B-cell leukemia lymphoma 2 gene rearrangement analysis

This test identifies the rearrangement of a gene called bcl-2 in the body. It is used to help diagnose and manage lymphoid cancers such as follicular lymphoma and diffuse large B-cell lymphoma. A sample from the bone marrow, cerebrospinal fluid, lymph node tissue, extranodal mass tissue, blood or another body fluid or tissue may be collected for this test.

Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. You may need this test if you have:

• Diffuse large B-cell lymphoma
• Follicular lymphoma

Bone marrow:

A bone marrow biopsy is a procedure that requires written consent. Review the consent form with the healthcare worker and ask any questions that you have before signing the consent form.

Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. You should also report if you have a history of allergic or other reactions to local anesthetics. Inform the healthcare worker of any past or present bone diseases. You may need to have other tests done before a bone marrow biopsy.

To prepare for a bone marrow biopsy, you may be offered a mild sedative prior to the procedure to help you relax. To decrease pain, you will also receive a topical or local anesthetic injection at the biopsy site.

Cerebrospinal fluid:

A lumbar puncture is a procedure that requires your written consent. Review the consent form with the healthcare worker and ask any questions that you have before signing the consent form. You may receive certain medications and need imaging tests done prior to the procedure.

Tell the person doing the lumbar puncture if you have a medical condition or are using a medication or supplement that causes excessive bleeding. Contact the healthcare worker if you have a history of chronic back pain, structural defects in your spine, or a past spinal surgery. Tell the healthcare worker if you have an infection on your back or if you have any psychiatric or neurological (nerve) conditions. You should also report if you have a history of allergic or other reactions to local anesthetics.

Fluid/Tissue:

Written consent may be required for a fine needle aspiration biopsy. Review the consent form with the healthcare worker and ask any questions you have before signing the form. Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. You should also report if you have a history of allergic or other reactions to local anesthetics.

Blood:

Before having blood collected, tell the person drawing your blood if you are allergic to latex. Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. Also tell the healthcare worker if you have felt nauseated, lightheaded, or have fainted while having blood drawn in the past.

Other body fluid and tissue samples:

A different sample other than the samples listed above may be used for this test. Ask your healthcare worker for information about how to prepare for this test. If you have questions or concerns about the preparation for this test, talk to the healthcare worker.

A sample from the bone marrow, cerebrospinal fluid, lymph node tissue, extranodal mass tissue, blood or another body fluid or tissue may be collected for this test.

Bone marrow:

Bone marrow is the tissue inside certain bones where new blood cells are made. A bone marrow sample is collected by biopsy. Local anesthesia may be used for a bone marrow biopsy. Your skin will be shaved and cleaned, and a sterile area will be prepared for the procedure. A needle will be inserted through the skin and into the bone using a twisting motion. A sample of marrow will be removed with a syringe, and another needle will be used to remove a piece of tissue. When the samples are collected, the needle will be removed.

Cerebrospinal fluid:

Cerebrospinal fluid is the fluid that surrounds the brain and spinal cord tissues. The procedure that collects a sample of cerebrospinal fluid is called a lumbar puncture. For this procedure, you may need to lie on your side facing away from the person performing the procedure. You may be asked to roll up into a ball with your knees brought close to your chest. This position allows your spine to spread apart slightly and helps direct needle placement. This procedure may also be done while you are in an upright sitting position, with your knees drawn up toward your chest.

An area in the lower back will be chosen for the needle insertion site. This is about at the level of the top of your hip bone. Your skin will be cleaned with antiseptic and the area will be draped with sterile cloth. Local anesthetic will be injected with a small needle to numb the area. Anesthetic cream may also be applied. After the anesthetic has taken effect, the lumbar puncture needle is inserted between the vertebrae and into the spinal column. Cerebrospinal fluid is drawn out for testing and the needle is removed. You may need to change positions during the procedure if the healthcare worker is having difficulty collecting a sample of fluid. This procedure may be done more than one time if collecting cerebrospinal fluid is difficult.

Fluid/Tissue:

A fine needle aspiration biopsy is used to collect fluid, or take small tissue samples from a cyst, lump or mass. First, the area over the biopsy site will be cleaned. A local anesthetic may be used to numb the area where the needle will be inserted.

A very tiny needle will be inserted into the area selected for testing. If fluid is present, it will be withdrawn from the area using a syringe. If a tissue sample is required for testing, the needle may be moved back and forth to get enough tissue. When sample collection is complete, the needle will be removed.

Blood:

When a blood sample from a vein is needed, a vein in your arm is usually selected. A tourniquet (large rubber strap) may be secured above the vein. The skin over the vein will be cleaned, and a needle will be inserted. You will be asked to hold very still while your blood is collected. Blood will be collected into one or more tubes, and the tourniquet will be removed. When enough blood has been collected, the healthcare worker will take the needle out.

Other body fluid and tissue samples:

A different sample other than the samples listed above may be used for this test. Methods used to collect other body fluids or tissue samples may vary. Ask the healthcare worker to explain how this sample may be collected. If you have questions or concerns about this test, talk to the healthcare worker.

The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the test. Inform the person doing the test if you feel that you cannot continue with the test.

Bone marrow:

Before a bone marrow biopsy, you may receive medication to help you relax. When the numbing medicine is injected, you may feel mild discomfort or stinging. The local anesthetic is used to minimize pain, but as the procedure needle is inserted, you may feel some pressure and discomfort. You may feel brief pain as the bone marrow is removed. You may feel discomfort at the procedure site for several days.

Cerebrospinal fluid:

Before a lumbar puncture, a local anesthetic is given to the procedure site to numb the area. You may feel mild discomfort or stinging when the numbing medicine is injected. You may feel a pressure, a popping sensation, and discomfort when the procedure needle is inserted. Tell the person doing the test if you feel pain or numbness down your leg during the procedure. You may have back discomfort for several days after the procedure.

Fluid/Tissue:

A local anesthetic is used to minimize pain during a fine needle aspiration biopsy. Even when local anesthetic is used, you may feel discomfort or pressure as the needle is inserted and moved during the procedure. After the biopsy, the procedure site may be sore for several days.

Blood:

During a blood draw, you may feel mild discomfort at the location where the blood sample is being collected.

Other body fluid and tissue samples:

A different sample other than the samples listed above may be used for this test. This test may feel different depending on many factors, including the sample needed and how it is collected. Ask the healthcare worker what to expect during this test.

Bone marrow:

After the sample of bone marrow is collected, pressure may be applied and a bandage will be placed over the biopsy site. You will be given instructions for when to remove the bandage, and the signs and symptoms of infection to watch for. Contact your healthcare worker if you experience a fever or increased pain, and if you see increasing redness, swelling, or pus at the procedure site.

Cerebrospinal fluid:

After the lumbar puncture is complete, a bandage will be placed over the site and pressure held until the bleeding or drainage has stopped. You will need to lie flat for at least 1 to 2 hours after the lumbar puncture. Healthcare workers will monitor for drainage from the puncture site for a period of time after the test. You may be able carefully turn from your back to your side. You will be offered fluids to drink.

Fluid/tissue:

After a fine needle biopsy, pressure may be held to the site briefly and a small bandage will be placed over the biopsy site. Ask for instructions for when to remove the dressing and how to monitor for signs and symptoms of infection. Contact your healthcare worker if you have a fever or increased pain, and if you see increasing redness, swelling, or pus at the procedure site.

Blood:

After a blood sample is collected from your vein, a bandage, cotton ball, or gauze may be placed on the area where the needle was inserted. You may be asked to apply pressure to the area. Avoid strenuous exercise immediately after your blood draw. Contact your healthcare worker if you feel pain or see redness, swelling, or discharge from the puncture site.

Other body fluid and tissue samples:

A different sample other than the samples listed above may be used for this test. Instructions for what to do after a collection of other body fluid or tissue samples may vary. Ask the healthcare worker to instruct you on what to expect after this test is completed. If you have questions or concerns about what to expect after the test is completed, talk to the healthcare worker.

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.