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Epic Code LAB3273 Diffuse Large B-Cell Lymphoma (DLBCL) Probe Panel by FISH

Test Name Alias

DLBCL by FISH | Double Hit Lymphoma by FISH | Triple Hit Lymphoma by FISH | 9223

Interface Order Alias

11604

Clinical Information

This probe panel detects specific structural chromosome abnormalities commonly associated with Diffuse Large B-cell Lymphoma.

 

Routine chromosome analysis is performed on all diagnostic samples and is recomended on all bone marrow specimens to exclude abnormalities not identified by the specified FISH probe(s).

 

Mandatory Reflex Information:

1. Immunohistochemical/In situ hybridization staining to include: CD3, CD20, CD5, CD10, BCL-1, Ki-67, EBERish, BCL-2, BCL-6, MUM1, MYC, CD30, and CD45

2. Cytogentic FISH testing to include: BCL-2, BCL-6, and MYC rearrangement testing.

Collection Instructions

Multiple specimen collection types. Submit only one:

 

Specimen Collection: Bone Marrow

Container(s): Green Top (Sodium Heparin)

Preferred volume to collect: 5.0 mL

Minimum volume to collect: 1.0 mL

Neonate volume to collect: 1.0 mL

Collection Instructions:

  • Collect bone marrow and transfer marrow from syringe to plain green top sodium heparin tube. 

 

Specimen Collection: Peripheral blood
Container/Tube: Green Top (Sodium Heparin)

Preferred volume to collect: 8.0 mL

Minimum volume to collect: 0.5 mL

Neonate volume to collect: 0.5 mL

Collection Instructions:

  • Peripheral blood may be substituted for Bone Marrow if circulating blasts are present 
  • Collect peripheral blood into a plain green top sodium heparin tube. 
  • Keep sample at room temperature and send to the Lab immediately. 

 

Specimen Collection: Formalin-fixed, paraffin-embedded (FFPE) tissue

Container(s): Block

Preferred Volume to Collect: 6 unstained slides cut between 4 and 6 microns thick

Collection Instructions:

  • Include an H&E slide scribed by Pathologist and Surgical Specimen Testing order sheet.
  • Place specimen in 10% Formalin and order Tissue Pathology in addition to Diffuse Large B-Cell Lymphoma (DLBCL) Probe Panel by FISH order.

 

Specimen Collection: Fine Needle Aspirate (FNA, such as lymph node)

Collection Instructions: Order FNA Cytology (refer to test code 202 for collection instructions) in addition to Diffuse Large B-Cell Lymphoma (DLBCL) Probe Panel by FISH order.

 

 

Specimen Collection:  Pleural Fluid

Collection instructions:  Place specimen in sterile container and order Medical Cytology in addition to Diffuse Large B-Cell Lymphoma (DLBCL) Probe Panel by FISH order.

 

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Spin: No

Aliquot: No

 

Transport Temperature: Ambient

 

If ambient temperature exceeds 80°F or is below 40°F, please send in an insulated container. All samples should be directed to the laboratory as soon as possible.

Specimen Stability

Ambient: 3 days for fresh (beyond 3 days, specimen viability will be detemined by Cytogenetics Lab)

Laboratory Retention: primary specimens 4 weeks; frozen pellets retained greater than 1 year

Test Frequency

Test Set Up: Monday – Friday 8:00 am – 5:00 pm, Saturday 8:00 am – 3:00 pm.

Technologist on call for Sunday set up.

Final report: 2-3 days. 2-5 days for paraffin embedded specimens.

Reference Range

An interpretative report will be provided.

Performing Department

CYTOGENETICS

Performing Department Laboratory Location

Spectrum Health Advanced Technology Laboratory (ATL), Grand Rapids, MI

Methodology

Performed by fluorescence in situ hybridization (FISH). This test was developed and its performance characteristics determined by Spectrum Health Cytogenetics Laboratory. It has not been cleared or approved by the US FDA. The FDA has determined that such clearance or approval is not necessary. This test is used for clinical purposes.

CPT

88275 x3, 88271 x6

CDM Code

4148275, 4148271

Epic Test ID

1230100614

LOINC

Specimen Type: 66746-9

Indication Provided: 42349-1

Result: in process

Interpretation: 59050-5

Comments: 69965-2

Beaker LOINC

LOINC Not available

Reviewed Date

10/22/2021

Beaker Names

Beaker Procedure Name: DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) PROBE PANEL BY FISH
Beaker Display Name: Diffuse Large B-Cell Lymphoma (DLBCL) Probe Panel by FISH (Lab Use Only)
BEAKER TEST NAME: DIFFUSE LARGE B-CELL LYMPHOMA PROBE PANEL BY FISH
BEAKER TEST REPORT NAME: Diffuse Large B-Cell Lymphoma Probe Panel by FISH

Beaker Synonyms

DLBCL BY FISH

Beaker Collection and Specimen Handling

BEAKER COLLECTION: AP Ambient

Beaker Location, Container and Temperature

LC CYTOGENETICS: 6 ML NA HEPARIN TUBE A (Preferred)-Ambient
LC CYTOGENETICS: CYTOGENETICS MEDIA (Acceptable)-Ambient
LC CYTOGENETICS: MISCELLANEOUS (Acceptable)-Ambient
LC CYTOGENETICS: STERILE CONTAINER A (Acceptable)-Ambient