Immunoglobulin Heavy (IGH) Chain Gene Rearrangement



- Assessment of clonality in suspected B-cell lymphoproliferative neoplasms and lymphoproliferative neoplasm of uncertain lineage
- As a marker of neoplastic cells in a subset of B- and T-lymphoblastic leukemias.


Extracted DNA is analyzed for immunoglobulin heavy chain gene rearrangements by a polymerase chain reaction method using V primers derived from framework 1, framework 2 and framework 3 regions in combination with a mixture of fluorescently labeled J primers.

Test Parameters

The sensitivity of this assay for detection of a clonal B-cell population is between 1:100 to 1:10,000 lymphocytes, depending on the number of polyclonal B-cells present. Approximately 10% of B-cell tumors that show extensive IGH somatic hypermutation (e.g., follicular lymphoma) may not be detected in this assay due to the sequence variability. IGH rearrangements can be seen in T-cell acute lymphoblastic leukemias and are thus not definitive for lineage in immature lymphoid neoplasms.

Turnaround Time

Five to seven working days

Sample Requirements

  • 10 ml peripheral blood in purple top tube (EDTA Vacutainer), sent on wet ice

  • 2-5 ml of bone marrow aspirate, sent on wet ice

  • Frozen tissue samples sent on dry ice

  • Formalin-fixed, paraffin embedded tissue blocks

Please provide a copy of the corresponding pathology report.

CPT Codes


Additional charges may apply for tissue extraction.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.