

If either the break-apart MYC or the MYC/IGH D-FISH probe sets are requested in isolation, both probe sets will be performed concurrently to optimize the detection of MYC rearrangements.

Useful For
​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 lymphomas
Specimen Requirements

Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Tissue
​Tissue block ​Slides
Collection Processing Instructions

A reason for testing and pathology report are required for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports. The laboratory will not reject testing if a reason for testing is not provided; however, appropriate testing and interpretation may be compromised or delayed. If not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

If the patient is being tracked for known abnormalities, an indication of which probes should be used is required for testing to be performed. See Table in Clinical Information on Mayo's website.​


Submit only 1 of the following specimens:

Specimen Type: Tissue

Preferred: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.

Additional Information:

1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).

2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.

Acceptable: Tissue slides

Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides. Include 1 hematoxylin and eosin-stained slide for the entire test order.

Specimen Stability Information
Specimen Type Temperature
​Tissue ​ ​Ambient (preferred)
​Refrigerated
Rejection Criteria
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. 
Interference

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

Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays.

Paraffin-embedded tissues that have been decalcified are generally unsuccessful for FISH analysis. The pathologist reviewing the hematoxylin and eosin-stained slide may find it necessary to cancel testing.

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​4 to 10 days ​Fluorescence In Situ Hybridization (FISH)
Reference Lab
Test Information
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.​
Reference Range Information

​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 is supportive of a diagnosis of a B-cell lymphoma. The specific abnormality detected may help subtype the neoplasm.
 
The absence of an abnormal clone does not rule out the presence of a neoplastic disorder.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
88377 ​1 ​if 1 probe set
​88377​2​if 2 probe sets
​88377​3​if 3 probe sets
​88377​4 ​if 4 probe sets
​88377​5​if 5 probe sets
​88377​6​if 6 probe sets
Classification
Synonyms/Keywords

​BLYM
BCL2 (18q21) rearrangement
BCL6 (3q27) rearrangement
Burkitt lymphoma
Burkitt-like lymphoma
CCND2
Diffuse Large Cell Lymphoma/"Double Hit"
Follicular lymphoma
Large BCL with IRF4 rearranged
MALT (18q21) rearrangement
MALT lymphoma
Mantle Cell Lymphoma (MCL)
MYC (8q24.1) rearrangement
MYC/Kappa
MYC/Lambda
Splenic Marginal Zone Lymphoma
t(11;14) (q13;q32) - CCND1/IGH
t(11;18) (q21;q21) - BIRC3/MALT1
t(14;18) (q32;q21) - IGH/MALT1
t(14;18)(q32;q21) - IGH/BCL2
t(2;8)(p12;q24) - IGK/MYC
t(8;14) (q24.1;q32) - MYC/IGH
t(8;22) (q24.1;q11.2) - MYC/IGL
IRF4
DUSP22
TNFRSF14
1p36

TI BLYMFSO

Test Components

This test does not include a pathology consultation. If a pathology consultation is desired, PATHC / Pathology Consultation should be ordered and the appropriate fluorescence in situ hybridization (FISH) test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the pre-analytic (tissue adequacy and probe selection, when applicable) and post-analytic (interpretation of FISH results in context of specific case, when applicable) phases.

This assay detects chromosome abnormalities observed in paraffin-embedded tissue samples of patients with B-cell lymphoma. If a blood or bone marrow specimen is submitted, the test will be canceled and BLPMF / B-Cell Lymphoma, Specified FISH, Varies will be added and performed as the appropriate test.

If either the break-apart MYC or the MYC/IGH D-FISH probe sets are requested in isolation, both probe sets will be performed concurrently to optimize the detection of MYC rearrangements.

Ordering Applications
Ordering Application Description
​COM ​B-Cell Lymphoma Tissue, FISH (BLYM)
​Cerner​B-Cell Lymphoma Tissue, FISH (BLYM)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements

Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Tissue
​Tissue block ​Slides
Collection Processing

A reason for testing and pathology report are required for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports. The laboratory will not reject testing if a reason for testing is not provided; however, appropriate testing and interpretation may be compromised or delayed. If not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

If the patient is being tracked for known abnormalities, an indication of which probes should be used is required for testing to be performed. See Table in Clinical Information on Mayo's website.​


Submit only 1 of the following specimens:

Specimen Type: Tissue

Preferred: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.

Additional Information:

1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).

2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.

Acceptable: Tissue slides

Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides. Include 1 hematoxylin and eosin-stained slide for the entire test order.

Specimen Stability Information
Specimen Type Temperature
​Tissue ​ ​Ambient (preferred)
​Refrigerated
Rejection Criteria
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. 
Interference

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

Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays.

Paraffin-embedded tissues that have been decalcified are generally unsuccessful for FISH analysis. The pathologist reviewing the hematoxylin and eosin-stained slide may find it necessary to cancel testing.

Useful For
​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 lymphomas
Test Components

This test does not include a pathology consultation. If a pathology consultation is desired, PATHC / Pathology Consultation should be ordered and the appropriate fluorescence in situ hybridization (FISH) test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the pre-analytic (tissue adequacy and probe selection, when applicable) and post-analytic (interpretation of FISH results in context of specific case, when applicable) phases.

This assay detects chromosome abnormalities observed in paraffin-embedded tissue samples of patients with B-cell lymphoma. If a blood or bone marrow specimen is submitted, the test will be canceled and BLPMF / B-Cell Lymphoma, Specified FISH, Varies will be added and performed as the appropriate test.

If either the break-apart MYC or the MYC/IGH D-FISH probe sets are requested in isolation, both probe sets will be performed concurrently to optimize the detection of MYC rearrangements.

Reference Range Information

​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 is supportive of a diagnosis of a B-cell lymphoma. The specific abnormality detected may help subtype the neoplasm.
 
The absence of an abnormal clone does not rule out the presence of a neoplastic disorder.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​4 to 10 days ​Fluorescence In Situ Hybridization (FISH)
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
88377 ​1 ​if 1 probe set
​88377​2​if 2 probe sets
​88377​3​if 3 probe sets
​88377​4 ​if 4 probe sets
​88377​5​if 5 probe sets
​88377​6​if 6 probe sets
Classification
For most current information refer to the Marshfield Laboratory online reference manual.