F IGH*; FP IGH*
Immunoglobulin heavy chain, 14q32 rearrangement
Non-Hodgkin lymphoma, Myeloma
Fluorescence in situ Hybridization (FISH)
*Performed by affiliate laboratory
5mL peripheral blood in sodium heparin
3mL bone marrow in sodium heparin
Fixed cytogenetically prepared cells in sterile centrifuge tube with pellet visible in 3:1, Methanol:Acetic Acid
FFPE tissue is acceptable for FISH analysis. Preferred fixative is 10% neutral buffered formalin. Tissues preserved in B5 fixative or decalcified are usually not suitable for FISH. Tumor sections cut 3-5 µm thick and mounted on positively charged organosilane coated (silanized) slides work well. Request several unstained sections (two for each probe) and one H&E stained slide
4°C to 25°C during transit, but specimens may be transported on refrigerated gel packs. Do not allow the gel pack to come in contact with the specimen. Do not freeze. Extreme temperatures should be avoided.
Clotted specimen; Specimen exposed to extreme temperature; Anticoagulant toxic to cells; Insufficient number of cells; Improper fixative
Rearrangements involving the IGH gene have been identified in about 50% of non-Hodgkin B-cell lymphomas (NHLs) and correlated to clinically relevant subgroups. A t(14;18)(q32;q21) is found in 88.1% of follicular lymphomas and a t(11;14)(q13;q32) is in 85.7% mantle cell lymphomas. IGH rearrangements are identified in 52.5% of diffuse large B-cell lymphomas. Rearrangements of the IgH gene occur in 34.7% of plasma cell myeloma cases and is among the most frequent chromosomal change. FISH can detect this rearrangement in either interphase or metaphase cells.