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Cancer — FISH Analysis

FISH Analysis (Individual probes) for Non-FFPE Hematological Disorders, Solid Tumors and Lymphoma

CPT Code(s):  88237, 88275 (x per analyses), 88271 (x per probe)

Service Code (IU Health): 53101259, 53100707, 53100640

Ordering Recommendation: Detection of known or suspected genetic abnormalities to confirm or establish patient diagnosis of tumor subtypes and prognostic grouping important for subsequent therapy. Companion testing with chromosome analysis to further delineate chromosomal abnormalities.

Synonyms: FISH, fluorescence in situ hybridization, hematopoietic malignancy, lymphoma, solid tumor, cancer

Methodology: Fluorescence in situ hybridization (FISH) analysis.

Performed: Monday through Friday

Reported: 2-3 days

List of FISH Probes: (for additional probes, contact laboratory)

Hematologic Probes:

  • 1q21
  • t(1;19) (PBX1/TCF3)
  • 1q25.2 (ABL2)
  • inv(3) (RPN1/MECOM)
  • 4q12 (PDGFRA)
  • t(4;14) (FGFR3/IGH) 
  • 5q32 (PDGFRB)
  • -5/del(5q)
  • t(6;9) (DEK/NUP214)
  • del(6q) (6q21 (PRDM1) & 6q23.3 (MYB))
  • del(7q)
  • 8 centromere
  • t(8;21) (RUNX1T1/RUNX1)
  • 9p21 (CDKN2A)
  • 9q34.1 (ABL1)
  • t(9;22) [BCR/ABL1]
  • 9q34.1 (ASS1)
  • 11q23 (KMT2A, formerly MLL)
  • 12 centromere
  • 12p13 (ETV6)
  • t(12;21) (ETV6/RUNX1)
  • 13q14 (RB1 & D13S319)
  • 14q32.3 (IGH)
  • t(14;16) (IGH/MAF)
  • t(15;17) (PML/RARA)
  • inv(16) (CBFB) 
  • inv(16) (MYH11/CBFB)
  • 17p13.1 (TP53)
  • 17q21.1 (RARA)
  • del(20q)
  • X/Y
  • Xp22.3/Yp11.2 (CRLF2)

Lymphoma Probes:

  • 3q27 (BCL6)
  • t(8;14) (MYC/IGH)
  • 8q24 (MYC)
  • t(11;14) (CCND1/IGH)
  • t(11;18) (BIRC3/MALT1)
  • t(14;18) (IGH/BCL2)
  • 18q21 (MALT1)

Solid Tumor Probes:

  • 2p24.1 (MYCN)
  • 13q14.1 (FOXO1)
  • 22q12 (EWSR1) 

Specimen Requirements

Collect: Bone marrow or peripheral blood in a dark green-top sodium heparin tube. Solid tumor biopsy in a sterile, screw-top container filled with tissue culture transport medium.

Specimen Volume: 0.5 cm or larger.

Storage/Transport: Room temperature. Do not freeze or expose to extreme temperatures.

Unacceptable Conditions: Frozen specimens. Formalin-fixed specimens. See “Solid Tumors, Paraffin-Embedded Tissue (PET) — FISH Analysis” for information for submitting PET specimens.

Stability: Ambient: 48 hours; Refrigerated: 48 hours; Frozen: Unacceptable  

Interpretive Data

Characteristics: When the percent of cells with an abnormality exceeds the established normal reference range for any given probe signal pattern, it is considered an abnormal clone. Absence of an abnormal clone does not rule out the possibility of a neoplastic disorder. A report detailing interpretation of results will be provided.

Limitations: The probes in this FISH panel detect only specific aberrations. Chromosomal alterations present outside the regions targeted by the probes will not be detected.