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T Cell Receptor Gamma Gene Rearrangement

P TCR

Test Synonym:

T Cell Receptor gamma (TCRγ) gene rearrangement, T cell gene rearrangement

Test Synonym:

83891 – Molecular isolation
83894 – Gel electrophoresis

83900 – Amplifcation multiplex, first sequence
83901 x18 – Amplification multiplex, each additional sequence

83909 – Identification
83912 – Interpretation and report

Turnaround Time:

3 days

Methodology:

Polymerase Chain Reaction (PCR), capillary gel electrophoresis

Specimen Requirements:

  • 5.0ml (min. 3.0ml) EDTA whole blood;
  • 3.0ml (min. 1.0ml) EDTA bone marrow
  • 5mm3 bone marrow core biopsy
  • Fresh tissue or frozen tissue in MPLN RPMI
  • 3.0ml (min. 2.0ml) FNA in MPLN RPMI medium
  • Formalin fixed paraffin-embedded tissue

    • Causes for Rejection:

    Insufficient volume; specimen at incorrect temperature, incorrect anticoagulant or fixative

    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 and 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

    • Reference Range:

    No rearrangement detected (germline)

    Indication:

    The T cell immune response is controlled by surface T cell antigen receptors, consisting of either alpha/beta (α/β) or gamma/delta (γ/δ) heterodimers. Diversity in T cell repertoire is generated by rearrangement of minigenes within T cell receptor germline sequences. Clonal rearrangement patterns can be analyzed by Southern blotting (RFLP) or PCR1. Evaluation of gene rearrangement via specific PCR primer sets2 is extremely useful in confirming a diagnosis of lymphoid malignancies of T cell lineage, and serves as a useful adjunct to morphologic and flow cytometric analyses. TCR gamma by PCR detects T lineage clonality in 90% of cases3.

    References:

    1. Medeiros et al. (1999). Review. Overview of the role of molecular methods in the diagnosis of malignant lymphomas. Arch Pathol Lab Med
    2. Meier et al. (2001). Simultaneous evaluation of T- and B-cell clonality, t(11;14) and t(14;18), in a single reaction by a four-color multiplex polymerase chain reaction assay and automated high-resolution fragment analysis: a method for the rapid molecular diagnosis of lymphoproliferative disorders applicable to fresh frozen and formalin-fixed, paraffin-embedded tissues, blood, and bone marrow aspirates. AJP 159(6):2031
    3. Lamberson et al. (2001). A PCR assay for detecting clonal rearrangement of the TCR-gamma gene. Mol Diagn 6(2):117