FISH, MALT Lymphoma, MALT1, rea18q21 with Reflex to API2/MALT1, t(11;18)

Message

For Specimen Integrity during Extreme Weather see the “Lockbox Usage in Extreme Weather” document at the top of this page.

Test Code

MALT1

CPT Codes
88271 (x2), 88275

Includes

If FISH, MALT Lymphoma, MALT1, rea18q21 is positive, then FISH, MALT Lymphoma, API2/MALT1, t(11;18) will be performed at an additional charge (CPT code(s): 88271 (x2), 88275),

Preferred Specimen

5 mL whole blood collected in a sodium heparin (green-top) tube, or
3 mL bone marrow collected in a sodium heparin (green-top) tube

Minimum Volume

1 mL

Other Acceptable Specimens

Formalin-fixed, paraffin-embedded tissue • 5x5 mm lymph node tissue or lymph node collected in a sterile container in Hank's Ringer's solution or culture medium with antibiotics

Instructions

Clinical history and reason for referral are required with test order. Prior therapy and transplant history should be provided with test order.
For bone marrow (1-3 mL) or whole blood (3-5 mL) use green top (sodium heparin) tube. For lymph node biopsy 5x5 mm in a sterile container in Hank's Ringer's solution or culture medium with antibiotics. Transportation medium available upon request. Formalin-fixed, paraffin-embedded tissue.

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

Room temperature: See instructions
Refrigerated: See instructions
Frozen: 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

Set up: Sun-Fri; Report available: 7 days

Reference Range

See Laboratory Report

Clinical Significance

The extra-nodal marginal zone B-cell lymphoma (MZBCL) of mucosa associated lymphoid tissue (MALT) type, which comprises 7% of all non-Hodgkin lymphomas, is an indolent disease, involving most often the stomach, where it usually follows chronic gastritis, due to Helicobacter pylori (HP) infection. This lymphoma may also localize in the lung, the thyroid, the salivary gland, and the orbit. Two common translocations in this lymphoma are the t(11;18)(q12;q21) (20-50% of cases) and the t(14;18) (q32;q21) (10-20% of cases). This break apart 18q21 probe is able to detect either of these translocations. It is suggested to follow up a positive FISH result with the specific dual-fusion API2/MALT1 probe to detect the presence of the translocation (11;18) since this is often associated with resistance to HP treatment.

Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Dr
Chantilly, VA 20153

Last Updated: November 24, 2021

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.