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25628 B-Cell Lymphoma Tissue, FISH (BLYM)

B-Cell Lymphoma Tissue, FISH (BLYM)
Test Code: BLYMFSO
Synonyms/Keywords
BLYM
BCL2 (18q21) rearrangement
BCL6 (3q27) rearrangement
Burkitt lymphoma
Burkitt-like lymphoma
CCND2
Diffuse Large Cell Lymphoma/"Double Hit"
Follicular lymphoma
Large BCL with IRF4 rearranged
MALT (18q21) rearrangement
MALT lymphoma
Mantle Cell Lymphoma (MCL)
MYC (8q24.1) rearrangement
MYC/Kappa
MYC/Lambda
Splenic Marginal Zone Lymphoma
t(11;14) (q13;q32) - CCND1/IGH
t(11;18) (q21;q21) - BIRC3/MALT1
t(14;18) (q32;q21) - IGH/MALT1
t(14;18)(q32;q21) - IGH/BCL2
t(2;8)(p12;q24) - IGK/MYC
t(8;14) (q24.1;q32) - MYC/IGH
t(8;22) (q24.1;q11.2) - MYC/IGL
IRF4
DUSP22
TNFRSF14
1p36
Test Components

This test does not include a pathology consultation. If a pathology consultation is desired, PATHC / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the preanalytic (tissue adequacy and probe selection, when applicable) and postanalytic (interpretation of FISH results in context of specific case, when applicable) phases.

Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in the table: Common Chromosome Abnormalities in B-cell Lymphomas in Clinical Information.

If the patient is being tracked for known abnormalities, indicate which probes should be used.

A charge and CPT code is applied for each probe set hybridized, analyzed, and reported.

Initial probe sets are run and completed within 4 days. If, based on testing algorithms, results of the initial probe sets require reflex testing, complete results will be available within 10 days. 

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 lymphomas
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Lymph node ​Tissue block ​Slides
​Solid tumor ​Tissue block ​Slides
Collection Processing Instructions

​Tissue Block: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.

Slides:  For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.

A reason for referral and pathology report are required in order for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports.

Specimen Stability Information
Specimen Type Temperature
​Tissue ​ ​Ambient (preferred)
​Refrigerated
Rejection Criteria
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. 
Interference

This test is not approved by the FDA and it is best used as an adjunct to existing clinical and pathologic information.

Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays.

Paraffin-embedded tissues that have been decalcified are generally unsuccessful for FISH analysis. The pathologist reviewing the hematoxylin and eosin-stained slide may find it necessary to cancel testing.

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​4 to 10 days ​Fluorescence In Situ Hybridization (FISH)
Reference Lab
Test Information
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.​
Reference Range Information

​An interpretive report will be provided. 

Interpretation
​A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for any given probe.
 
Detection of an abnormal clone is supportive of a diagnosis of a B-cell lymphoma. The specific abnormality detected may help subtype the neoplasm.
 
The absence of an abnormal clone does not rule out the presence of a neoplastic disorder.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
88377 ​1 ​if 1 probe set
​88377​2​if 2 probe sets
​88377​3​if 3 probe sets
​88377​4 ​if 4 probe sets
​88377​5​if 5 probe sets
​88377​6​if 6 probe sets
Classification
Synonyms/Keywords
BLYM
BCL2 (18q21) rearrangement
BCL6 (3q27) rearrangement
Burkitt lymphoma
Burkitt-like lymphoma
CCND2
Diffuse Large Cell Lymphoma/"Double Hit"
Follicular lymphoma
Large BCL with IRF4 rearranged
MALT (18q21) rearrangement
MALT lymphoma
Mantle Cell Lymphoma (MCL)
MYC (8q24.1) rearrangement
MYC/Kappa
MYC/Lambda
Splenic Marginal Zone Lymphoma
t(11;14) (q13;q32) - CCND1/IGH
t(11;18) (q21;q21) - BIRC3/MALT1
t(14;18) (q32;q21) - IGH/MALT1
t(14;18)(q32;q21) - IGH/BCL2
t(2;8)(p12;q24) - IGK/MYC
t(8;14) (q24.1;q32) - MYC/IGH
t(8;22) (q24.1;q11.2) - MYC/IGL
IRF4
DUSP22
TNFRSF14
1p36
Test Components

This test does not include a pathology consultation. If a pathology consultation is desired, PATHC / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the preanalytic (tissue adequacy and probe selection, when applicable) and postanalytic (interpretation of FISH results in context of specific case, when applicable) phases.

Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in the table: Common Chromosome Abnormalities in B-cell Lymphomas in Clinical Information.

If the patient is being tracked for known abnormalities, indicate which probes should be used.

A charge and CPT code is applied for each probe set hybridized, analyzed, and reported.

Initial probe sets are run and completed within 4 days. If, based on testing algorithms, results of the initial probe sets require reflex testing, complete results will be available within 10 days. 

Ordering Applications
Ordering Application Description
​COM ​B-Cell Lymphoma Fish, Tissue
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Lymph node ​Tissue block ​Slides
​Solid tumor ​Tissue block ​Slides
Collection Processing

​Tissue Block: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.

Slides:  For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.

A reason for referral and pathology report are required in order for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports.

Specimen Stability Information
Specimen Type Temperature
​Tissue ​ ​Ambient (preferred)
​Refrigerated
Rejection Criteria
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. 
Interference

This test is not approved by the FDA and it is best used as an adjunct to existing clinical and pathologic information.

Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays.

Paraffin-embedded tissues that have been decalcified are generally unsuccessful for FISH analysis. The pathologist reviewing the hematoxylin and eosin-stained slide may find it necessary to cancel testing.

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 lymphomas
Test Components

This test does not include a pathology consultation. If a pathology consultation is desired, PATHC / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge. Mayo Hematopathology Consultants are involved in both the preanalytic (tissue adequacy and probe selection, when applicable) and postanalytic (interpretation of FISH results in context of specific case, when applicable) phases.

Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in the table: Common Chromosome Abnormalities in B-cell Lymphomas in Clinical Information.

If the patient is being tracked for known abnormalities, indicate which probes should be used.

A charge and CPT code is applied for each probe set hybridized, analyzed, and reported.

Initial probe sets are run and completed within 4 days. If, based on testing algorithms, results of the initial probe sets require reflex testing, complete results will be available within 10 days. 

Reference Range Information

​An interpretive report will be provided. 

Interpretation
​A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for any given probe.
 
Detection of an abnormal clone is supportive of a diagnosis of a B-cell lymphoma. The specific abnormality detected may help subtype the neoplasm.
 
The absence of an abnormal clone does not rule out the presence of a neoplastic disorder.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​4 to 10 days ​Fluorescence In Situ Hybridization (FISH)
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
88377 ​1 ​if 1 probe set
​88377​2​if 2 probe sets
​88377​3​if 3 probe sets
​88377​4 ​if 4 probe sets
​88377​5​if 5 probe sets
​88377​6​if 6 probe sets
Classification
For most current information refer to the Marshfield Laboratory online reference manual.