Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)
CPT4 code
Name of the Procedure:
Molecular Cytogenetics: Chromosomal In Situ Hybridization, Analyze 3-5 Cells (e.g., for Derivatives and Markers)
Summary
Chromosomal in situ hybridization, a molecular cytogenetic technique, is used to detect and localize specific DNA sequences on chromosomes. This procedure involves analyzing 3-5 cells to identify any chromosomal abnormalities, such as derivative chromosomes or genetic markers, that might be linked to various genetic conditions or diseases.
Purpose
This procedure is designed to diagnose and understand genetic disorders, cancers, or congenital anomalies. The goal is to identify chromosomal abnormalities that can guide treatment plans and provide insights into the genetic basis of a patient's condition.
Indications
- Unexplained developmental delays or intellectual disabilities
- Congenital abnormalities
- Suspected chromosomal syndromes
- Certain types of cancers (e.g., leukemia, lymphoma)
- Unexplained infertility or recurrent pregnancy loss
Preparation
- No special preparation is typically required.
- Patients may need to provide a sample of blood, bone marrow, or tissue where the cells will be harvested for analysis.
- Certain medications may need to be paused based on physician advice.
Procedure Description
- Sample Collection: A sample (blood, bone marrow, or tissue) is collected.
- Cell Preparation: Cells are isolated and cultured if necessary.
- Hybridization: Fluorescent probes specific to regions of interest on chromosomes are applied to the cell preparations.
- Microscopy: Cells are examined under a fluorescence microscope.
- Analysis: At least 3-5 cells are analyzed to identify any chromosomal abnormalities.
Tools used include a fluorescence microscope and specialized fluorescent probes. This procedure does not typically require anesthesia or sedation.
Duration
The entire process, from sample preparation to analysis, may take a few days, although the actual hybridization and microscopy parts of the procedure take several hours.
Setting
This procedure is performed in a specialized laboratory with capabilities for molecular cytogenetic analysis, usually located in a hospital or a dedicated diagnostic center.
Personnel
- Clinical Geneticist or Pathologist
- Laboratory Technicians specialized in cytogenetics or molecular biology
Risks and Complications
- Minimal risks associated with sample collection (e.g., slight bleeding or infection at the collection site).
- Rare chance of sample contamination or inadequate cell preparation leading to inconclusive results.
Benefits
- Accurate identification of chromosomal abnormalities.
- Aids in diagnosing genetic disorders and planning appropriate interventions.
- Helps in identifying specific markers for targeted therapies in cancers.
Recovery
- There is no extended recovery period required.
- Patients can resume normal activities immediately after sample collection.
- Follow-up appointments may be necessary to discuss results and subsequent steps.
Alternatives
- Comparative Genomic Hybridization (CGH)
- Single Nucleotide Polymorphism (SNP) array analysis
- Karyotyping
Pros and cons of alternatives should be discussed with a healthcare provider to determine the most appropriate option based on the individual’s condition.
Patient Experience
Patients may feel minor discomfort during sample collection. There are no significant sensations during the hybridization and analysis phases as these occur in the lab. Pain management is typically unnecessary, and any discomfort associated with sample collection can be managed with standard care methods.