Update Type: Replacement Test
Test Updated: 12/01/2021
Test Overview
Test Methodology

Interphase Fluorescence In Situ Hybridization (FISH)

Test Usage

This panel differentiates double-hit or triple-hit lymphomas (which have MYC rearrangements together with BCL2 and/or BCL6 rearrangements) from Burkitt lymphoma or diffuse large B-cell lymphoma. Double-hit and triple-hit lymphomas are difficult to classify morphologically without the aid of cytogenetics/FISH or IHC, and are associated with an aggressive course. Testing is indicated when B-cell lymphoma patients experience transformation, relapse, or refractory disease. MYC rearranges with an immunoglobulin partner in approximately 60% of MYC-rearranged DLBCL/HGBCL of which 75% are MYC/IGH fusion. In addition, a small subset of lymphomas with MYC rearrangement (4%) may be missed when using the MYC breakapart probe alone, but some of these cases may be detected using the MYC/IGH fusion probe set (PMID: 30523057). The FISH panel for high grade B-cell lymphoma includes MYC (8q24), IGH/MYC/CEN8 [t(8;14)], BCL2 (18q21) and BCL6 (3q27) translocations.

Reference Range *

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

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

Test Details
Days Set Up
Monday - Friday, 8:00am - 4:00pm
Analytic Time

7-10 days

Soft Order Code
MiChart Code
Cytogenetics, High-grade B-cell Lymphoma FISH Panel
Specimen Requirements
Collection Instructions

Collect blood or bone marrow using aseptic technique. Place 2-5 mL blood or 1 - 3 mL bone marrow aspirate in a green top (sodium heparin) tube. Invert the tube several times to prevent clotting. Send at room temperature as soon as possible. Do not allow specimen to overheat or freeze. Clotted samples, samples containing <5 million dividing cells, and samples that are greater than 24 hours old are suboptimal.

Normal Volume
5 mL whole blood or 2-3 mL bone marrow
Minimum Volume
2 mL whole blood or 1 mL bone marrow; additional specimen may be required for patients with extremely low white cell counts.
Rejection Criteria
Formalin fixed, frozen or grossly contaminated specimens.
Additional Information

"Stand alone" FISH testing will include Tissue Culture at an additional charge.

CPT Code
88237x1, 88275 x4, 88271x8
Fee Code
EA027 x1, EA041 x4, EA040 x8