Lab Test

Aggressive B-cell Lymphoma Panel by Fluorescence In Situ Hybridization (FISH) Analysis

FISH, genetic, double hit lymphoma, triple hit lymphoma, B-cell lymphoma, High-Grade B-Cell Lymphoma, with MYC and BCL2, and/or BCL6 Rearrangements (Aggressive B-cell Lymphoma, IgK (lg Kappa chain) gene rearrangement for Burkitt’s lymphoma, IgL (lg Lambda chain) gene rearrangement for Burkitt’s lymphoma, MYC gene rearrangement for Burkitt’s lymphoma-associated translocations, IgH/MYC fusion for t(8;14) detection

Test Codes

Please contact the Cytogenetics Laboratory if assistance with ordering in EPIC is needed. EPIC: LAB7113



Specimen Collection Criteria

Collect: Bone marrow aspirate in a Dark Green-top Sodium Heparin tube, lymph node touch preparation, or paraffin-embedded tissue section.

A copy of the requisition must be sent with the specimen. 

Physician Office/Draw Specimen Preparation

Do not freeze specimen. Maintain specimens at room temperature (20-25°C or 68-77°F) prior to courier pickup. For delays in transport (greater than 24 from the time of collection), refrigerate (2-8°C or 36-46°F) the specimen.

Preparation for Courier Transport

Transport: Bone marrow, lymph node touch preparation, or paraffin-embedded tissue, at room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F).

Rejection Criteria

Specimens arriving in the Laboratory 4 days or more following the original collection date.

Frozen or fixed specimens.

In-Lab Processing

Specimens are processed immediately upon receipt in the Laboratory.


Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 96 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days. A backup cell pellet is maintained for three weeks after the case has been signed out.


Royal Oak Cytogenetics Laboratory


Monday – Friday, 8:00 am – 5:00 pm.
Results available within 7 days of receipt in the Laboratory.

Reference Range

Positive or negative for a neoplastic clone. An interpretative report will be provided.

Test Methodology

Fluorescence In Situ Hybridization (FISH) Analysis.


A positive FISH result indicates the presence of MYC, IGH/BCL2, and/or BCL6 gene rearrangement.

Clinical Utility

The presence in a B-cell lymphoma of MYC gene rearrangement plus either BCL2 or BCL6 rearrangement defines a double-hit lymphoma and predicts a poor prognosis that requires aggressive treatment. This assay can be performed on a bone marrow biopsy, lymph node touch preparation, or a paraffin-embedded tissue section.

CPT Codes

For MYC Gene Rearrangement: 88271x1, DNA probe, each.
For IGH/MYC: 88271x3.
For Ig Kappa or Ig Lambda: 88271x1, DNA probe, each.
For All Assays: 88275x1, Interphase analysis, 100-300 cells.


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