If polymerase chain reaction (PCR) testing is negative, no sequencing is performed, and the test is resulted as negative.
If PCR testing is positive, sequencing is performed. Strong positive results are first submitted to Sanger sequencing, which can yield results in as few as 4 days. Weak positive results, or Sanger sequencing results that are mixed, are submitted to next-generation sequencing (ie, targeted metagenomics testing).
BCLL IGVH IGHV Next Gen Sequencing Test Somatic mutation (or Hypermutation) CLL prognosis
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.
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.
The following probe sets are available within this B-cell lymphoma FISH profile:
-8q24.1 rearrangement, MYC
-18q21 rearrangement, BCL2
-3q27 rearrangement, BCL6
-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.
This test is only qualitative and should not be used for routine monitoring (ie, quantitative mRNA level).
Monitoring of most patients with chronic myeloid leukemia (CML) should be performed using BCRAB / BCR/ABL, p210, mRNA Detection, Reverse Transcription-PCR (RT-PCR), Quantitative, Monitoring Chronic Myelogenous Leukemia (CML), Varies.
Monitoring of patients known to carry a p190 fusion should be performed using BA190 / BCR/ABL, p190, mRNA Detection, Reverse Transcription-PCR (RT-PCR), Quantitative, Monitoring Assay, Varies.
Blastomyces Dermatitidis QNT AG
Panel includes Blood Gas (pH, partial pressure of carbon dioxide pCO2, partial pressure of oxygen pO2, base excess BE)
This B-cell acute lymphoblastic leukemia (B-ALL) fluorescence in situ hybridization (FISH) test may be ordered in 4 distinct ways allowing different combinations of probes to be utilized based on the clinical question. The 4 ways this B-ALL FISH test can be ordered are as follows:
-Standard (diagnostic) B-ALL FISH panel
-Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) panel
-Combined-Standard (diagnostic) B-ALL FISH panel + Ph-like ALL panel
-Individual B-ALL FISH probes (per client request)
The specific B-ALL FISH panel or FISH probes requested must be noted on the request form or in the reason for referral. If no specific panel or FISH probe request is indicated, the "Standard (diagnostic) B-ALL FISH panel" will be performed.
The Standard (diagnostic) B-ALL FISH panel includes testing for the following abnormalities, using the FISH probes listed:
Hyperdiploidy, +4,+10,+17: D4Z1/D10Z1/D17Z1
t(12;21)(p13;q22), ETV6/RUNX1 fusion, ETV6/RUNX1 D-FISH
iAMP21, RUNX1 amplification, ETV6/RUNX1 D-FISH
t(9;22)(q34;q11.2), BCR/ABL1 fusion, BCR/ABL1 D-FISH
t(1;19)(q23;p13), PBX1/TCF3 fusion, PBX1/TCF3 D-FISH
t(11q23;var), MLL (KMT2A) rearrangement, MLL (KMT2A) break-apart
del(9p), CDKN2A deletions, CDKN2A/D9Z1
t(14q32;var), IGH rearrangement, IGH break-apart
del(17p), TP53 deletions, TP53/D17Z1
8q24.1 rearrangement, MYC break-apart
t(Xp22.33;var) or t(Yp11.32;var), P2RY8 rearrangement, P2RY8 break-apart
t(Xp22.33;var) or t(Yp11.32;var), CRLF2 rearrangement, CRLF2 break-apart
-When an MLL (KMT2A) rearrangement is identified, reflex testing will be performed to identify the translocation partner. Probes include identification of t(4;11)(q21;q23) AFF1/MLL, t(6;11)(q27;q23) MLLT4/MLL, t(9;11)(p22;q23) MLLT3/MLL, t(10;11)(p13;q23) MLLT10/MLL, t(11;19)(q23;p13.1) MLL/ELL, or t(11;19)(q23;p13.3) MLL/MLLT1.
-When an IGH and/or CRLF2 rearrangement is identified, reflex testing will be performed using the CRLF2/IGH fusion probe set to identify a potential t(X;14)(p22.33;q32) or t(Y;14) (p11.32;q32) "cryptic translocation."
-When an extra signal of ABL1 is identified in BCR/ABL1 testing, reflex testing will be performed using the ABL1 break-apart probe set to identify the presence or absence of an ABL1 rearrangement.
-If a MYC rearrangement is identified, break-apart probe sets for BCL2 and BCL6 will be performed.
*The "Standard (diagnostic) B-ALL FISH panel" will be automatically reflexed to the Philadelphia Ph-like ALL panel on pediatric and young adult patients (age <30) who demonstrate normal or nonclassical abnormalities on the Standard (diagnostic) panel. In other circumstances, the Ph-like ALL panel may be recommended and the client notified before performing this testing.
The Ph-like ALL panel includes testing for the following abnormalities using the FISH probes listed:
-t(1q25;var), ABL2 rearrangement, ABL2 break-apart
-t(5q33;var), PDGFRB rearrangement, PDGFRB break-apart
-t(9p24.1;var), JAK2 rearrangement, JAK2 break-apart
-t(9q34;var), ABL1 rearrangement, ABL1 break-apart
-t(Xp22.33;var) or t(Yp11.32;var), P2RY8 rearrangement, P2RY8 break-apart
-t(Xp22.33;var) or t(Yp11.32;var), CRLF2 rearrangement, CRLF2 break-apart
-monosomy 7 or del(7p), IKZF1 deletions, IKZF1/CEN7 enumeration
-When a PDGFRB rearrangement is identified, reflex testing may be performed using the PDGFRB/ETV6 fusion probe set to identify a potential t(5;12)(q33;p13) translocation.
-When a CRLF2 rearrangement is identified, reflex testing will be performed using the CRLF2/IGH fusion probe set to identify a potential t(X;14)(p22.33;q32) or t(Y;14) (p11.32;q32) "cryptic translocation."
-If an ABL1 rearrangement is identified, reflex testing will be performed using the BCR/ABL1 dual-color, double fusion FISH probe set to evaluate for the presence or absence of BCR/ABL1 fusion.
We recommend the following testing algorithm for patients with B-acute lymphoblastic leukemia (B-ALL):
-At diagnosis, standard (diagnostic) B-ALL FISH panel and/or conventional chromosome studies (CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow) should be performed. If there is limited specimen available for CHRBM, this test will be performed instead.
-If the patient clinically relapses, a conventional chromosome study is useful to identify cytogenetic changes in the neoplastic clone or the possible emergence of a new therapy-related myeloid clone.
If this test is ordered and the laboratory is informed that the patient is on a COG protocol, this test will be canceled and automatically reordered by the laboratory as COGBF / B-Lymphoblastic Leukemia/Lymphoma, Children's Oncology Group Enrollment Testing, FISH, Varies.
Anaplastic thyroid carcinoma BRAF BRAF mutation BRAFD Brain cancer Circulating tumor cells Circulating tumor DNA CNS tumor Colon cancer Colorectal cancer Craniopharyngioma Erdheim-Chester disease Glioma Hairy Cell leukemia Histiocytic lesion Liquid biopsy Lung cancer Melanoma Papillary thyroid carcinoma V600E V600K
Quantitative direct agglutination procedure for the detection of antibody to B. abortus, B. melitensis, and B. suis.
Antibodies to Brucella canis, a rare cause of brucellosis, are not detected by this method.