B-cell Immunoglobulin Kappa Light Chain Gene Rearrangement
Test Code
P IGK
Test Synonyms
B-cell gene rearrangement
Associations
B-cell leukemia, Lymphoma
Methodology
Polymerase chain reaction (PCR), Capillary gel electrophoresis
CPT Codes
83891 – Molecular isolation
83900 – Amplfication multiplex, first sequence
83901 x14 – Amplification multiplex, each additional sequence
83909 x3 Identification by capillary electrophoresis
83912 – Interpretation and report
83900 – Amplfication multiplex, first sequence
83901 x14 – Amplification multiplex, each additional sequence
83909 x3 Identification by capillary electrophoresis
83912 – Interpretation and report
Turnaround Time
3 days
Specimen Requirements
- 5.0 mL (min. 3.0 mL) whole blood EDTA
- 3.0 mL (min. 1.0 mL) bone marrow EDTA
- 5 mm^3 bone marrow core biopsy, fresh tissue or frozen tissue in MPLN RPMI
- 3.0 mL (min. 2.0 mL) FNA in MPLN RPMI medium
- Formalin fixed paraffin embedded tissue
Specimen Stability
- EDTA whole blood or bone marrow stable at 18-25°C for 72 hours
- Bone marrow biopsy, fresh tissue or FNA in MPLN RPMI at 2-8°C stable for 72 hours
- Frozen tissue at 20°C stable indefinitely
- Paraffin embedded tissue at 18-25°C stable indefinitely
Storage & Handling
- EDTA whole blood, bone marrow, bone marrow biopsy, fresh tissue or FNA, ship in a Styrofoam container with an ice pack (Do not allow the ice pack to directly contact the sample)
- Frozen tissue, ship on dry ice
- Paraffin embedded tissue, ship ambient
Causes for Rejection
Insufficient volume; Specimen at incorrect temperature; Incorrect anticoagulant or fixative
Reference Range
No rearrangement detected (germline)
Related Content
Flow Cytometry
Description
Evaluation for suspected clonal B-cell lymphoproliferations when morphologic, immunochemical, and/or flow cytometry analyses are inconclusive. Molecular IgK testing is a useful complement to IgH analysis for confirmation of clonality in post-germinal center (mature) B-cell neoplasms where clonotypic IgH signatures may not be detected due to somatic hypermutation of VH genes.
References
- Van Krieken JHJM et al. (2007). Improved reliability of lymphoma diagnosis via PCR-based clonality testing:--Report of the BIOMED-2 Concerted Action BHMA-CT98-3936. Leukemia. 21:201-206.
- Evans P et al. (2007). Significantly improved PCR-based clonality testing in B-cell malignancies by use of multiple immunoglobulin targets: Report of the BIOMED-2 Concerted Action BHMA-CT98-3936. Leukemia. 21:207-214.
- Liu H et al. (2007). A practical strategy for the routine use of BIOMED-2 PCR assays for detection of B- and T-cell clonality in diagnostic haematopathology. Br J Haematol. 138:31-43.
- Pai RK et al. (2005). B-cell clonality determination using an immunoglobulin κ light chain polymerase chain reaction method. J Molec Diagn. 7:300-307.
- Van Dongen JJM et al. (2003). Design and standardization of PCR primers and protocols for detection and clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerned Action BMH4-CT98-3936. Leukemia. 17:2257-2317.
