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SYT 18q11.2 Synovial Sarcoma by FISH*

Test Code


Test Synonyms

SYT gene rearrangement, 18q11, 18q11.2 rearrangement


Synovial sarcomas


Fluorescence in situ Hybridization (FISH)
*Performed by affiliate laboratory

Turnaround Time

7-9 days

Specimen Requirements

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

Specimen Stability
Blood and bone marrow = 4°C to 25°C, specimens are stable up to 72 hours
Fixed cell pellets are stable for years when stored at -28°C to 15°C
Storage & Handling

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.

Causes for Rejection

Improper fixative; Tissue not fixed; Insufficient tissue; Specimen exposed to extreme temperature

Reference Range

In a normal cell that lacks a t(18q11.2) in the SYT gene region, a two fusion signal pattern is observed, reflecting the two intact copies of SYT (Figure 1). In an abnormal cell with a simple t(18q11.2), a one fusion, one green and one orange signal pattern is expected.


Synovial sarcomas (SS), which account for 5-10% of soft tissue sarcomas, are seen mainly in adolescents and adults aged between 15 and 45 years. More than 85-95% of them arise in the deep soft tissues of the extremities. Synovial sarcomas harbor the t(X;18)(p11.2;q11.2), resulting in the fusion of the SYT gene at 18q11 with either the SSX1 or the SSX2 gene (or, rarely, SSX4), which is a primary cytogenetic anomaly in ~90% of the cases. Detection of this translocation is highly specific for SS. Break-apart assays have been found more suitable for detection of the t(X;18) in SS, given the presence of multiple partner loci. FISH can detect this abnormality in paraffin embedded interphase cells.

  1. Subramaniam, Manish Mani et al. (2007). Cancer Genetics and Cytogenetics. 172:23-28.