Test Catalog

Test ID: SGTF    
MYB (6q23) Rearrangement FISH, Tissue

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

Assessing for MYB gene rearrangements in patients with primary salivary gland carcinoma to aid in confirming or excluding the diagnosis of primary salivary gland adenoid cystic carcinomas

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 consultation. 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.

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

Salivary adenoid cystic carcinomas (ACC), although uncommon, are frequent among salivary gland malignancies. ACC is typically an aggressive tumor with a poor prognosis. Histologically, ACC show significant morphologic overlap with other salivary gland tumors, but have a much different clinical course. Because ACC requires a management distinct from histologically similar lesions, it is important to make an accurate diagnosis. Translocations between MYB (6q23.3) and NFIB (9p24) have been identified in a large proportion of primary salivary gland ACC. These alterations have not been identified in other salivary gland tumors. Therefore, separation of MYB, in the proper clinical and histologic context, is diagnostic for ACC and can be confirmed by FISH with MYB break-apart probes.

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 positive result is detected when the percent of cells with an abnormality exceeds the normal cutoff for the probe set.


A positive result suggests rearrangement of the MYB locus. The presence of a MYB rearrangement in conjunction with the proper clinical and histologic features is diagnostic of adenoid cystic carcinomas (ACC). A confirmed diagnosis of ACC results in specific clinical management that may be distinct from the management of other salivary gland neoplasms.


A negative result suggests no rearrangement of the MYB gene region at 6q23.3. The absence of a MYB rearrangement does not exclude the diagnosis of ACC, as a subset of ACCs do not show an MYB rearrangement.

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 U.S. Food and Drug Administration, and it is best used as an adjunct to existing clinical and pathologic information.


This test is only intended to be used in the diagnosis of salivary gland tumors. This test has not been validated on adenoid cystic carcinoma (ACC) arising from nonsalivary gland locations. The results of this test are intended to be interpreted in association with the pathologic and clinical findings. The absence of MYB rearrangement does not exclude the diagnosis of ACC.


Fixatives other than formalin (eg, Prefer, Bouin) may not be successful for FISH assays, however nonformalin-fixed samples will not be rejected.


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

The probe was independently validated in a blinded study on 48 paraffin-embedded adenoid cystic carcinoma tissue specimens and 25 noncancerous control specimens. The normal controls were used to generate a normal cutoff for this assay.

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

1. Mitani Y, Rao PH, Futreal PA, et al: Novel chromosomal rearrangements and break points at the t(6;9) in salivary adenoid cystic carcinoma: association with MYB-NFIB chimeric fusion, MYB expression, and clinical outcome. Clin Cancer Res 2011;17(22):7003-7014

2. West RB, Kong C, Clarke N, et al: MYB expression and translocation in adenoid cystic carcinomas and other salivary gland tumors with clinicopathologic correlation. Am J Surg Pathol 2011;35(1):92-99

3. Bell D, Roberts D, Karpowicz M, et al: Clinical significance of Myb protein and downstream target genes in salivary adenoid cystic carcinoma. Cancer Biol Ther 2011;12:569-573