T-cell clonality (TCR)
Immunoglobulin gene rearrangements are formed from the earliest stages of B-cell and T-cell development onwards. Random coupling between one of many V, (D) and J genes results in the formation of a unique V(D)J exon that encodes the actual antigen-binding moiety of the Ig or TCR chain. Owing to the huge diversity in Ig/TCR rearrangements, the diversity of different Ig or TCR molecules is estimated to be in the order of 1012 (10 000 000 000 000). Consequently each lymphocyte has a unique antigen receptor molecule on its membrane and the chance that two different lymphocytes coincidentally bear the same receptor is almost negligible. Hence, identical rearrangements are not derived from multiple independently generated cells, but rather reflect the clonal nature of the involved cell population.
T-cell clonality studies can help to discriminate between malignant and reactive lymphoproliferations in patients with suspected lymphoproliferative disorder. Multiplex PCR is performed using BIOMED-2 primers followed by fragment analysis to detect presence of clonal rearrangements in T-cell receptor gamma gene (TCRG).
Where a molecular assessment will aid diagnosis or management in the following:
• M225.3 (Suspected lymphoma)
• M111.2 (T-Cell NHL)
Refer to the NHSE National genomic test directory for cancer
FFPE tissue curls, uncoated/uncharged slides. Minimal tumour content of 5% is required for clonality studies. The tumour content and the amount of tissue to be cut must be assessed by a histopathologist prior to sending the sample.
For other sample types, please liaise with the laboratory.
Record last updated
November 18, 2025
Sample Container
4ml EDTA Vacutainers (Lavender top)
Search test database
Test Results
Yes, we have a Pathology User Guide
Yes. Please email your request to Imperial.nwlpcustomerservice@nhs.net
Results are communicated to clinical staff and are normally not communicated direct to patients either on telephone requests or in written report. If you need to contact us please click here to view the contact details page
Please contact the Customer Service Team Monday to Friday from 8:30am – 6:00pm on 0203 313 5353. Alternatively, see the Pathology User Guide for how to contact the relevant department. If advice is not urgent you can also email your query to Imperial.nwlpcustomerservice@nhs.net
Additional tests may be added by discussion with the relevant laboratory. The time limit for adding additional tests to a sample already received in the laboratory will depend on the type of sample and the department it was sent to.
Information on the repertoire of tests performed by pathology, including reference ranges, turnaround times and specimen requirements, can be found in the test directory.
Phlebotomy services are not managed by NWLP. For further information please see:
Imperial College Healthcare Trust Phlebotomy services
Chelsea and Westminster Hospital NHS Foundation Trust Phlebotomy services
NWLP operates UKAS accredited medical laboratories as per the references below. The current scope of accreditation for all NWLP’s laboratories can be found on the UKAS website.
See the following UKAS ref numbers:
- Clinical Biochemistry Ref: 8673
- Haematology and Blood Transfusion Ref: 8674
- Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) Ref: 8659
- Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) Ref: 9615
If you require copies of our certificate of accreditation and associated documentation please contact Imperial.nwlpcustomerservice@nhs.net.
UKAS requires the laboratories to be accredited for a particular repertoire/scope (ISO15189), any changes or additions to repertoire require assessment by UKAS (extension to scope).
The BD Hospital Tube Guide, BD GP Tube Guide and BD Paediatric Tube Guide provide visual references to the correct tube types and collection instructions.
Home testing
INSTRUCTION SHEET FOR BLOOD SAMPLE COLLECTION
We also have two instruction videos available (one with subtitles and one without) – please click on the links to view the videos on Google.
Our accreditations
Upholding excellence in diagnostic standards
Our laboratories are accredited by the UK Accreditation Service (UKAS) against the international standard ISO15189:2022. UKAS is the accreditation body for the UK that assesses medical laboratories.
Find out more about our accreditations on the UKAS website.
UKAS website