Days Set Up
Monday - Friday
Analytic Time

3 - 10 days

MiChart Code
T Cell Clonality- TRG Gene Rearrangement
Soft Order Code
GRT

Test Updated:

Synonyms

Gene Rearrangement, TCRgamma
T Cell Gene Rearrangement
Gene Rearrangement, T Cell
TCR Gamma GR by PCR (TRG by PCR)
Gene Rearrangement, T-Cell
GRTPCR
T Cell Gamma Gene Rearrangement
TRG Gene Rearrangement
GRT
MLABEL
T CELL GENE REARR. BY PCR
TCRgamma Gene Rearrangement
T-Cell Clonality
T cell antigen receptor, gamma, Gene Rearrangement

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Test Overview

Test Methodology

Polymerase Chain Reaction (PCR) with 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 T-cell population with monoclonal rearrangement of the T-cell receptor gamma locus 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 T-cell receptor genes rearranged in exactly the same configuration. Accordingly, demonstration of monoclonality is indicative of the presence of a monoclonal T-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 Onsite

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.

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
81342
Pro Fee Code
 
LOINC
 

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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.