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Test Code KLISH Kappa and Lambda Light Chain mRNA, In Situ Hybridization (ISH) Technical Component Only


Ordering Guidance


This test includes only technical performance of the stain (no pathologist interpretation is performed). If diagnostic consultation by a pathologist is required order PATHC / Pathology Consultation.



Shipping Instructions


Attach the green "Attention Pathology" address label (T498) and the pink Immunostain Technical Only label included in the kit to the outside of the transport container.



Specimen Required


Specimen Type: Tissue

Supplies: Immunostain Technical Only Envelope (T693)

Container/Tube: Immunostain Technical Only Envelope

Preferred:

-Formalin-fixed, paraffin-embedded tissue block

OR

-2 Unstained, positively charged glass slides (25- x 75- x 1-mm) per test ordered; sections 4-microns thick

Acceptable: None


Forms

If not ordering electronically, complete, print, and send a Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request (T763) with the specimen.

Secondary ID

70615

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ISTOI ISH Initial, Tech Only No No
ISTOA ISH Additional, Tech Only No No

Method Name

In Situ Hybridization (ISH)

Reporting Name

Kappa/Lambda ISH, Tech Only

Specimen Type

TECHONLY

Specimen Stability Information

Specimen Type Temperature Time Special Container
TECHONLY Ambient (preferred)
  Refrigerated 

Reject Due To

Wet/frozen tissue 
Cytology smears 
Nonformalin fixed tissue 
Nonparaffin embedded tissue 
Noncharged slides 
ProbeOn slides 
Snowcoat slides 		 Reject 

Interpretation

This test does not include pathologist interpretation, only technical performance of the stain. If interpretation is required, order PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case.

 

The positive and negative controls are verified as showing appropriate immunoreactivity. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request; call 855-516-8404.

 

Interpretation of this test should be performed in the context of the patient’s clinical history and other diagnostic tests by a qualified pathologist.

Cautions

Age of a cut paraffin section can affect immunoreactivity. Stability thresholds vary widely among published literature and are antigen dependent. Best practice is for paraffin sections to be cut within 6 weeks.

 

The charge of glass slides can be affected by environmental factors and subsequently may alter slide staining. Sending unsuitable glass slides can result in inconsistent staining due to poor slide surface chemistry.

 

Best practices for storage of positively charged slides:

-Minimize time slides are stored after being unpackaged

-Limit exposure to high humidity and heat

-Minimize exposure to plastics

Clinical Reference

1. Akhtar N, Ruprai A, Pringle JH, et al. In situ hybridization detection of light chain mRNA in routine bone marrow trephines from patients with suspected myeloma. Br J Haematol. 1989;73:296-301

2. Weiss LM, Movahed LA, Chen YY, et al. Detection of immunoglobulin light-chain mRNA in lymphoid tissues using a practical in-situ hybridization method. Am J Pathol. 1990;137:979-988

3. Hristov AC, Comfere NI, Vidal CI, Sundram U. Kappa and lambda immunohistochemistry and in situ hybridization in the evaluation of atypical cutaneous lymphoid infiltrates. J Cutan Pathol. 2020;47(11):1103-1110. doi:10.1111/cup.13858

4. Magaki S, Hojat SA, Wei B, So A, Yong WH. An introduction to the performance of immunohistochemistry. Methods Mol Biol. 2019;1897:289-298. doi:10.1007/978-1-4939-8935-5_25

Day(s) Performed

Monday through Friday

Report Available

1 to 3 days

Specimen Retention Time

Until staining is complete

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

88365-TC, primary

88364-TC, if additional ISH

LOINC Code Information

Test ID Test Order Name Order LOINC Value
KLISH Kappa/Lambda ISH, Tech Only Order only;no result

 

Result ID Test Result Name Result LOINC Value
70792 Kappa/Lambda ISH, Tech Only Bill only; no result

Testing Algorithm

For the initial technical component only in situ hybridization (ISH) stain performed, the appropriate bill only test ID will be reflexed and charged (ISTOI). For each additional technical component only ISH stain performed, an additional bill only test ID will be reflexed and charged (ISTOA).