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Test Code LABBCLF B-Cell Lymphoma, FISH, Blood or Bone Marrow

Additional Codes

Test Name in EPIC EPIC Test Code Mnemonic Mayo Test ID


Useful For

Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with various B-cell lymphomas using blood or bone marrow specimens


Tracking known chromosome abnormalities and response to therapy in patients with B-cell neoplasms

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_PBCT Probe, +2 No, (Bill Only) No
_PADD Probe, +1 No, (Bill Only) No
_PB02 Probe, +2 No, (Bill Only) No
_PB03 Probe, +3 No, (Bill Only) No
_IL25 Interphases, <25 No, (Bill Only) No
_I099 Interphases, 25-99 No, (Bill Only) No
_I300 Interphases, >=100 No, (Bill Only) No

Testing Algorithm

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.


See Malignant Lymphoma, Guideline for Bone Marrow Staging Studies in Special Instructions.


Depending on the lymphoma subtype suspected, the most appropriate probes to order are listed in the table "Common Chromosome Abnormalities in B-cell Lymphomas" in Clinical Information.


If the patient is being tracked for known abnormalities, indicate which probes should be used.


If no probes (or lymphoma subtype) are specified at the time of order, a panel of the following probe sets will be performed:

-8q24.1 rearrangement, MYC

-18q21 rearrangement, BCL2

-3q27 rearrangement, BCL6

-t(11;14), CCND1/IGH

-17p-, TP53/D17Z1

-18q21 rearrangement, MALT1

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

B-cell Lymphoma, FISH, B/BM

Specimen Type


Advisory Information

This assay detects chromosome abnormalities observed in the blood and bone marrow of patients with B-cell lymphoma. For testing paraffin-embedded tissue samples from patients with B-cell lymphoma, see BLYMF / B-Cell Lymphoma, FISH, Tissue.

Shipping Instructions

Advise Express Mail or equivalent if not on courier service.

Necessary Information

Provide a reason for referral with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.

Specimen Required

Submit only 1 of the following specimens:


Specimen Type: Blood

Container/Tube: Green top (sodium heparin)

Specimen Volume: 7-10 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.


Specimen Type: Bone marrow

Container/Tube: Green top (sodium heparin)

Specimen Volume: 1-2 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.



Specimen Type: Touch prep or fresh tissue

Specimen Minimum Volume

Blood: 2 mL
Bone Marrow: 1 mL

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)

Reject Due To

No specimen should be rejected.

Clinical Information

Lymphoid neoplasms are known to be complex and the prognosis and clinical course of patients with lymphoma is highly variable. Genetic abnormalities have emerged as one of the most reliable criteria for categorizing lymphomas. Several chromosome abnormalities and variants of these abnormalities have been associated with various kinds of lymphoma (see Table).


Common Chromosome Abnormalities in B-cell Lymphomas

 Lymphoma Type

 Chromosome Abnormality

  FISH Probe

Burkitt (pediatric,

≤18 years old)

8q24.1 rearrangement

5'/3' MYC







3q27 rearrangement

3'/5' BCL6

18q21 rearrangement

3'/5' BCL2

Diffuse large B-cell,

Burkitt-like "double-hit"

8q24.1 rearrangement

5'/3' MYC



    Reflex: t(2;8)(p12;q24.1)


    Reflex: t(8;22)(q24.1;q11.2)  


    Reflex: 3q27 rearrangement

3'/5' BCL6

    Reflex: 18q21 rearrangement

3'/5' BCL2

Large BCL with IRF4 Rearranged

6p24.3 rearrangement

3'/5' IRF4

18q21 rearrangement

3'/5' BCL2

3q27 rearrangement

3'/5' BCL6


18q21 rearrangement

3'/5' BCL2

3q27 rearrangement

3'/5' BCL6

Mantle Cell



Blastoid subtype only: deletion of 17p


Blastoid subtype only: 8q24.1 rearrangement

5'/3' MYC


18q21 rearrangement

5'/3' MALT1

Splenic Marginal Zone

Deletion of 7q


Deletion of 17p


Reference Values

An interpretive report will be provided.


A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for any given probe.


Detection of an abnormal clone supports a diagnosis of a B-cell neoplasm; the specific abnormality detected may help subtype the neoplasm


The absence of an abnormal clone does not rule out the presence of neoplastic disorder.


This test is not approved by the U.S. Food and Drug Administration and it is best used as an adjunct to existing clinical and pathologic information.


Bone marrow is the preferred sample type for this FISH test. If bone marrow is not available, a blood specimen may be used if there are malignant cells in the blood specimen (as verified by hematopathology).

Supportive Data

Each probe was independently tested on a set of normal bone marrow control samples and bone marrow samples from patients diagnosed with a B-cell lymphoma. Normal cutoffs were calculated based on the results from 25 normal specimens. Each probe set was evaluated to confirm the probe set detected the abnormality it was designed to detect.

Method Description

This test is performed using either commercially available or laboratory-developed probes. Rearrangements involving MYC, BCL2, BCL6, CCND2, or MALT1 are detected using dual-color break-apart (BAP) strategy probes, translocations involving MYC, MALT1, or CCND1/IGH are identified using dual-color, dual-fusion (D-FISH) strategy probes, and deletions (7q32 or TP53) using enumeration strategy probes. For enumeration and BAP strategy probe sets, 200 interphase nuclei are scored; 500 interphase nuclei are scored when D-FISH probes are used. Two technologists analyze each probe set and the results are expressed as the percent abnormal nuclei.(Unpublished Mayo method)

Day(s) and Time(s) Performed

Samples processed Monday through Sunday. Results reported Monday through Friday; 8 a.m. to 5 p.m. CST.

Analytic Time

7 days

Specimen Retention Time

Four weeks

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

88271x2, 88291 – DNA probe, each (first probe set), Interpretation and report

88271x2 – DNA probe, each; each additional probe set (if appropriate)

88271x1 – DNA probe, each; coverage for sets containing 3 probes (if appropriate)

88271x2 – DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271x3 – DNA probe, each; coverage for sets containing 5 probes (if appropriate)

88274 w/modifier 52 – Interphase in situ hybridization, <25 cells, each probe set (if appropriate)

88274 – Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)     

88275 – Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BLPF B-cell Lymphoma, FISH, B/BM In Process


Result ID Test Result Name Result LOINC Value
51900 Result Summary 50397-9
51902 Interpretation 69965-2
51901 Result Table No LOINC Needed
54546 Result In Process
CG684 Reason for Referral 42349-1
CG685 Specimen 31208-2
51903 Source 31208-2
51904 Method 49549-9
54455 Additional Information 48767-8
53867 Disclaimer 62364-5
51905 Released by 18771-6