Test Overview
Test Methodology

Interphase Fluorescence In Situ Hybridization (FISH)

Test Usage

The presence of certain clonal abnormalities in the bone marrow of cytopenic patients strongly supports the diagnosis of MDS, even in cases with the absence of diagnostic morphology findings. The MDS FISH Panel is used to ascertain common recurrent genetic abnormalities that are frequently observed in MDS. Multiple studies have demonstrated the added value of MDS FISH on bone marrow is extremely low when a satisfactory karyotype is obtained (20 interpretable metaphases). MDS FISH panel is recommended to be performed post hoc in the event of an unsatisfactory karyotype. The MDS FISH panel includes tests for the following chromosome abnormalities using probes for the specific gene locus: EGR1/D5S23 probe set to detect monosomy 5 and 5q deletion, D7S486/CEP7 probe set to detect monosomy 7 and 7q deletion, TP53/CEP17 probe set to detect 17p (TP53) deletion, and 20q12/20qter/8cen probe set to detect trisomy 8 and/or deletion of 20q.

1. American Society for Clinical Pathology, Choose Wisely. https://www.choosingwisely.org/clinician-lists/american-society-clinica…
2. Bunting CT, Senior T, Susson Y, Rivera A, Saxe D, Bunting ST. Utility of Fluorescence In Situ Hybridization Panel for Myelodysplastic Syndrome in Evaluation of Cytopenia in a Pediatric Hospital: A 5-Year Retrospective Review and Utilization Management. Lab Med. 2017;48(3):266-270. PMID: 28934515
3. Yang W, Stotler B, Sevilla DW, Emmons FN, Murty VV, Alobeid B, Bhagat G. FISH analysis in addition to G-band karyotyping: utility in evaluation of myelodysplastic syndromes? Leuk Res. 2010;34(4):420-5. PMID: 19800120
4. Coleman JF, Theil KS, Tubbs RR, Cook JR. Diagnostic yield of bone marrow and peripheral blood FISH panel testing in clinically suspected myelodysplastic syndromes and/or acute myeloid leukemia: a prospective analysis of 433 cases. Am J Clin Pathol. 2011;135(6):915-20.PMID: 21571964

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

5 days after chromosome analysis is completed with an inadequate result.

Soft Order Code
MiChart Code
Cytogenetics, MDS FISH panel
  • Myelodysplastic Syndrome (MDS), FISH
  • FISH for Myelodysplastic Syndrome
Specimen Requirements
Collection Instructions

Collect bone marrow using aseptic technique. Place 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
2-3 mL bone marrow
Minimum Volume
1 mL bone marrow
Rejection Criteria
Rejection Criteria:
Formalin fixed, frozen or grossly contaminated specimens.
Additional Information

This FISH testing is a reflex test used when standard chromosome analysis is inadequate or has less than 20 normal metaphase cells.

CPT Code
88237, 88275 x3, 88271x6
Fee Code
EA027, EA041 x3, EA040 x6