B-cell Receptor IGH Gene Rearrangement, PCR

Casandra

Casandra Test Code QD87071Version 1 (DRAFT)

Performing Lab

Lab Quest DiagnosticsLab Test ID 90362CPT Codes 81261, 84999

B-cell Receptor IGH Gene Rearrangement, PCR

Also known as: Heavy Chain Gene Rearrangement, Immunoglobulin Heavy Chain, B-Cell Clonality, B cell PCR

Clinical Use

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Use

This test detects clonal immunoglobulin heavy chain (IGH) gene rearrangements by PCR and fragment analysis to assess B‑cell clonality in suspected lymphoproliferative disorders such as leukemia or lymphoma, and provides a pathologist‑integrated interpretation. Useful in establishing clonality, particularly in B‑cell neoplasms. ([questdiagnostics.com](https://www.questdiagnostics.com/healthcare-professionals/clinical-education-center/faq/faq124?utm_source=openai))

Special Instructions

Insurance authorization is required for outpatient orders; inpatients may be sent without prior authorization. ([rchsd.org](https://www.rchsd.org/lab-test/b-cell-receptor-igh-gene-rearrangement-pcr-90362/?utm_source=openai))

Limitations

IGH PCR may yield false‑negative results in up to 5‑20% of B‑cell neoplasms due to absent or incomplete rearrangements (e.g., immature B‑cell neoplasms) or extensive somatic hypermutation (e.g., follicular lymphoma). For increased sensitivity, combined IGH and IGK testing (B‑cell clonality panel) is recommended in such contexts. ([questdiagnostics.com](https://www.questdiagnostics.com/healthcare-professionals/clinical-education-center/faq/faq124?utm_source=openai))

Test Details