High-Grade B-cell Lymphoma — FISH Analysis

CPT Code(s): 88237, 88239, 88275, 88271 (x per probe)

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

Ordering Recommendation: For detection of alterations associated with high-grade B-cell lymphoma (HGBL), to identify and track chromosome abnormalities in HGBL patients, and to evaluate response to therapy.

Synonyms: FISH, hematopoietic malignancy, lymphoma, non-Hodgkin’s lymphoma, Burkitt Lymphoma, Burkitt-like Lymphoma, Diffuse Large Cell Lymphoma, Follicular Lymphoma, High-grade lymphoma, High-grade B-cell lymphoma, Double or triple hit lymphoma.

Methodology: Fluorescence in situ hybridization (FISH) analysis.

Performed: PET — Tuesday, Thursday, Friday; Cell suspension — Monday–Friday

Reported: 2-3 days

Panels: High-Grade Lymphoma Panel — BCL6, t(8;14)(MYC/IGH), MYC, t(14;18) (IGH/BCL2)

Collect: For PET Specimens: 10% buffered formalin-fixed, paraffin-embedded tissue specimen. For Cell Suspensions: Non-diluted bone marrow aspirate in sodium heparin (dark green top) tube, heparinized syringe or solid tumor biopsy in a sterile, screw-top container filled with tissue culture transport medium.

Specimen Volume: For PET Specimens: 2-3 (4-micron) sections on positively charged slides. For Cell Suspensions: For bone marrow aspirate: 2 mL for normal WBC (decreased WBC requires more, elevated WBC requires less); 0.5 mL (minimum). For tissue: 0.5 cm or larger.

Storage/Transport: For PET Specimens: Room temperature. Protect from excessive heat. For Cell Suspensions: Room temperature. Do not freeze or expose to extreme temperatures.

Unacceptable Conditions: For PET Specimens: Do not send a block, de-calcified bone or specimens fixed/processed in non-10% buffered formalin or frozen. For Cell Suspensions: Frozen specimens. Formalin-fixed specimens of fresh tumor.

Stability: For PET Specimens: Ambient: Indefinitely; Frozen: Unacceptable. For Cell Suspensions: Ambient: 48 hours; Refrigerated: 48 hours; Frozen: Unacceptable