T-cell Lymphoma Panel
CPT Code(s)
88271x2, 88275x2
Performed
Clinical & Molecular Cytogenetics Laboratory
Clinical Indication and Relevance
Fluorescence in situ hybridization (FISH) is a sensitive method to detect smaller genomic changes associated with various hematological malignancies and solid tumors. There are several advantages with FISH technology over routine chromosome analysis and such advantages include the ability of FISH technology to detect genomic abnormalities in non-viable and non-dividing tissues, rapid turnaround time, and increased resolution. However, FISH technology is complementary to routine chromosome analysis and cannot substitute routine chromosome analysis for diagnosis of cancer.
Clinical Background
The common genomic abnormalities seen in T-cell lymphoma usually involve the T-cell receptor genes (TCR) with various transcription factors. The genes that are commonly involved are TCR-alpha (TCRA) and TCR-delta (TCRD) at 14q11, TCR-beta (TCRB) at 7q35, TCR-gamma (TCRG) at 7p15. The ALK gene rearrangements occur in about 2% of adults and 13% of children.
Methodology
Culture/Hybridization/Microscopy/Interpretation
The samples are usually cultured for 24 hours before hybridizing with the probes. After hybridization and post-hybridization washes, the slides are analyzed under a fluorescence microscope equipped with epifluorescence and appropriate filter sets. Analysis and scoring are carried out by two certified technologists in a blinded fashion. Results are reviewed by both the laboratory manager and the director.
Specimen Collection / Handling Requirements
Probe List
| T-Cell Lymphoma | ||
| Probe Name | Locus/CHR | Catalogue # |
| TCRB | 7q34 | Cytocell LPS048 |
| TCRAD | 14q11.2 | Cytocell LPH047 |
| TCL1 | 14q32.13-q32.2 | Cytocell LPH046 |
Minimum Specimen Requirements
Bone Marrow and/or Leukemia Blood
Container: Sodium Heparin (green top tube)
Optimal Quantity: 2-3 ml
Minimum Quantity: 1-2 ml
Storage: Room Temperature
Stability at Room Temperature: 8 hours, then refrigerate
Transportation: Avoid freezing or heating over 35°C
Lymph node
Container: Sterile container with saline or transport media
Optimal Quantity: 1 x 1 x 1 cm piece of non-necrotic tissue
Storage: Room Temperature
Stability at Room Temperature: 8 hours, then refrigerate
Transportation: Avoid freezing or heating over 35°C
Turnaround time
Final report in 7-10 days
Communication
The morphologic interpretation and correlation of results on all cases is performed by a board-certified doctoral level scientist (laboratory director). The final report has a narrative description of results. If abnormalities are present, they are explained in a paragraph which helps to clarify and correlate chromosomal findings with phenotype. References are included in the report to help the referring physician with interpretation, which include books or journals that contain appropriate information. Recommendations are made as to any additional testing, if necessary.
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