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Burkitt Lymphoma Panel by Fluorescence In Situ Hybridization (FISH) Analysis

FISH, Burkitt, t(8;14), genetic, IgK (lg Kappa chain) gene rearrangement for Burkitt’s lymphoma, IgL (lg Lambda chain) gene rearrangement for Burkitt’s lymphoma, MYC gene rearrangement for Burkitt’s lymphoma-associated translocations, IgH/MYC fusion for t(8;14) detection

Test Codes

Please contact the Cytogenetics Laboratory if assistance with ordering in EPIC is needed. Paraffin Tissue: LAB6707, Touch Preparations: LAB6708, Bone Marrow Suspension: LAB6702

Department

Cytogenetics

Specimen Collection Criteria

Collect: Bone marrow aspirate in a Dark Green-top Sodium Heparin tube, lymph node touch preparation, or paraffin-embedded tissue section.

A copy of the requisition must be sent with the specimen. 

Physician Office/Draw Specimen Preparation

Do not freeze specimen. Maintain specimens at room temperature (20-25°C or 68-77°F) prior to courier pickup. For delays in transport (greater than 24 from the time of collection), refrigerate (2-8°C or 36-46°F) the specimen.

Preparation for Courier Transport

Transport: Bone marrow, lymph node touch preparation, or paraffin-embedded tissue, at room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F).

Rejection Criteria

Specimens arriving in the Laboratory 4 days or more following the original collection date.

Frozen or fixed specimens.

In-Lab Processing

Specimens are processed immediately upon receipt in the Laboratory.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 96 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days. A backup culture maintained for two weeks after the case has been signed out.

Laboratory

Royal Oak Cytogenetics Laboratory

Performed

Monday – Friday, 8:00 am – 5:00 pm.
Results available within 7 days of receipt in the Laboratory.

Reference Range

Positive or negative for a neoplastic clone. An interpretative report will be provided.

Test Methodology

Fluorescence In Situ Hybridization (FISH) Analysis.

Interpretation

A positive FISH result indicates the presence of the respective rearrangement. Initially, the MYC gene rearrangement probe and IGH/MYC probe can be run simultaneously if requested. If MYC is rearranged, but no IGH/MYC juxtaposition is identified, the Ig Kappa and Ig lambda probes are used.

Clinical Utility

The identification of specific chromosome abnormalities has emerged as one of the most important criteria for categorizing B-cell lymphomas. Specifically, in Burkitt and Burkitt-like lymphomas, three translocations are identified: t(8;14)(q24;q32), t(2;8)(q11;q24), and t(8;22)(q24;q11). While most cases demonstrate the common t(8;14) that repositions the C-MYC proto-oncogene next to the promoter for the Ig heavy chain gene at 14q32, 15-20% of cases will be associated with one of the two variant translocations. These translocations result in juxtaposition of C-MYC next to either the Ig kappa locus at 2q11 or Ig lambda locus at 22q11. All these rearrangements place the C-MYC gene under the transcriptional regulatory mechanisms of the respective Ig genes, resulting in constitutive overexpression of C-MYC leading to malignant transformation. The identification of one of these abnormalities is a requirement to make a diagnosis of either Burkitt or Burkitt-like lymphoma. 

This assay can be performed on a bone marrow biopsy, lymph node touch preparation, or a paraffin -embedded tissue section. A MYC gene rearrangement probe is used initially to confirm MYC gene rearrangement in the sample. If positive, a tri-color dual fusion IGH/MYC/CEP8 FISH probe that recognizes juxtaposition of IGH and MYC genes is utilized. If this assay provides a negative result, Ig kappa and Ig lambda rearrangement probes are used to identify the less common t(2;8) or t(8;22), respectively.

Guidelines for Cytogenetic/Molecular Testing of Hematopoietic Malignancy

CPT Codes

For MYC Gene Rearrangement: 88271x1, DNA probe, each.
For IGH/MYC: 88271x3.
For Ig Kappa or Ig Lambda: 88271x1, DNA probe, each.
For All Assays: 88275x1, Interphase analysis, 100-300 cells.

Contacts

Last Updated

12/30/2022