New Search

Laboratory Test Directory

ALK Gene Amplification Detection, FISH Tumor Analysis

Components

Name Method Department Units
ALK Amplification by FISH, NBL Fluorescence in situ hybridization (FISH)
Cytogenetics

Specimen Requirements

Bone marrow

Container Type Container Size Specimen Volume
Preferred

Green tube (Sodium heparin), No Gel

3 mL 3 mL
Stability

Room temperature - 24 hour(s)
Refrigerated - 72 hour(s)

Specimen Preparation

  • Keep at room temperature
  • Transport to laboratory as soon as possible

Tissue (Fresh)

Container Type Container Size Specimen Volume
Preferred

Sterile container with saline

N/A
Stability

Room temperature - 24 hour(s)
Refrigerated - 72 hour(s)

Specimen Preparation

  • Transport to the lab immediately after collection
  • Keep at room temperature or refrigerate

Paraffin embedded tissue

Container Type Container Size Specimen Volume
Required

Paraffin block

N/A
Stability

Room temperature - 6 month(s)

Specimen Preparation

  • Protect from heat
  • Keep at room temperature
  • Do not decalcify

Unstained tissue slide

Container Type Container Size Specimen Volume
Required

Charged Slides

N/A 6 slides (3 micron)
Stability

Room temperature - 6 month(s)

Specimen Preparation

  • Keep at room temperature
  • Protect from heat
  • Must accompany H&E slide from adjacent section
  • Do not decalcify

Tissue (Snap-frozen)

Container Type Container Size Specimen Volume
Preferred

Tissue cassette

N/A
Alternate

Cryogenic tube

N/A
Stability

Frozen - 6 month(s)

Specimen Preparation

  • Freeze immediately after collection.
  • Immediately place on dry ice and transport frozen
  • Keep frozen
  • Protect from heat

OCT-embedded tissue

Container Type Container Size Specimen Volume
Preferred

Tissue cassette

N/A
Alternate

Cryogenic tube

N/A
Stability

Frozen - 6 month(s)

Specimen Preparation

  • Keep frozen
  • Immediately place on dry ice and transport frozen
  • Protect from heat

Reasons for Rejection

  • Inadequate tissue
  • Delayed or improper handling
  • Tissue degradation
  • Wrong type of specimen
  • Decalcified tissue

Comments

Please click on the Lab Form Link in the Forms Section to print and complete the Pediatric Oncology Genetic Test Requisition Form. Submission of completed Requisition Form is required, and submission of informed consent form is recommended (but not required).

This test is a FISH analysis performed on tumor specimens and identifies amplification of the ALK oncogene locus. Presence or absence of ALK amplification may be used to help assign risk classification for the patient's neuroblastoma or other tumors.

Acceptable specimen types for this test include fresh tissue, snap-frozen tissue, OCT-embedded tissue, paraffin-embedded tissue, involved bone marrow, and unstained slides (6 consecutive, unstained, 3 micron-thick sections placed on positively charged slides; decalcified sections will not be accepted; must accompany a hematoxylin and eosin (H&E) stained slide from the adjacent section). Samples submitted under a COG protocol can also be used in many cases for this test (some COG-banked samples may require approval from the study chair to be used for this test). Pathology review by a Nationwide Children's Laboratory Services pathologist will be performed on all tumor samples to verify tumor percentage.

Send all samples via overnight courier service. Send snap-frozen or OCT-embedded tissue buried in dry ice. Send fresh tissue, paraffin-embedded tissue, or bone marrow at room temperature. Saturday deliveries are accepted; please check "Saturday Delivery" on shipment label for Saturday delivery. Please call (614) 722-5321 for any questions regarding this test. 


Children with neuroblastoma (NBL) are assigned a specific risk group (low, intermediate, or high) based on a variety of clinical and biological factors. Most children with NBL will be enrolled in Children’s Oncology Group (COG) protocols. However, Laboratory Services offers the targeted ALK sequencing and ALK amplification detection by FISH on a clinical basis for those patients who are NOT enrolled in a COG protocol or need testing off-study. ALK amplification is present in approximately 2% of all NBL cases. ALK amplification is usually seen with MYCN (N-Myc) amplification. ALK amplification and ALK mutations are rarely found in the same tumor. Copy number gains involving ALK (not amplification) can occur in a subset of cases. These copy number gains typically involve the entire gain of chromosome 2 or 2p (rather than a focal gain of ALK). These copy number changes are also seen in conjunction with the presence of MYCN amplification.

Forms

Lab Form

CPT Code

  • 88271
  • 88275