| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
FISH, ALL/NHL, MYC-BA, 8q24 Rearrangement
Test Code14706
CPT Codes
88271 (x2), 88275
Preferred Specimen
5 x 5 mm lymph node collected in a sterile container in Hanks' Ringers solution or culture medium with antibiotics
Minimum Volume
1 mL bone marrow • 3 mL whole blood
Other Acceptable Specimens
3 mL bone marrow or 5 mL whole blood collected in a sodium heparin (green-top) or sodium heparin lead-free (tan-top) •
Formalin-fixed, paraffin-embedded tissue block or slides • Fresh (unfixed) tissue
Formalin-fixed, paraffin-embedded tissue block or slides • Fresh (unfixed) tissue
Instructions
For bone marrow (1-3 mL) or whole blood (3-5 mL), use a green-top tube with sodium heparin. For lymph node biopsy, 5x5 mm in sterile container in Hanks' Ringer's solution or culture medium with antibiotics. Transportation medium available upon request.
Specimen viability decreases during transit. Send specimen to testing lab for viability determination. Do not freeze **Do not reject**
Specimen viability decreases during transit. Send specimen to testing lab for viability determination. Do not freeze **Do not reject**
Transport Temperature
Room temperature
Specimen Stability
See instructions
Methodology
Fluorescence in situ Hybridization (FISH)
FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Sets up 7 days a week.
Clinical Significance
This fluorescence in situ hybridization (FISH) assay uses a break-apart probe to detect the MYC translocation. The results of this test may aid in the diagnosis, risk stratification, and treatment decisions of B cell neoplasms.
Rearrangements of the MYC (or c-MYC) gene, which encodes a transcription factor, are associated with B cell neoplasms including Burkitt lymphoma (BL), diffuse large B cell lymphoma (DLBCL), and plasmablastic lymphoma [1]. The MYC arrangements occur in all patients with BL and 5% to 8% of patients with DLBCL [2]; most are caused by translocation of MYC to the IGH, IGK, or IGL locus [1]. Because this FISH assay with a MYC break-apart probe can detect MYC translocation with various partner genes, it is the optimal assay for the evaluation of the MYC locus in patients with BL and DLBCL [3]. However, further testing may be needed to identify a specific translocation partner gene.
A combination of genetic techniques is often involved in identifying genetic abnormalities. FISH testing is complementary to conventional cytogenetic analysis (karyotyping) and can be used to detect common cytogenetic abnormalities. However, because FISH is limited to probing specific chromosomal regions, it does not replace conventional cytogenetic analysis or chromosomal microarray for screening unknown abnormalities.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Naresh KN, et al. B-cell lymphoid proliferations and lymphomas. In: WHO Classification of Tumours Editorial Board. The World Health Organization Classification of Haematolymphoid Tumours. 5 Beta V2 ed. IARC Press; 2022:chap 4. Accessed June 12, 2023. https://tumourclassification.iarc.who.int
2. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). B-cell lymphomas. Version 5.2023. Updated July 7, 2023.https://www.nccn.org
3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Pediatric aggressive mature B-cell lymphomas. Version 1.2023. Updated April 4, 2023. https://www.nccn.org
Rearrangements of the MYC (or c-MYC) gene, which encodes a transcription factor, are associated with B cell neoplasms including Burkitt lymphoma (BL), diffuse large B cell lymphoma (DLBCL), and plasmablastic lymphoma [1]. The MYC arrangements occur in all patients with BL and 5% to 8% of patients with DLBCL [2]; most are caused by translocation of MYC to the IGH, IGK, or IGL locus [1]. Because this FISH assay with a MYC break-apart probe can detect MYC translocation with various partner genes, it is the optimal assay for the evaluation of the MYC locus in patients with BL and DLBCL [3]. However, further testing may be needed to identify a specific translocation partner gene.
A combination of genetic techniques is often involved in identifying genetic abnormalities. FISH testing is complementary to conventional cytogenetic analysis (karyotyping) and can be used to detect common cytogenetic abnormalities. However, because FISH is limited to probing specific chromosomal regions, it does not replace conventional cytogenetic analysis or chromosomal microarray for screening unknown abnormalities.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Naresh KN, et al. B-cell lymphoid proliferations and lymphomas. In: WHO Classification of Tumours Editorial Board. The World Health Organization Classification of Haematolymphoid Tumours. 5 Beta V2 ed. IARC Press; 2022:chap 4. Accessed June 12, 2023. https://tumourclassification.iarc.who.int
2. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). B-cell lymphomas. Version 5.2023. Updated July 7, 2023.https://www.nccn.org
3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Pediatric aggressive mature B-cell lymphomas. Version 1.2023. Updated April 4, 2023. https://www.nccn.org
