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FISH analysis for B Cell lymphomas

Category Specialist Integrated Haematological Malignancy Diagnostic Service (SIHMDS) >> Cytogenetics
Test background

FISH involves the application of fluorescent DNA probes specific to genes or genetic regions of interest that highlight abnormalities involving these regions.

Clinicial Indications

Mature B-cell lymphoma can be low grade, intermediate grade, or high grade, and the prognosis and clinical course are highly variable. Genetic abnormalities have emerged as one of the most important prognostic markers in B-cell lymphomas and can aid in diagnosis. Several chromosome anomalies and variants of these anomalies have been associated with various lymphoma subtypes (see table below). Fluorescence in situ hybridization (FISH) permits the detection of these abnormalities in bone marrow samples and in FFPE lymph node samples.
Burkitt: IGH-MYC; MYC breakapart
Mantle Cell: IGH-CCND1
Follicular: IGH-BCL2
Diffuse large B-cell; Burkitt-like 'double-hit' BCL6, BCL2, MYC, IGH

Reference range

N/A

Sample & container required See notes section
Sample volume Samples would not be rejected on the basis of small volume, however, 5 mL is ideal.
Turnaround time Burkitt and Burkitt-like: 95% should be reported within 3 working days; Other lymphoma: 95% should be reported within 21 calendar days (laboratory average 5 days)
Notes

Sample required:

LIQUID: Bone marrow in cytogenetic transport medium (preferred) or lithium heparin. EDTA samples are only suitable in cases requiring FISH only. If in doubt please use lithium heparin. Samples which are non-sterile, clotted or collected in sodium citrate, fixative or saline are not suitable.Please note that informative FISH on liquid bone marrow samples requires at least 5% infiltration.

SOLID TISSUE: FFPE lymph node or BMTB.

To ensure appropriate analysis and interpretation it is important to provide clear and concise clinical information.