Days Set Up
Monday - Friday
Analytic Time

3 - 10 days

MiChart Code
B Cell Clonality- IGH Gene Rearrangement
Soft Order Code

Test Updated:


Gene Rearrangement, B Cell
IGH Gene Rearrangement
Gene Rearrangement, B-Cell
B Cell Gene Rearrangement
B-Cell Clonality

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All specimens should be accompanied by a requisition.

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MLabs provides all the supplies necessary for the collection of specimens.

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Test Overview

Test Methodology

Polymerase Chain Reaction (PCR) followed by capillary electrophoresis

Test Usage

Lymphoproliferative disorders are often characterized by an expansion of the lymphocyte populations. The distinction of benign from malignant proliferations can be accomplished by the integration of clinical, morphologic, immunophenotypic, and molecular genetic studies. With regard to molecular studies, an evaluation for the presence of a B-cell population with monoclonal rearrangement of the immunoglobulin gene can provide adjunctive information to support a final diagnosis. These studies are based on the premise that all cells of a malignant lymphoid population have a common, clonal origin and therefore are expected to contain immunoglobulin genes rearranged in exactly the same configuration. Thus, demonstration of monoclonality is indicative of the presence of a monoclonal B-cell population and polyclonality is indicative of a polyclonal population. The clinical implications of these results must be interpreted in the context of the individual patient’s clinicopathologic presentation.

Reference Range

Interpretive report provided.

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Specimen Requirements

Collection Offsite

Collect blood or bone marrow in a lavender top tube. Refrigerate and send intact blood or bone marrow specimen within 48 hours of collection. Fresh tissue (preferably 0.5cm3, sent in RPMI) and fresh aspirates or body fluids are acceptable. Refrigerate and send, preferably within 24 hours. Frozen tissue specimens – preferably frozen with 1 hour of collection – may also be sent frozen on dry ice. Fresh cell suspensions in RPMI should be refrigerated and sent, preferably within 48 hours. Frozen cell suspensions – preferably frozen with 1 hour of collection – may also be sent frozen on dry ice. For formalin-fixed, paraffin-embedded tissue, a tissue block is preferred. Unstained, UNBAKED slides (5-8, 10-micron slides; 10-15 if few neoplastic cells are present) with associated H&E stained slide are also acceptable. Decalcified tissue or other fixatives will be accepted and the assay attempted, however these may result in failed testing due to degraded nucleic acid. Both blocks and slides should be stored at room temperature.

Lavender Top Tube
Normal Volume
5 mL EDTA (lavender) whole blood; 3 mL EDTA (lavender) bone marrow; Fresh/frozen tissue and fresh aspirates or body fluids; Fresh/frozen cells in RPMI; Formalin-fixed, paraffin-embedded tissue.
Extracted DNA is also acceptable if extracted in a CLIA certified laboratory.
Minimum Volume

Billing Information

CPT Code
Pro Fee Code

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Our High Standard

Quality that sets us apart

As the reference laboratory division of Michigan Medicine's Department of Pathology, MLabs shares the institution's commitment to applying established quality principles to clinical laboratory testing. Like other large organizations in complex, consequential fields, we rely on an established approach to monitor quality throughout the testing process.