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Test Catalog

Test ID: PLASF    
Plasma Cell Proliferative Disorder, FISH, Tissue

Useful For Suggests clinical disorders or settings where the test may be helpful

Supporting the diagnosis of plasmacytoma when coordinated with a surgical pathology consultation

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

This test does not include a pathology consult. If a pathology consult is requested, PATHC / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge.

 

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.Indicate if the entire panel is to be performed. If the patient is being tracked for known abnormalities, indicate which probes should be used.

 

Panel includes testing for the following abnormalities using the probes listed:

17p-, TP53/D17Z1

1q gain, TP73/1q22

t(14;16)(q32;q23), IGH/MAF

t(4;14)(p16.3;q32), FGFR3/IGH

8q24.1 rearrangement, MYC

-13/13q-, RB1/LAMP1

+9/+15, D9Z1/D15Z4

+3/+7, D3Z1/D7Z1

14q32 rearrangement, IGH

t(11;14), CCND1/IGH

t(14;20)(q32;q12), IGH/MAFB

t(6;14)(p21;q32), CCND3/IGH

 

If no probes are specified, probes will be selected based on disease risk stratification, pathologic review, and history (if applicable).

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

A plasmacytoma is a localized proliferation of plasma cells that are cytologically and immunophenotypically identical to the plasma cell clones seen in myeloma. There are 2 primary types of plasmacytomas; solitary plasmacytoma of bone (SPB) and extramedullary plasmacytoma (EP).

 

SPBs are a localized bone tumor comprised of plasma cells and account for about 5% of all plasma cell neoplasms. Common sites for SPBs are the vertebrae, ribs, skull, pelvis, femur, clavicle, and scapula. Patients often present with pathological fracture and/or bone pain near the lesion. Treatment is typically radiation therapy; at 10 years, 35% of patients appear to be cured, 55% develop myeloma, and 10% have local recurrence.

 

EPs are tumors of plasma cells that form in areas away from the bone and account for 3% to 5% of all plasma cell neoplasms. Approximately 80% of EPs occur in the upper respiratory tract. Less common locations include the gastrointestinal tract, bladder, testis, central nervous system, and skin. Treatment consists of radiation therapy. Regional recurrence develops in about 25% of patients, but development of myeloma is less frequent, occurring in only about 15% of patients.

 

Genetics of both types of plasmacytomas, while not extensively studied, appears to be the same as plasma cell myeloma.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretive report will be provided.

Interpretation Provides information to assist in interpretation of the test results

A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for a given probe set.

 

A positive result supports the diagnosis of a plasmacytoma.

 

A negative result does not exclude the diagnosis of a plasmacytoma.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test is not approved by the US Food and Drug Administration and is best used as an adjunct to existing clinical and pathologic information.

 

Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays. Although FISH testing will not be rejected due to nonformalin-fixation results may be compromised.

 

Paraffin-embedded tissues that have been decalcified are generally unsuccessful for FISH analysis. The pathologist reviewing the hematoxylin and eosin-stained slide may find it necessary to cancel testing.

Supportive Data

Each probe was independently tested and verified on paraffin-embedded tissue specimens. Normal cutoffs were calculated based on the results of at least 25 normal specimens. For each probe set a series of chromosomally abnormal specimens were evaluated to confirm each probe set detected the anomaly it was designed to detect.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Swerdlow S, Campo E, Harris NL, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press: Lyon. 2017

2. Nolan KD, Mone MC, Nelson EW: Plasma cell neoplasms: review of disease progression and report of a new variant. Surg Oncol 2005;14:85-90

3. Dingli D, Kyle RA, Rajkumar SV, et al: Immunoglobulin free light chains and solitary plasmacytoma of bone. Blood 2006;108(6):1979-1983