{"id":1198,"date":"2018-12-20T16:21:55","date_gmt":"2018-12-20T16:21:55","guid":{"rendered":"https:\/\/wp.uthscsa.edu\/pathology\/?page_id=1198"},"modified":"2020-09-04T17:07:35","modified_gmt":"2020-09-04T17:07:35","slug":"fish-mm","status":"publish","type":"page","link":"https:\/\/lsom.uthscsa.edu\/pathology\/reference-labs\/clinical-molecular-cytogenetics\/fish-mm\/","title":{"rendered":"FISH-MM"},"content":{"rendered":"

[vc_row][vc_column width=”2\/3″][vc_column_text]<\/p>\n

Fluorescence\u00a0In\u00a0Situ Hybridization \u2013 Multiple Myeloma Panel<\/h3>\n

Test Overview<\/p>\n

CPT Code(s)<\/strong><\/p>\n

88237-52, 88271\u00d73, 88275, 88291<\/p>\n

Methodology<\/strong><\/p>\n

Plasma cell isolation\/Culture\/Hybridization\/Microscopy\/Interpretation<\/p>\n

Specimen Requirements<\/strong><\/p>\n

Bone Marrow and\/or Leukemia Blood<\/em><\/strong><\/p>\n

Container: Sodium Heparin (green top tube)<\/p>\n

Optimal Quantity: 2-3 ml<\/p>\n

Minimum Quantity: 1-2 ml<\/p>\n

Storage: Room Temperature<\/p>\n

Stability at Room Temperature: 8 hours, then refrigerate<\/p>\n

Transportation: Avoid freezing or heating over 35o<\/sup>C<\/p>\n

Test Details<\/p>\n

Clinical Significance<\/strong><\/p>\n

Fluorescence in situ hybridization (FISH) is a sensitive method to detect smaller genomic changes associated with various hematological malignancies and solid tumors.\u00a0\u00a0There 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.\u00a0\u00a0However, FISH technology is complementary to routine chromosome analysis and cannot substitute routine chromosome analysis for diagnosis of cancer.<\/p>\n

Clinical Background<\/strong><\/p>\n

Plasma cell disorders are genetically diverse group of diseases arising from malignant proliferation of monoclonal population of plasma cells.\u00a0\u00a0This group consists of monoclonal\u00a0gammopathy\u00a0of undetermined significance (MGUS), plasma\u00a0cytoma, smoldering myeloma, and plasma cell myeloma or multiple myeloma.\u00a0\u00a0Genomic abnormalities are important prognostic factors in myeloma.\u00a0\u00a0Routine chromosome\u00a0anlaysis\u00a0is often limiting and is not efficient in detecting these genomic abnormalities since there is limited infiltration of plasma cells in the bone marrow and also due to the slow proliferation of plasma cells.<\/p>\n

Studies have shown enrichment for plasma cells is most efficient in detecting these\u00a0prognostically\u00a0significant genomic abnormalities.\u00a0\u00a0Our lab has unique expertise in isolating plasma cells and using the negative fraction for routine chromosome analysis to detect non-plasma cell abnormalities.\u00a0\u00a0In fact, we are the first laboratory to design a protocol utilizing the negative fraction for chromosome analysis with considerable success.<\/p>\n

Methods<\/strong><\/p>\n

The plasma cells are isolated using a CD134 magnetic antibody separation method. The isolated plasma cells are harvested and hybridized with the probes.\u00a0\u00a0After hybridization and post-hybridization washes, the slides are analyzed under a fluorescence microscope equipped with\u00a0epifluorescence\u00a0and appropriate filter sets.\u00a0\u00a0Analysis and scoring is carried out by two certified technologists in a blinded fashion.\u00a0\u00a0Results are reviewed by both the laboratory manager and the director. The multiple myeloma\u00a0panel\u00a0includes the following probes.<\/p>\n\n\n\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t
11q deletion<\/td>D11Z1 \/ ATM<\/td>Cytocell\u00a0(cat # LPH011)<\/td>\n<\/tr>\n
17p deletion<\/td>p53<\/td>Cytocell\u00a0(cat # LPH017)<\/td>\n<\/tr>\n
13q deletion<\/td>RB1 \/ CTB-163C9<\/td>Cytocell\u00a0(cat # LPS011)<\/td>\n<\/tr>\n
t(11;14)<\/td>CCND1 \/ IGH<\/td>Cytocell\u00a0(cat # LPH021)<\/td>\n<\/tr>\n
t(4;14)<\/td>FGFR3 \/ IGH<\/td>Cytocell\u00a0(cat # LPH030)<\/td>\n<\/tr>\n
t(14;16)<\/td>IGH \/ MAF<\/td>Cytocell\u00a0(cat # LPH029)<\/td>\n<\/tr>\n
hyperdiploidy<\/td>ATM \/ MAF \/ FGFR3<\/td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n

Interpretation of Results<\/strong><\/p>\n

The morphologic interpretation and correlation of results on all cases is performed by a board-certified doctoral level scientist (laboratory director).\u00a0The final report has a narrative description of results.\u00a0\u00a0If abnormalities are present, they are explained in a paragraph which helps to clarify and correlate chromosomal findings with phenotype.\u00a0References 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.[\/vc_column_text][\/vc_column][vc_column width=”1\/3″][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"

[vc_row][vc_column width=”2\/3″][vc_column_text] Fluorescence\u00a0In\u00a0Situ Hybridization \u2013 Multiple Myeloma Panel Test Overview CPT Code(s) 88237-52, 88271\u00d73, 88275, 88291 Methodology Plasma cell isolation\/Culture\/Hybridization\/Microscopy\/Interpretation 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 […]<\/p>\n","protected":false},"author":161,"featured_media":0,"parent":615,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/child-page.php","meta":{"footnotes":""},"class_list":["post-1198","page","type-page","status-publish","hentry"],"yoast_head":"\nFISH-MM - Department of Pathology and Laboratory Medicine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lsom.uthscsa.edu\/pathology\/reference-labs\/clinical-molecular-cytogenetics\/fish-mm\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"FISH-MM - 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