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Kappa Lambda Light Chain RNA Detection by in-situ Hybridization

Kappa Lambda in-situ, Kappa or Lambda RNA detection.

Department

Advanced Diagnostics

Specimen Collection Criteria

Collect: Paraffin-embedded tissue. A paraffin block must be submitted. (Slides or paraffin shavings are not acceptable.) Submit formalin-fixed, paraffin-embedded block with corresponding H&E slide. Tissue should be well fixed and well processed. Specimen must be accompanied by a completed requisition and must contain the patient name, date of birth, collection date, ordering physician, and source of specimen. 

Physician Office/Draw Specimen Preparation

Maintain paraffin-embedded tissue or slides at room temperature (20-25°C or 68-77°F) until transport.

Preparation for Courier Transport

Transport: Paraffin-embedded tissue, at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

• Tissue in fixatives other than 10% formalin or zinc formalin.
• Decalcified tissue.
• Improper labeling, inadequate information. 

Inpatient Specimen Preparation

Please refer to Surgical Specimen, Routine in the Beaumont Laboratory Test Directory. 

In-Lab Processing

Maintain specimens at room temperature (20-26°C or 68-78.8°F) until testing.

Storage

Specimen Stability for Testing:

• Room Temperature (20-26°C or 68-78.8°F): Indefinitely 
• Refrigerated (2-8°C or 36-46°F): Unacceptable 
• Frozen (-20°C/-4°F or below): Unacceptable 

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26°C or 68-78.8°F): 7 days

Laboratory

Royal Oak Anatomic Pathology – Advanced Diagnostics Laboratory.

Performed

Monday – Friday.
Results available in 4 business days.

Reference Range

An interpretive report will be provided.

Test Methodology

Kappa and Lambda Light Chain Immunoglobulin messenger RNA (mRNA) can be detected in tissue sections by a hybridization reaction with oligonucleotide probes. The test utilizes horseradish peroxidase-conjugated detection chemistry to localize fluorescein-labeled oligonucleotide probes. Following the hybridization of fluorescein-labeled probes to target sequences in the tissue, a stringent wash solution containing a blocking agent is used to remove excess bound probe and to block nonspecific binding sites on the tissue that may otherwise react with the detection reagents. The fluorescein label is amplified via a mouse antifluorescein isothiocyanate (FITC) linker antibody. This can be visualized with HRP conjugated anti mouse antibody and a colorimetric reaction or the enzyme conjugate with its substrate. This reaction results in the deposition of an insoluble brown product at the site of hybridization. 

Interpretation

A pathologist’s interpretation of results will be added to the surgical report.

Clinical Utility

Each test contains a cocktail of oligonucleotide probes. The intended target is the kappa light chain immunoglobulin messenger RNA (mRNA) in the cytoplasm of immunoblastic cells, plasma cells and plasmacytoid cells. Assessing the light chain immunoglobulin restriction is important in malignant lymphoma diagnosis. The relationship between monoclonal B-cell proliferation and light chain mRNA restriction aid in the distinction between neoplastic and reactive lymphoid proliferations and the evaluation of multiple myeloma, plasmacytoma, lymphomas with plasmacytoid features, immunoblastic lymphomas, and reactive plasma cell proliferations. 

CPT Codes

88364x2
88365

Contacts

Last Updated

9/29/2022