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HelpTest ID BLPMF B-Cell Lymphoma, Specified FISH, Varies
Ordering Guidance
This test should only be ordered if the sample is known to have a sufficient clonal B-cell population. If a flow cytometry result is available and does not identify a sufficient clonal B-cell population, this test order will be canceled, and no charges will be incurred.
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.
This assay detects chromosome abnormalities observed in blood or bone marrow samples of patients with B-cell lymphoma. If a paraffin-embedded tissue specimen is submitted, the test will be canceled and BLYM / B-Cell Lymphoma, FISH, Tissue will be added and performed as the appropriate test.
For patients with B-cell acute lymphoblastic leukemia/lymphoma (B-ALL/LBL), order either BALAF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies or BALPF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies, depending on the age of the patient.
For testing paraffin-embedded tissue samples from patients with B-cell lymphoblastic Lymphoma, see BLBLF / B-Cell Lymphoblastic Leukemia/Lymphoma, FISH, Tissue.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. A list of probes requested for analysis is required. Probes available for this test are listed in the Testing Algorithm section.
2. A reason for testing and a flow cytometry and/or a bone marrow pathology report should be sent with each specimen The laboratory will not reject testing if this information is not provided, however appropriate testing and/or interpretation may be compromised or delayed in some instances. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Bone marrow
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 2 to 3 mL
Collection Instructions:
1. It is preferable to send the first aspirate from the bone marrow collection.
2. Invert several times to mix bone marrow.
3. Send bone marrow in original tube. Do not aliquot.
Acceptable:
Specimen Type: Blood
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood in original tube. Do not aliquot.
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 lymphoma
Evaluating specimens in which standard cytogenetic analysis is unsuccessful
Testing Algorithm
This test includes a charge for the probe application, analysis and professional interpretation of results for 1 probe set (2 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.
This is not intended as a panel test and the desired probe(s) or suspected B-cell lymphoma subtype must be specified upon order. If the patient is being evaluated for known abnormalities, individual probe(s) must be listed in the probe request field. This test is only appropriate for the following known subtypes of B-cell lymphoma:
Pediatric Burkitt lymphoma testing (18 years or younger):
-Recommended probe request = 5’/3’ MYC, MYC/IGH, MYC/IGK, MYC/IGL, 3’/5’ BCL2, 3’/5’ BCL6
Diffuse large B-cell, "double-hit", "triple hit" lymphoma testing:
-Recommended probe request = 5’/3’ MYC, MYC/IGH, reflex with 3’/5’ BCL2, 3’/5’ BCL6
*If reflex is included in the probe request, break-apart BCL2 and BCL6 reflex testing would occur when a MYC disruption is observed
Follicular lymphoma testing:
-Recommended probe request = 3’/5’ BCL2, 3’/5’ BCL6
Mantle cell lymphoma (MCL) testing:
-Recommended probe request = CCND1/IGH, 5’/3’ CCND1 as reflex
*If reflex is included in the probe request, break-apart CCND1 reflex testing would occur when an additional CCND1 FISH signal is detected to rule out a CCND1 gene disruption
Blastoid Mantle cell lymphoma testing:
-Recommended probe request = CCND1/IGH, TP53, 5’/3’ MYC, MYC/IGH, 5’/3’ CCND1 as reflex
*If reflex is included in the probe request, break-apart CCND1 reflex testing would occur when an additional CCND1 FISH signal is detected to rule out a CCND1 gene disruption
Splenic marginal zone lymphoma testing:
-Recommended probe request = D7Z1/7q32, TP53/D17Z1
See Common Chromosome Abnormalities in B-cell Lymphomas in Clinical Information for specific gene locations associated with these B-cell lymphoma subtypes.
If the laboratory is not provided a specific probe request or an appropriate B-cell lymphoma subtype, the following probes will be performed.
-t(3q27;var) rearrangement, BCL6 break-apart
-7q-, D7Z1/7q32
-8q24.1 rearrangement, MYC break-apart
-t(8;14)(q24.1;q32), MYC/IGH fusion
-t(11;14)(q13;q32), CCND1/IGH fusion
-17/17p-, TP53/D17Z1
-t(18q21;var) rearrangement, BCL2 break-apart
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal B-cells are available for FISH testing. If the result does not identify a sufficient clonal B-cell population, this FISH test order will be canceled, and no charges will be incurred. The B-cell lymphoma subtype will be used by the laboratory to determine appropriate FISH probes, if determined and applicable.
For more information see Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm
Special Instructions
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
B-cell Lymphoma, Specified FISHSpecimen Type
VariesSpecimen Minimum Volume
Blood: 2 mL
Bone Marrow: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
88271 x 2, 88275, 88291-FISH Probe, Analysis, Interpretation; 1 probe set
88271 x 2, 88275-FISH Probe, Analysis; each additional probe set (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BLPMF | B-cell Lymphoma, Specified FISH | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 614229 | Result Summary | 50397-9 |
| 614230 | Interpretation | 69965-2 |
| 614231 | Result Table | 93356-4 |
| 614232 | Result | 62356-1 |
| GC105 | Reason for Referral | 42349-1 |
| GC106 | Probes Requested | 78040-3 |
| GC107 | Specimen | 31208-2 |
| 614233 | Source | 31208-2 |
| 614234 | Method | 31208-2 |
| 614235 | Additional Information | 48767-8 |
| 614236 | Disclaimer | 62364-5 |
| 614237 | Released By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.