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Test Code MISCF Miscellaneous Studies Using Chromosome-Specific Probes, FISH

Reporting Name

Miscellaneous Studies, FISH

Useful For

Resolution of unusual or complex structural alterations, questionable mosaicism, and unbalanced chromosome abnormalities that cannot be resolved by chromosome or chromosomal microarray analysis

 

Identifying gain, loss, or rearrangement of chromosome regions using gene or locus-specific probes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies

Specimen Required


Ordering Guidance


Consult with the laboratory before ordering this test.

 

The fluorescence in situ hybridization (FISH) probes to be analyzed must be specified on the request when ordering, otherwise test processing may be delayed in order to determine the intended analysis. If specific probes are not provided, this test may be canceled by the laboratory.

 

If testing bone marrow or blood samples for specific hematologic malignancies is desired, order HEMMF / Hematologic Specified FISH, Varies. If specific FISH probes for hematologic malignancies are ordered and a bone marrow or blood sample is received, this test will be canceled and automatically reordered by the laboratory as HEMMF / Hematologic Specified FISH, Varies.



Necessary Information


1. A list of probes requested for analysis is required.

2. A reason for testing should be submitted 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. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

3. A pathology report may be requested by the laboratory to optimize testing and aid in the interpretation of results. Acceptable pathology reports include working drafts, preliminary pathology, or surgical pathology reports.



Specimen Required


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.

 

Advise Express Mail or equivalent if not on courier service.

 

Submit only 1 of the following specimens:

 

Specimen Type: Amniotic fluid

Supplies: Refrigerate/Ambient Shipping Box, 5 lb (T329)

Container/Tube: Amniotic fluid container

Specimen Volume: 20-25 mL

Collection Instructions:

1. Optimal timing for specimen collection is during 14 to 18 weeks of gestation, but specimens collected at other weeks of gestation are also accepted. Provide gestational age at the time of amniocentesis.

2. Discard the first 2 mL of amniotic fluid.

3. Place the tubes in a shipping box.

4. Fill remaining space with packing material.

Additional Information:

1. Unavoidably, about 1% to 2% of mailed-in specimens are not viable.

2. Bloody specimens are undesirable.

3. If the specimen does not grow in culture, you will be notified within 7 days of receipt.

4. Results will be reported and telephoned or faxed, if requested.

 

Specimen Type: Blood (only accepted for Congenital/Hereditary [nonhematologic] testing)

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Green top (heparin) or lavender top (EDTA)

Specimen Volume: 6 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Send whole blood specimen in original tube. Do not aliquot.

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

 

Specimen Type: Chorionic villi (CVS)

Supplies: CVS Media (RPMI) and Small Dish (T095)

Container/Tube: 15-mL tube containing 15 mL of transport media

Specimen Volume: 20 to 25 mg

Collection Instructions:

1. Collect specimen by the transabdominal or transcervical method.

2. Transfer chorionic villi to a Petri dish containing transport medium (eg, CVS media (RPMI)).

3. Using a stereomicroscope and sterile forceps, assess the quality and quantity of the villi and remove any blood clots and maternal decidua.

 

Specimen Type: Lymph node

Supplies: Hank's Solution (T132)

Container/Tube: Sterile container with sterile Hank's balanced salt solution, Ringer's solution, or normal saline

Specimen Volume: 1 cm(3)

 

Specimen Type: Skin biopsy

Supplies: Hank's Solution (T132)

Container/Tube: Sterile container with sterile Hank's balanced salt solution, Ringer's solution, or normal saline

Specimen Volume: 1-cm(3) biopsy specimen of muscle/fascia from the thigh

Collection Instructions:

1. Wash biopsy site with an antiseptic soap.

2. Thoroughly rinse area with sterile water.

3. Do not use alcohol or iodine preparations.

4. A local anesthetic may be used.

5. Biopsy specimens are best taken by punch biopsy to include full thickness of dermis.

 

Specimen Type: Tissue

Preferred: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.

Additional Information:

1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).

2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.

 

Acceptable: Slides

Collection Instructions: For each probe set ordered, 4 consecutive, unstained, 5 micron-thick sections placed on positively charged slides. Include 1 hematoxylin and eosin-stained slide for the entire test order.

 

Supplies: Hank's Solution (T132)

Specimen Type: Tumor

Container/Tube: Sterile container with sterile Hank's balanced salt solution, Ringer's solution, or normal saline

Specimen Volume: 0.5 to 3 cm(3) or larger


Specimen Minimum Volume

Amniotic fluid: 5 mL; Blood: 2 mL; Chorionic villi: 5 mg; Lymph node: 0.5 cm(3); Solid tumor: 0.5 cm(3)

Testing Algorithm

Consult with the laboratory before ordering this test.

 

This test includes a charge for the probe application, analysis, and professional interpretation of results for 1 probe set (2 individual fluorescence in situ hybridization probes). Additional charges will be incurred for all additional probe sets performed. If no cells are available for analysis, no analysis charges will be incurred.

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)
  Refrigerated 

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Friday

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 US 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)

88273 w/modifier 52-Chromosomal in situ hybridization, less than 10 cells (if appropriate)

88273-Chromosomal in situ hybridization, 10-30 cells (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
MISCF Miscellaneous Studies, FISH 62367-8

 

Result ID Test Result Name Result LOINC Value
52163 Result Summary 50397-9
52165 Interpretation 69965-2
52164 Result Table 93356-4
54586 Result 62356-1
CG746 Reason for Referral 42349-1
CG943 Specimen 31208-2
52167 Source 31208-2
52168 Tissue ID 80398-1
52169 Method 85069-3
55028 Additional Information 48767-8
53829 Disclaimer 62364-5
52170 Released By 18771-6

Clinical Reference

1. Remstein ED, Dogan A, Einerson RR, et al: The incidence and anatomic site specificity of chromosomal translocations in primary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) in North America. Am J Surg Pathol. 2006 Dec;30(12):1546-1553

2. Fonseca R, Blood E, Rue M, et al: Clinical and biologic implications of recurrent genomic aberrations in myeloma. Blood. 2003 Jun 1;101(11):4569-4575

3. Van Dyke DL, Shanafelt TD, Call TG, et al: A comprehensive evaluation of the prognostic significance of 13q deletions in patients with B-chronic lymphocytic leukaemia. Br J Haematol. 2010 Feb;148(4):544-550

4. Wiktor A, Van Dyke DL: FISH analysis helps identify low-level mosaicism in Ullrich-Turner syndrome patients. Genet Med. May-Jun 2004;6:132-135

5. Swerdlow SH, Campo E, Harris NL, eds, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC; 2017

6. American College of Medical Genetics and Genomics (ACMG): Technical Standards and Guidelines for Clinical Genetics Laboratories. ACMG; 2008. Updated January 2018. Accessed July 27, 2022. Available at www.acmg.net/PDFLibrary/Standards-Guidelines-Cytogenetics.pdf

Method Description

This test is performed using commercially available and laboratory-developed probes. Depending on the indication for testing, analysis of metaphase cells or interphase nuclei is performed. Two technologists analyze each probe set and all results are reported indicating presence, absence, or rearrangement of the gene region being interrogated. If interphase nuclei are scored, the results are expressed as the percent abnormal nuclei.(Unpublished Mayo method)

Report Available

9 to 10 days

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Method Name

Fluorescence In Situ Hybridization (FISH)

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
_ML10 Metaphases, 1-9 No, (Bill Only) No
_M30 Metaphases, >=10 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

Secondary ID

35267