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HelpTest Code BILAO Biliary Tract Malignancy, FISH, Varies
Specimen Required
Supplies: PreservCyt Vial (T536)
Specimen Type: Bile duct brushing, bile duct aspirate, hepatobiliary brushing, or hepatobiliary aspirate (fine-needle aspiration is not acceptable)
Container/Tube: Separate ThinPrep vial, containing 20 mL PreservCyt or CytoLyt solution for each specimen
Specimen Volume: Entire collection
Collection Instructions:
1. If performing local cytology in addition to fluorescence in situ hybridization testing, aliquot half of the specimen into another ThinPrep vial before processing the specimen.
2. Submission of residual specimen (after processing other testing) may compromise the sensitivity of the test.
3. Label each specimen with specific source (eg, right hepatic duct or common bile duct).
Forms
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| BILOB | Biliary Tract Malignancy, FISH | No | No |
| BILOC | Biliary Tract Malignancy, FISH | No | No |
| BILOD | Biliary Tract Malignancy, FISH | No | No |
| BILOE | Biliary Tract Malignancy, FISH | No | No |
| BILOF | Biliary Tract Malignancy, FISH | No | No |
Testing Algorithm
When this test is ordered, fluorescence in situ hybridization testing will be performed. When additional specimens are received, the laboratory will add BILOB to the second specimen, BILOC to the third specimen, and so on.
Method Name
Fluorescence In Situ Hybridization (FISH)
Specimen Type
VariesSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Refrigerated (preferred) | |
| Ambient | ||
Reject Due To
| Pancreatic mass Pancreatic cyst Pancreatic fine-needle aspiration (FNA) |
Reject |
Clinical Information
Endoscopic retrograde cholangiopancreatography (ERCP) is used to examine patients with biliary tract obstruction or stricture for possible malignancy. Biopsies and cytologic specimens are obtained at the time of ERCP. Cytologic analysis complements biopsy by sometimes detecting malignancy in patients with a negative biopsy. Nonetheless, a number of studies suggest that the overall sensitivity of bile duct brushing and bile aspirate cytology is quite low.
Fluorescence in situ hybridization (FISH) is a technique that utilizes fluorescently-labeled DNA probes to examine cells for chromosomal alterations. FISH can be used to detect cells with chromosomal changes (eg, aneuploidy) that are indicative of malignancy. Studies in our laboratory indicate that the sensitivity of FISH to detect malignant cells in biliary brush specimens is superior to that of conventional cytology.
Reference Values
No abnormality detected by fluorescence in situ hybridization
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
88377