{"id":674,"date":"2018-12-10T17:53:11","date_gmt":"2018-12-10T17:53:11","guid":{"rendered":"https:\/\/wp.uthscsa.edu\/pathology\/?page_id=674"},"modified":"2018-12-10T17:53:11","modified_gmt":"2018-12-10T17:53:11","slug":"fish-panels","status":"publish","type":"page","link":"https:\/\/lsom.uthscsa.edu\/pathology\/reference-labs\/clinical-molecular-cytogenetics\/fish-panels\/","title":{"rendered":"FISH – PANELS*"},"content":{"rendered":"

[vc_row][vc_column width=”1\/2″][vc_column_text]<\/p>\n

Fluorescence\u00a0In\u00a0Situ Hybridization \u2013 AML\/MDS Panel<\/h3>\n

Test Overview<\/p>\n

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

88237-52, 88271×3, 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

Turnaround Time<\/strong><\/p>\n

Final report in 5 days for 90% of cases<\/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

Acute\u00a0Myelogenous\u00a0Leukemia\/Myelodysplastic\u00a0syndrome is a group of heterogeneous hematologic conditions with characteristic chromosome abnormalities leading to specific gene rearrangements.\u00a0\u00a0About half of the patients with AML\/MDS may show chromosome abnormalities which can be classified as primary and secondary or treatment related abnormalities.\u00a0\u00a0The chromosome abnormalities are known to correlate with prognosis and response to treatment.\u00a0\u00a0Although majority of such abnormalities can be detected on routine chromosome analysis, interphase FISH analysis due to its high sensitivity can detect low-level clones thus identifying\u00a0prognostically\u00a0and therapeutically important genetic abnormalities.<\/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 AML\/MDS FISH panel includes the following probes.<\/p>\n\n\n\n\n\n\n\n\n\n\n
5q deletion \/\u00a0monosomy\u00a05<\/td>\nTAS2R1 \/ EGR1<\/td>\nCytocell\u00a0(cat # LPH024)<\/td>\n<\/tr>\n
7q deletion \/\u00a0monosomy\u00a07<\/td>\nRELN \/ TES<\/td>\nCytocell\u00a0(cat # LPH025)<\/td>\n<\/tr>\n
t(8;21)<\/td>\nETO \/ AML1 (RUNX1\/RUNX1T1)<\/td>\nCytocell\u00a0(cat # LPH026)<\/td>\n<\/tr>\n
11q rearrangement<\/td>\nMLL<\/td>\nCytocell\u00a0(cat # LPH013)<\/td>\n<\/tr>\n
t(15;17)<\/td>\nPML \/ RARA<\/td>\nCytocell\u00a0(cat # LPH023)<\/td>\n<\/tr>\n
inv(16)<\/td>\nMYH11 \/ CBFB<\/td>\nCytocell\u00a0(cat # LPH022)<\/td>\n<\/tr>\n
17p deletion<\/td>\np53<\/td>\nCytocell\u00a0(cat # LPH017)<\/td>\n<\/tr>\n
20q deletion \/\u00a0monosomy\u00a020<\/td>\nMYBL2 \/ PTPRT<\/td>\nCytocell\u00a0(cat # LPH020)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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.<\/p>\n

 <\/p>\n

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

Test Overview<\/p>\n

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

88237-52, 88271×3, 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

Acute lymphoblastic\/lymphocytic leukemia (ALL) is the most common hematological malignancy seen in children.\u00a0\u00a0A large number of specific chromosome abnormalities and\/or gene rearrangements are seen in patients with ALL with the incidence of such abnormalities ranging from 65-85% for adults and 60-70% for children.\u00a0\u00a0Detection of these abnormalities are vital in stratification of patients into different treatment groups and it is now mandatory to carry out chromosome and FISH studies, especially in children, for enrollment into Children\u2019s Oncology Group (COG) treatment protocols. Although majority of such abnormalities can be detected on routine chromosome analysis, interphase FISH analysis due to its high sensitivity can detect low-level clones thus identifying\u00a0prognostically\u00a0and therapeutically important genetic abnormalities.<\/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 ALL FISH panel includes the following probes.<\/p>\n\n\n\n\n\n\n\n\n\n\n
8q rearrangement<\/td>\ncMYC<\/td>\nCytocell\u00a0(cat # LPH010)<\/td>\n<\/tr>\n
9p deletion<\/td>\np16 \/ D9Z3<\/td>\nCytocell\u00a0(cat # LPH009)<\/td>\n<\/tr>\n
hyperdiploidy\u00a0\u2013\u00a0chr.\u00a04<\/td>\nFIP1L1 \/ CHIC2 \/ PDGFRA<\/td>\nCytocell\u00a0(cat # LPH032)<\/td>\n<\/tr>\n
hyperdiploidy\u00a0\u2013\u00a0chrs. 10 & 17<\/td>\nD10Z1 \/ D17Z1<\/td>\nCytocell\u00a0(cat # LPE010G\/LPE017R)<\/td>\n<\/tr>\n
t(12;21)<\/td>\nETV6 \/ AML1<\/td>\nCytocell\u00a0(cat # LPH012)<\/td>\n<\/tr>\n
11q rearrangement<\/td>\nMLL<\/td>\nCytocell\u00a0(cat # LPH013)<\/td>\n<\/tr>\n
t(9;22)<\/td>\nABL1 \/ BCR<\/td>\nCytocell\u00a0(cat # LPH038)<\/td>\n<\/tr>\n
14q rearrangement<\/td>\nIGH<\/td>\nCytocell\u00a0(cat # LPH014)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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.<\/p>\n

 <\/p>\n

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

Test Overview<\/p>\n

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

88237-52, 88271×3, 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.\u00a0\u00a0Studies 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\n\n\n\n\n
11q deletion<\/td>\nD11Z1 \/ ATM<\/td>\nCytocell\u00a0(cat # LPH011)<\/td>\n<\/tr>\n
17p deletion<\/td>\np53<\/td>\nCytocell\u00a0(cat # LPH017)<\/td>\n<\/tr>\n
13q deletion<\/td>\nRB1 \/ CTB-163C9<\/td>\nCytocell\u00a0(cat # LPS011)<\/td>\n<\/tr>\n
t(11;14)<\/td>\nCCND1 \/ IGH<\/td>\nCytocell\u00a0(cat # LPH021)<\/td>\n<\/tr>\n
t(4;14)<\/td>\nFGFR3 \/ IGH<\/td>\nCytocell\u00a0(cat # LPH030)<\/td>\n<\/tr>\n
t(14;16)<\/td>\nIGH \/ MAF<\/td>\nCytocell\u00a0(cat # LPH029)<\/td>\n<\/tr>\n
hyperdiploidy<\/td>\nATM \/ MAF \/ FGFR3<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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.<\/p>\n

 <\/p>\n

Fluorescence In Situ Hybridization \u2013 CLL Panel<\/h3>\n

Test Overview<\/p>\n

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

88237-52, 88271×3, 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\n\n\n\n\n\n
6q deletion<\/td>\nD6Z1 \/ MYB<\/td>\nCytocell\u00a0(cat # LPH016)<\/td>\n<\/tr>\n
trisomy 12<\/td>\nD12Z1<\/td>\nCytocell\u00a0(cat # LPE012R)<\/td>\n<\/tr>\n
11q deletion<\/td>\nD11Z1 \/ ATM<\/td>\nCytocell\u00a0(cat # LPH011)<\/td>\n<\/tr>\n
t(14;18)<\/td>\nIGH \/ BCL2<\/td>\nCytocell\u00a0(cat # LPH018)<\/td>\n<\/tr>\n
14q rearrangement<\/td>\nIGH<\/td>\nCytocell\u00a0(cat # LPH014)<\/td>\n<\/tr>\n
17p deletion<\/td>\np53<\/td>\nCytocell\u00a0(cat # LPH017)<\/td>\n<\/tr>\n
t(11;14)<\/td>\nCCND1 \/ IGH<\/td>\nCytocell\u00a0(cat # LPH021)<\/td>\n<\/tr>\n
13q deletion<\/td>\nRB1 \/ CTB-163C9<\/td>\nCytocell\u00a0(cat # LPS011)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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.<\/p>\n

[\/vc_column_text][\/vc_column][vc_column width=”1\/2″][vc_column_text]<\/p>\n

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

Test Overview<\/p>\n

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

88237-52, 88271×3, 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

Myeloproliferative\u00a0neoplasms associated with activated tyrosine kinase and presenting with eosinophilia are a distinct group of\u00a0myeloproliferative\u00a0and lymphoid neoplasms.\u00a0\u00a0These neoplasms, especially those with rearrangements involving the platelet derived growth factor receptor alpha (PDGFRA), platelet derived growth factor receptor beta (PDGFRB), fibroblast growth factor receptor 1 (FGFR1) and BCR\/ABL1 fusion, respond well to treatment with tyrosine kinase inhibitors like\u00a0imatinib\u00a0and hence are called\u00a0imatinib\u00a0responsive neoplasms.\u00a0\u00a0The most common chromosomal rearrangements seen in this group include\u00a0t(4;12) resulting in PDGFRA rearrangement, t(5;12) resulting in PDGFRB rearrangement, t(9;22) resulting in BCR\/ABL1 rearrangement\u00a0\u00a0and chromosome 8 abnormalities resulting in FGFR1rearrangements.\u00a0\u00a0Although some of these chromosome abnormalities can be detected on routine chromosome analysis, FISH is more sensitive in identifying and accurately characterizing the underlying gene rearrangements and hence is the preferred method for diagnosis.<\/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 MPD panel includes the following probes.<\/p>\n\n\n\n\n\n\n
t(9;22)<\/td>\nABL1 \/ BCR<\/td>\nCytocell\u00a0(cat # LPH038)<\/td>\n<\/tr>\n
4q rearrangement<\/td>\nFIP1L1 \/ CHIC2 \/ PDGFRA<\/td>\nCytocell\u00a0(cat # LPH032)<\/td>\n<\/tr>\n
t(5;12)<\/td>\nPDGFRB<\/td>\nCytocell\u00a0(cat # LPH031)<\/td>\n<\/tr>\n
8p11 rearrangement<\/td>\nFGFR1<\/td>\nCytocell\u00a0(cat # LPS018)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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.<\/p>\n

 <\/p>\n

Fluorescence In Situ Hybridization \u2013 B-cell Lymphoma Panel<\/h3>\n

Test Overview<\/p>\n

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

88237-52, 88271×3, 88275, 88291<\/p>\n

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

Culture\/Hybridization\/Microscopy\/Interpretation<\/p>\n

Specimen Requirements<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
Bone Marrow and\/or Leukemia Blood<\/strong><\/td>\nLymph Node<\/strong><\/td>\n<\/tr>\n
Container: Sodium Heparin (green top tube)<\/td>\nContainer: Transport Media\/Saline<\/td>\n<\/tr>\n
Optimal Quantity: 2-3 ml<\/td>\nOptimal Quantity: 23 cm<\/td>\n<\/tr>\n
Minimum Quantity: 1-2 ml<\/td>\nMinimum Quantity: 13 cm<\/td>\n<\/tr>\n
Storage: Room Temperature<\/td>\nStorage: Room Temperature<\/td>\n<\/tr>\n
Stability at Room Temperature: 8 hours, then refrigerate<\/td>\nStability at Room Temperature: 8 hours, then refrigerate<\/td>\n<\/tr>\n
Transportation: Avoid freezing or heating over 35oC<\/td>\nTransportation: Avoid freezing or heating over 35o<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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

B-cell lymphoma is a large group of\u00a0heterogenous\u00a0disorders and comprises a majority of non-Hodgkin lymphomas.\u00a0\u00a0The most common abnormality seen in these disorders is the IGH gene translocations or rearrangements involving the 14q32 locus.\u00a0\u00a0Included in this group is follicular lymphoma (FL),\u00a0Burkitt\u00a0Lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL).\u00a0\u00a0The characteristic chromosome abnormality, t(14;18) resulting in IGH\/BCL2 fusion is seen in about 80% of FL, and about 20-30% of DLBCL while a majority of patients with BL harbor the characteristic t(8;14) resulting in\u00a0cMYC\/IGH fusion.\u00a0\u00a0BCL6 gene rearrangements are also associated with B-cell lymphoma.\u00a0Cyclin\u00a0D1 gene rearrangements, especially the\u00a0t(11;14) distinguishes mantle cell lymphoma (ML) from other\u00a0lymphoproliferative\u00a0disorders and hence is diagnostic for ML. Although majority of such abnormalities can be detected on routine chromosome analysis, interphase FISH analysis due to its high sensitivity can detect low-level clones thus identifying\u00a0prognostically\u00a0and therapeutically important genetic abnormalities.<\/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 B-cell lymphoma panel includes the following probes.<\/p>\n\n\n\n\n\n\n
t(14;18)<\/td>\nIGH \/ BCL2<\/td>\nCytocell\u00a0(cat # LPH018)<\/td>\n<\/tr>\n
8q rearrangement<\/td>\ncMYC<\/td>\nCytocell\u00a0(cat # LPH010)<\/td>\n<\/tr>\n
3q rearrangement<\/td>\nBCL6<\/td>\nCytocell\u00a0(cat # LPH035)<\/td>\n<\/tr>\n
t(11;14)<\/td>\nCCND1 \/ IGH<\/td>\nCytocell\u00a0(cat # LPH021)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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.<\/p>\n

 <\/p>\n

Fluorescence In Situ Hybridization \u2013 T-cell Lymphoma Panel<\/h3>\n

Test Overview<\/p>\n

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

88237-52, 88271×3, 88275, 88291<\/p>\n

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

Culture\/Hybridization\/Microscopy\/Interpretation<\/p>\n

Specimen Requirements<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
Bone Marrow and\/or Leukemia Blood<\/em><\/strong><\/td>\nLymph Node<\/em><\/strong><\/td>\n<\/tr>\n
Container: Sodium Heparin (green top tube)<\/td>\nContainer: Transport Media\/Saline<\/td>\n<\/tr>\n
Optimal Quantity: 2-3 ml<\/td>\nOptimal Quantity: 23<\/sup>\u00a0cm<\/td>\n<\/tr>\n
Minimum Quantity: 1-2 ml<\/td>\nMinimum Quantity: 13<\/sup>\u00a0cm<\/td>\n<\/tr>\n
Storage: Room Temperature<\/td>\nStorage: Room Temperature<\/td>\n<\/tr>\n
Stability at Room Temperature: 8 hours, then refrigerate<\/td>\nStability at Room Temperature: 8 hours, then refrigerate<\/td>\n<\/tr>\n
Transportation: Avoid freezing or heating over 35o<\/sup>C<\/td>\nTransportation: Avoid freezing or heating over 35o<\/sup>C<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/strong>Turnaround Time<\/strong><\/p>\n

Final report in 5 days for 90% cases<\/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

The common genomic abnormalities seen in T-cell lymphoma usually involve the T-cell receptor genes (TCR) with various transcription factors.\u00a0\u00a0The 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.\u00a0\u00a0The ALK gene rearrangements occur in about 2% of adults and 13% of children.<\/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\u00a0are\u00a0analyzed using 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.\u00a0\u00a0The T-cell lymphoma FISH panel includes the following probes.<\/p>\n\n\n\n\n\n
inv(7) \/\u00a0iso(7q)<\/td>\nTCRB<\/td>\nCytocell\u00a0(cat # LPH048)<\/td>\n<\/tr>\n
inv(14) \/ 14q rearrangement<\/td>\nTCRAD<\/td>\nCytocell\u00a0(cat # LPH047)<\/td>\n<\/tr>\n
t(2;5) \/ 2p rearrangement<\/td>\nALK<\/td>\nCytocell\u00a0(cat # LPS 019)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/strong>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.<\/p>\n

*Probes used on panels may be ordered as single tests<\/strong><\/p>\n

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