Laboratory Services

Large B-Cell Lymphoma (LBCL); High Grade B-Cell Lymphoma

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Updated Test Information:

Test Description
Large B-Cell Lymphoma (LBCL); High Grade B-Cell Lymphoma
Synonym(s)

LBCL, High grade B-cell lymphoma, double hit lymphoma, triple hit lymphoma, Burkitts lymphoma, Diffuse Large B-Cell Lymphoma (DLBCL)

General Information

Ex: Probes: BCL6 (3q27.3q28), BCL2 (18q21.33), MYC (8q24.21), Reflex probe: IGH (14q32.33)/MYC (8q24.21)/CEP8 (8p11.2) (probe sets may be ordered separately)


Disease(s): B-Cell lymphoma, double-hit lymphoma, triple hit lymphoma

Specimen Requirements

Bone Marrow Aspirate and Peripheral Blood
2-5 mL Sodium Heparin tube (preferred)
EDTA tube (acceptable)


Formalin fixed paraffin embedded (FFPE) tissue blocks or
2 unstained slides (4-5 microns thick sections)
1 H&E slide for pathology review (required)


Fixed-cell pellet from cytogenetic analysis slides with metaphase and/or interphase nuclei. (If sending slides please send at least 6 slides for testing)

Additional Processing Details

Transport to the testing lab at room temp is acceptable. Do not allow sample to overheat or freeze. Use cold pack for transport, making sure cold pack is not in direct contact with specimen

Required Information

Complete the Incyte Diagnostics hematology requisition with the patient's demographics and relevant clinical history. Label the specimen containers with patient's full name, second unique identifier, and specimen site/source. Please provide a copy of the patient's complete blood count (CBC) report.

Unacceptable Specimen Conditions

Specimen containers without two (2) patient identifiers, specimens submitted in inappropriate collection media, frozen specimens.

Department (code)

FISH

Methodology

Fluorescence in-Situ Hybridization (FISH)

Estimated TAT

Heme samples: 3-5 working days from receipt


FFPE samples: 4-7 working days from receipt

Testing Schedule

Monday-Friday

Retention

Heme samples: 7 days after release of final report


FFPE samples:
Blocks: 10 years
H&E and IHC Slides: 10 years
IF Slides: 30 days

CPT Code(s)

88377x3 without reflex, 88377x4 with reflex

Additional Information

Clinical Significance: This panel differentiates double-hit or triple-hit lymphomas (which have MYC rearrangements together with BCL6 and/or BCL2 rearrangements) from Burkitt lymphoma or diffuse large B-cell lymphoma. Double-hit and triple-hit lymphomas are difficult to classify morphologically without aid of cytogenetics/FISH or IHC, and are associated with an aggressive course. MYC/IGH/CEP8 will confirm heavy chain rearrangement when MYC is rearranged.

If Flow Cytometry studies are also being ordered, it is preferable to submit an EDTA (purple top) tube specifically for Flow Cytometry. If only one tube can be submitted, please submit one sodium heparin (green top) tube for both FISH and Flow Cytometry studies.