{"id":1203,"date":"2018-12-20T16:23:24","date_gmt":"2018-12-20T16:23:24","guid":{"rendered":"https:\/\/wp.uthscsa.edu\/pathology\/?page_id=1203"},"modified":"2020-04-28T21:55:03","modified_gmt":"2020-04-28T21:55:03","slug":"fish-cll","status":"publish","type":"page","link":"https:\/\/lsom.uthscsa.edu\/pathology\/reference-labs\/clinical-molecular-cytogenetics\/fish-cll\/","title":{"rendered":"FISH-CLL"},"content":{"rendered":"

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

Fluorescence In Situ Hybridization \u2013 CLL 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

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

Chronic lymphocytic leukemia (CLL) is leukemia of small mature B-cells and mostly affect adults age 65 and above.\u00a0\u00a0CLL is the most common lymphoid malignancy accounting for about 11% of all hematological malignancies and 25% of all\u00a0leukemias.\u00a0\u00a0Up to 50% of patients with CLL may have clonal cytogenetic abnormalities identified on routine chromosome analysis.\u00a0\u00a0However, CLL clones (lymphocytes) do not divide in culture and are resistant to mitogens, thus making routine cytogenetic analysis more difficult.\u00a0\u00a0FISH on the other hand is highly sensitive in detecting the genomic changes that have significant prognostic implications in CLL.<\/p>\n

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

The samples are usually cultured for 24-hours before hybridizing 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 CLL panel includes the following probes.<\/p>\n\n\n\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t
6q deletion<\/td>D6Z1 \/ MYB<\/td>Cytocell\u00a0(cat # LPH016)<\/td>\n<\/tr>\n
trisomy 12<\/td>D12Z1<\/td>Cytocell\u00a0(cat # LPE012R)<\/td>\n<\/tr>\n
11q deletion<\/td>D11Z1 \/ ATM<\/td>Cytocell\u00a0(cat # LPH011)<\/td>\n<\/tr>\n
t(14;18)<\/td>IGH \/ BCL2<\/td>Cytocell\u00a0(cat # LPH018)<\/td>\n<\/tr>\n
14q rearrangement<\/td>IGH<\/td>Cytocell\u00a0(cat # LPH014)<\/td>\n<\/tr>\n
17p deletion<\/td>p53<\/td>Cytocell\u00a0(cat # LPH017)<\/td>\n<\/tr>\n
t(11;14)<\/td>CCND1 \/ IGH<\/td>Cytocell\u00a0(cat # LPH021)<\/td>\n<\/tr>\n
13q deletion<\/td>RB1 \/ CTB-163C9<\/td>Cytocell\u00a0(cat # LPS011)<\/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 In Situ Hybridization \u2013 CLL Panel Test Overview CPT Code(s) 88237-52, 88271\u00d73, 88275, 88291 Methodology 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 or […]<\/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-1203","page","type-page","status-publish","hentry"],"yoast_head":"\nFISH-CLL - 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-cll\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"FISH-CLL - 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