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25629 B-Cell Lymphoma, FISH Bld/BM (BLPF)

B-Cell Lymphoma, FISH Bld/BM (BLPF)
Test Code: BLPFSO
Synonyms/Keywords
​17p- (17p deletion) or TP53
BCL2 (18q21) rearrangement
BCL6 (3q27) rearrangement
Burkitt Lymphoma
Burkitt-like Lymphoma
Diffuse Large Cell Lymphoma/"Double Hit"
Follicular Lymphoma
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(2;8)(p12;q24) - IGK/MYC
t(8;14)(q24.1;q32) - MYC/IGH
t(8;22)(q24.1;q11.2) - MYC/IGL
Extra-nodal Marginal Zone Lymphoma (ENMZL)
Triple hit lymphoma
Test Components

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.

When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal B-cells are available for FISH testing. If the result does not identify a sufficient clonal B-cell population, this FISH test order will be canceled and no charges will be incurred.

If FISH testing proceeds, probes will be performed based on the lymphoma subtype suspected/identified utilizing the table "Common Chromosome Abnormalities in B-cell Lymphomas" located in Clinical Information.

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

The following probe sets are available within this B-cell lymphoma FISH profile:

-8q24.1 rearrangement, MYC

-t(8;14), MYC/IGH

-18q21 rearrangement, BCL2

-3q27 rearrangement, BCL6

-t(11;14), CCND1/IGH

-17p deletion, TP53/D17Z1

-7q deletion, D7Z1/7q32

-18q21 rearrangement, MALT1

Marginal zone lymphoma (MZL) can be evaluated via probes for specific subtypes, as follows: mucosa-associated lymphoid tissue (MALT) lymphoma or extra-nodal marginal zone lymphoma (ENMZL) using the MALT1 rearrangement probe and splenic marginal zone lymphoma using probes for 7q deletion and 17p deletion. If no MZL subtype is provided, we will evaluate using probes for MALT1, 7q deletion and 17p deletion. 

Useful For
​Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various B-cell lymphomas using blood or bone marrow specimens
 
Tracking known chromosome abnormalities and response to therapy in patients with B-cell neoplasms
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Submit only 1 of the following specimens:  ​ ​ ​ ​ ​
​Whole Blood ​Sodium-heparin Green Top Tube(GTT) ​7-10 mL ​2 mL
​Bone Marrow ​​Sodium-heparin Green Top Tube(GTT) ​2 mL ​1 mL
Collection Processing Instructions

1. Provide a reason for testing with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.

2. A pathology or flow cytometry report may be requested by the Genomics Laboratory to optimize testing and aid in interpretation of results.

Specimen Stability Information
Specimen Type Temperature
​Blood and Bone Marrow ​ 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 U.S. Food and Drug Administration and it is best used as an adjunct to existing clinical and pathologic information.

Bone marrow is the preferred sample type for this FISH test. If bone marrow is not available, a blood specimen may be used if there are malignant cells in the blood specimen (as verified by hematopathology).

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories Monday through Friday ​7 to 10 days ​Fluorescence In Situ Hybridization (FISH)
Reference Lab
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 supports a diagnosis of a B-cell neoplasm; the specific abnormality detected may help subtype the neoplasm
 
The absence of an abnormal clone does not rule out the presence of neoplastic disorder.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​88291 ​1
​88271 ​2
​88271 ​2 ​Probe, +2 ​If needed
​88271 ​1 ​Probe, +1 ​​If needed
​88271 ​2 ​Probe, +2 ​​If needed
​88271 ​3 ​Probe, +3 ​​If needed
​88274 ​1 ​Interphases, <25 ​​If needed
​88274 ​1 ​Interphases, 25-99 ​​If needed
​88275 ​1 ​Interphases, >=100 ​​If needed
Classification
Synonyms/Keywords
​17p- (17p deletion) or TP53
BCL2 (18q21) rearrangement
BCL6 (3q27) rearrangement
Burkitt Lymphoma
Burkitt-like Lymphoma
Diffuse Large Cell Lymphoma/"Double Hit"
Follicular Lymphoma
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(2;8)(p12;q24) - IGK/MYC
t(8;14)(q24.1;q32) - MYC/IGH
t(8;22)(q24.1;q11.2) - MYC/IGL
Extra-nodal Marginal Zone Lymphoma (ENMZL)
Triple hit lymphoma
Test Components

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.

When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal B-cells are available for FISH testing. If the result does not identify a sufficient clonal B-cell population, this FISH test order will be canceled and no charges will be incurred.

If FISH testing proceeds, probes will be performed based on the lymphoma subtype suspected/identified utilizing the table "Common Chromosome Abnormalities in B-cell Lymphomas" located in Clinical Information.

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

The following probe sets are available within this B-cell lymphoma FISH profile:

-8q24.1 rearrangement, MYC

-t(8;14), MYC/IGH

-18q21 rearrangement, BCL2

-3q27 rearrangement, BCL6

-t(11;14), CCND1/IGH

-17p deletion, TP53/D17Z1

-7q deletion, D7Z1/7q32

-18q21 rearrangement, MALT1

Marginal zone lymphoma (MZL) can be evaluated via probes for specific subtypes, as follows: mucosa-associated lymphoid tissue (MALT) lymphoma or extra-nodal marginal zone lymphoma (ENMZL) using the MALT1 rearrangement probe and splenic marginal zone lymphoma using probes for 7q deletion and 17p deletion. If no MZL subtype is provided, we will evaluate using probes for MALT1, 7q deletion and 17p deletion. 

Ordering Applications
Ordering Application Description
​COM ​B-Cell Lymphoma, FISH Bld/BM
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)
Submit only 1 of the following specimens:  ​ ​ ​ ​ ​
​Whole Blood ​Sodium-heparin Green Top Tube(GTT) ​7-10 mL ​2 mL
​Bone Marrow ​​Sodium-heparin Green Top Tube(GTT) ​2 mL ​1 mL
Collection Processing

1. Provide a reason for testing with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.

2. A pathology or flow cytometry report may be requested by the Genomics Laboratory to optimize testing and aid in interpretation of results.

Specimen Stability Information
Specimen Type Temperature
​Blood and Bone Marrow ​ 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 U.S. Food and Drug Administration and it is best used as an adjunct to existing clinical and pathologic information.

Bone marrow is the preferred sample type for this FISH test. If bone marrow is not available, a blood specimen may be used if there are malignant cells in the blood specimen (as verified by hematopathology).

Useful For
​Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various B-cell lymphomas using blood or bone marrow specimens
 
Tracking known chromosome abnormalities and response to therapy in patients with B-cell neoplasms
Test Components

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.

When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal B-cells are available for FISH testing. If the result does not identify a sufficient clonal B-cell population, this FISH test order will be canceled and no charges will be incurred.

If FISH testing proceeds, probes will be performed based on the lymphoma subtype suspected/identified utilizing the table "Common Chromosome Abnormalities in B-cell Lymphomas" located in Clinical Information.

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

The following probe sets are available within this B-cell lymphoma FISH profile:

-8q24.1 rearrangement, MYC

-t(8;14), MYC/IGH

-18q21 rearrangement, BCL2

-3q27 rearrangement, BCL6

-t(11;14), CCND1/IGH

-17p deletion, TP53/D17Z1

-7q deletion, D7Z1/7q32

-18q21 rearrangement, MALT1

Marginal zone lymphoma (MZL) can be evaluated via probes for specific subtypes, as follows: mucosa-associated lymphoid tissue (MALT) lymphoma or extra-nodal marginal zone lymphoma (ENMZL) using the MALT1 rearrangement probe and splenic marginal zone lymphoma using probes for 7q deletion and 17p deletion. If no MZL subtype is provided, we will evaluate using probes for MALT1, 7q deletion and 17p deletion. 

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 supports a diagnosis of a B-cell neoplasm; the specific abnormality detected may help subtype the neoplasm
 
The absence of an abnormal clone does not rule out the presence of 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 ​7 to 10 days ​Fluorescence In Situ Hybridization (FISH)
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​88291 ​1
​88271 ​2
​88271 ​2 ​Probe, +2 ​If needed
​88271 ​1 ​Probe, +1 ​​If needed
​88271 ​2 ​Probe, +2 ​​If needed
​88271 ​3 ​Probe, +3 ​​If needed
​88274 ​1 ​Interphases, <25 ​​If needed
​88274 ​1 ​Interphases, 25-99 ​​If needed
​88275 ​1 ​Interphases, >=100 ​​If needed
Classification
For most current information refer to the Marshfield Laboratory online reference manual.