Gene fusions involving the IGH gene at 14q32 and BCL2 at 18q21 are common in follicular lymphomas, and can also occur in diffuse large B-cell lymphomas (DLBCL). The identification of such fusions can assist in diagnosis and classification of disease.
Presence of an IGH-BCL2 gene fusion can be useful in diagnosing and sub-classifying B-NHLs. In association with BCL6 and MYC gene fusions (see Multiple hit lymphoma FISH), this fusion can also indicate prognosis in B-cell lymphoma with features intermediate between DLBCL and Burkitt lymphoma.
This is an assay for non-heritable mutations. It does not raise issues of ethics or consent that are different from most other investigations ordered in the routine care of a patient.
Fluorescent in situ hybridisation (FISH) analysis, using probes to identify fusion of IGH with BCL2, due to a t(14;18)(q32;q21) translocation. If performed on FFPE tissue, some cells in the section may be sliced by the process, and only contain some of the regions of interest. Sections may contain bony, fatty or necrotic material, which may interfere with processing and/or analysis. Dense tissue also makes identification of individual cells difficult. The accuracy of the results is dependent on the correct identification of tumour on the sections provided, and the assumption that positive results will be identified by a large proportion of cells within the tumour having a rearrangement.
Requesting the Test
This test is usually requested by a haematologist or oncologist. This test is often requested as part of the Multiple hit lymphoma FISH panel.
0.5 mL bone marrow in transport media, or formalin-fixed, paraffin embedded tissue (FFPE).
To help ensure the quality of the test, a genetic test should be done with a dedicated sample whenever possible i.e. a sample collected specifically for that test rather than a sample that is used for multiple tests.
We recommend that the patient or another adult check the labelling of request forms and sample tubes.
If requesting on FFPE, please label each slide with patient and block identifiers plus number them sequentially 1-15. Stain slides 1 and 15 with H&E and leave slides 2-14 unstained.
Up to 4 weeks.
If more information is required, the requesting clinician can call our laboratory on (07) 3377 8573.
An MBS rebate is available as part of the Multiple hit lymphoma FISH panel in DLBCL or high-grade B-cell lymphoma, if criteria are met (item number 73364).