t(14;18) IGH/BCL2 pin

FISH

t(14;18) IGH/BCL2

Alternate Test Names:
t(14;18)(q32;q21) (IGH/BCL2)
Non Hodgkin Lymphoma (Indolent B-NHL) Panel test
Non Hodgkin Lymphoma (Aggressive B-NHL) Panel test

Methodology: FISH

Clinical Significance:
This FISH assay specifically detects the t(14;18)(q32;q21) involving the BCL2 and IGH chain genes. This translocation is present in over 90% of follicular lymphomas and in a significant minority (20-30%) of diffuse large B cell lymphomas. It is characterized by the aberrant juxtaposition of the BCL2 proto-oncogene on chromosome 18 with the immunoglobulin heavy chain gene on chromosome 14, resulting in constitutive overexpression of the BCL2 protein which ultimately leads to alterations in programmed cell death (i.e., apoptosis) and tumor cell proliferation. Evaluation for a t(14;18)(q32;q21) is of use in the diagnostic evaluation for follicular lymphoma as well as in the evaluation of aggressive B cell lymphomas where Burkitt's lymphoma (BL), diffuse large B cell lymphoma (DLBCL), and the intermediate category are diagnostic considerations. In aggressive B cell lymphoma, the presence of a t(14;18)(q32;q21) in addition to a MYC rearrangement argues against the diagnosis of BL. The presence of a t(14;18)(q32;q21) is seen more often in DLBCLs of germinal center cell type and has been reported to be a poor prognostic factor in some studies.

Probe type: Dual color, dual fusion translocation

Organ: Blood/Bone Marrow, Body Fluids, Colon & Other GI, Lymph Node / Spleen, Skin & Mucosa

Disease State: B Cell Non-Hodgkin Lymphoma (not otherwise classified), Burkitt's Lymphoma, Diffuse Large B Cell Lymphoma, Follicular Lymphoma

CPT Code(s): 88374 (reference only; CPTs may vary)

Turnaround Time: Within 3-4 business days of receipt

Schedule: Monday - Friday

Specimen Requirements:
• Peripheral blood, Preferred: 3 ml in sodium heparin (green top) / Acceptable: 3 ml in EDTA (purple top) - OR -
• Bone marrow aspirate, Preferred: 1-2 ml in sodium heparin (green top) / Acceptable: 1-2 ml in EDTA (purple top) - OR -
• Fresh tissue in RPMI - OR -
• Formalin-fixed, paraffin-embedded tissue (FFPE)

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