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Test Code 5332 Immunoglobulin Gene Rearrangement, Varies

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Shipping Instructions


Body fluid or spinal fluid must arrive within 4 days (96 hours) of collection.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Body fluid

Container/Tube: Sterile container

Specimen Volume: At least 5 mL

Collection Instructions:

1. If the volume is large, pellet cells prior to sending.

2. Send less volume at ambient temperature or as a frozen cell pellet.

Specimen Stability Information:

Body Fluid: Ambient/Refrigerated/Frozen

Cell Pellet: Frozen

 

Specimen Type: Paraffin-embedded bone marrow aspirate clot

Container/Tube: Paraffin block

Specimen Stability Information: Ambient 

 

Specimen Type: Frozen tissue

Container/Tube: Plastic container

Specimen Volume: 100 mg

Collection Instructions: Freeze tissue within 1 hour of collection.

Specimen Stability Information: Frozen

 

Specimen Type: Paraffin-embedded tissue

Container/Tube: Paraffin block

Specimen Stability Information: Ambient

 

Specimen Type: Tissue

Slides: Unstained slides

Specimen Volume: 10 Slides

Specimen Stability Information: Ambient

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 5-10 mL

Specimen Stability Information: Ambient/Refrigerated

 

Specimen Type: Extracted DNA from blood or bone marrow

Container/Tube: 1.5- to 2-mL tube

Specimen Volume: Entire specimen

Collection Instructions: Label specimen as extracted DNA from blood or bone marrow and provide indication of volume and concentration of DNA

Specimen Stability Information: Refrigerated/Ambient


Specimen Minimum Volume

Body and spinal fluid: 1 mL
Tissue: 50 mg
Extracted DNA from blood or bone marrow: 50 microliters (mcL) at 20 ng/mcL

Specimen Stability Information

Specimen Type Temperature Time
Varies Varies

Reference Values

An interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Friday

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

81261-IGH (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas B-cell), gene rearrangement analysis to detect abnormal clonal populations; amplified methodology (eg. polymerase chain reaction)

81264-IGK (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell) gene rearrangement analysis, evaluation to detect abnormal clonal populations

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BCGRV Immunoglobulin Gene Rearrange, V In Process

 

Result ID Test Result Name Result LOINC Value
MP017 Specimen: 31208-2
19915 Final Diagnosis: 34574-4

Clinical Information

The immunoglobulin (Ig) genes (heavy, kappa, and lambda) are comprised of numerous, discontinuous coding segments. As B cells develop, the segments are rearranged such that each mature B cell and plasma cell has a unique rearrangement profile. Other cell types usually retain the nonrearranged gene structures. Clonal expansion of any B cell or plasma cell will result in a population of cells that all contain an identical Ig gene rearrangement profile.

 

Reactive B-cell or plasma cell expansions are polyclonal, with each clone containing relatively few cells and no single clone predominating. Conversely, neoplastic clones are generally large such that the clonal cells are the predominant B cells or plasma cells present.

 

In the appropriate clinical and pathologic setting, detection of a prominent Ig gene rearrangement profile may be equated to the presence of a neoplastic B-cell or plasma cell clone.

Interpretation

An interpretive report will be provided.

 

The interpretation of the presence or absence of a predominant immunoglobulin (Ig) gene rearrangement profile is sometimes subjective. These results must always be interpreted in the context of other clinicopathologic information to determine the significance of the result.

 

The detection of a clonal Ig gene rearrangement by this test is not synonymous with the presence of a B-cell or plasma cell neoplasm.

Clinical Reference

1. van Dongen JJ, Wolvers-Tettero IL: Analysis of immunoglobulin and T-cell receptor genes. Part II: Possibilities and limitations in the diagnosis and management of lymphoproliferative diseases and related disorders. Clin Chim Acta 1991 April;198(1-2):93-174

2. Coad JE, Olson DJ, Lander TA, et al: Molecular assessment of clonality in lymphoproliferative disorders: I. Immunoglobulin gene rearrangements. Mol Diagn 1996 December;1(4):335-355

Method Name

Genomic DNA Extracted Followed by Polymerase Chain Reaction (PCR)

Testing Algorithm

The following algorithms are available in Special Instructions:

-Gastric MALT Lymphoma Diagnostic Algorithm      

-Gastric MALT Posttherapy Follow-up Algorithm

Forms

1. Hematopathology Patient Information (T676) in Special Instructions

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.