T-Cell Receptor Gamma Gene Rearrangement
Test Code
P TCR
Test Synonyms
T-cell receptor gamma (TCRγ) gene rearrangement, T cell gene rearrangement
Associations
T-cell clonality
Methodology
Polymerase chain reaction (PCR), capillary gel electrophoresis
CPT Codes
83891 – Molecular isolation
83900 – Amplifcation multiplex, first sequence
83901 x18 – Amplification multiplex, each additional sequence
83909 – Identification
83912 – Interpretation and report
83907 - Paraffin block
83900 – Amplifcation multiplex, first sequence
83901 x18 – Amplification multiplex, each additional sequence
83909 – Identification
83912 – Interpretation and report
83907 - Paraffin block
Turnaround Time
3 days, 4 days if specimen is paraffin embedded tissue
Specimen Requirements
- 5.0 mL (min. 3.0 mL) EDTA whole blood
- 3.0 mL (min. 1.0 mL) EDTA bone marrow
- 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 stable at 2-8°C for 72 hours
- Frozen tissue stable at -20°C indefinitely
- Paraffin embedded tissue stable at 18-25°C 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)
Description
Evaluation for suspected clonal T-cell lymphoproliferations when morphologic, immunochemical, and/or flow cytometry analyses are inconclusive.
References
- Bruggemann M et al. (2007). Powerful strategy for polymerase chain reaction-based clonality assessment in T-cell malignancies. Report of the BIOMED-2 Concerted Action CT98-3936. Leukemia. 21:215-221.
- Langerak AW et al. (2007). Polymerase chain reaction-based clonality testing in tissue samples with reactive lymphoproliferations: usefulness and pitfalls. Report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 21:222-229.
- Liu H et al. (2007). A practical strategy for the routine use of BIOMED-2 PCR assays for the detection of B- and T-cell clonality in diagnostic haematopathology. Br J Haematol. 138:31-43.
- 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.
- Saberg Y et al. (2003). Molecular immunoglobulin/T-cell receptor clonality analysis in cutaneous lymphoproliferations. Experience with the BIOMED-2 standardized polymerase chain reaction protocol. Haematologica. 88:659-670.
- 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 Concerted Action BMH4-CT98-3936. Leukemia. 17:2257-2317.
