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HelpTest Code LAB9740 Immunoglobulin Gene Rearrangement, Blood
Additional Codes
BCGR
Useful For
Determining whether a B-cell or plasma cell population is polyclonal or monoclonal using whole blood specimens
Identifying neoplastic cells as having B-cell or plasma cell differentiation
Monitoring for a persistent neoplasm by detecting an immunoglobulin gene rearrangement profile similar to one from a previous neoplastic specimen
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole bloodShipping Instructions
Specimen must arrive within 7 days of collection.
Specimen Required
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD)
Specimen Volume: 4 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole blood | Ambient (preferred) | 7 days | |
| Refrigerated | 7 days |
Special Instructions
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
CPT Code Information
81261-IGH (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas B-cell), gene rearrangement analysis to detect abnormal clonal populations; amplified methodology (eg. polymerase chain reaction)
81264-IGK (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell) gene rearrangement analysis, evaluation to detect abnormal clonal populations
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BCGR | Immunoglobulin Gene Rearrange, B | 61113-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 18229 | Final Diagnosis: | 34574-4 |
| 608948 | Signing Pathologist | 19139-5 |
Interpretation
An interpretive report will be provided.
The interpretation of the presence or absence of a predominant immunoglobulin gene rearrangement profile is sometimes subjective. These results must always be interpreted in the context of other clinicopathologic information to determine the significance of the result.
The detection of a clonal immunoglobulin gene rearrangement by this test is not synonymous with the presence of a B-cell or plasma cell neoplasm.
Method Description
Genomic DNA is extracted from all specimens.
In the polymerase chain reaction (PCR) assay, a total of 34 upstream and 5 downstream primers are used (Invivoscribe IGH and IGK gene clonality reagents). The primers are designed to amplify fragments from all theoretical rearrangements of the immunoglobulin heavy and kappa light chain genes. Each unique rearrangement should produce PCR fragments of unique sizes. The primers cannot amplify anything if the immunoglobulin genes are not rearranged because the distance is too great. The primers are labeled with a fluorescent tag so that the PCR product can be detected. The PCR fragments are analyzed by capillary gel electrophoresis using a genetic analyzer for fragment size and amount.(Unpublished Mayo method)
Report Available
5 to 7 daysSpecimen Retention Time
Whole blood: 2 weeks; Extracted DNA: 3 monthsReject Due To
| Gross hemolysis | Reject |
| Moderately to severely clotted | Reject |
Method Name
Polymerase Chain Reaction (PCR)
Forms
1. Hematopathology Patient Information (T676)
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.