Name of the Procedure:

In Situ Hybridization (e.g., FISH), per specimen; each multiplex probe stain procedure

Summary

In situ hybridization (ISH) is a laboratory technique used to detect specific DNA or RNA sequences in tissue samples. A common method, fluorescent in situ hybridization (FISH), uses fluorescent probes to visualize the genetic material, helping to identify the presence of certain genetic abnormalities.

Purpose

This procedure is used to identify specific genetic abnormalities, such as chromosomal changes, gene fusions, or mutations. It helps diagnose certain cancers, genetic disorders, and infectious diseases. The goal is to provide accurate genetic information that can guide diagnosis, prognosis, and treatment decisions.

Indications

• Unexplained lumps or masses suspected to be cancerous
• Suspicious genetic anomalies indicated by other tests
• Family history of genetic disorders
• Need for further genetic information to determine treatment plans

Preparation

• No specific preparation is usually required for the patient.
• Tissue specimen is typically obtained through a biopsy or surgical procedure.
• Patient may need to provide consent for tissue analysis.

Procedure Description

1. A tissue sample is collected from the patient.
2. The tissue is fixed and embedded in a paraffin block.
3. Thin sections of the tissue are placed on microscope slides.
4. Fluorescent probes, specific to the DNA or RNA sequences of interest, are applied to the tissue sections.
5. The probes hybridize with the target sequences.
6. The slides are examined under a fluorescence microscope to visualize the genetic material.
7. Results are analyzed and reported.

Tools and Equipment:

• Microscopy
• Fluorescent probes
• Fluorescence microscope

Anesthesia or Sedation:

• Not required for the actual hybridization process

Duration

• The hybridization process usually takes a few hours to complete.
• Overall turnaround time, including sample preparation and analysis, can take several days.

Setting

• Performed in a specialized laboratory setting.

Personnel

• Pathologists
• Laboratory technicians
• Geneticists

Risks and Complications

• Minimal risk to the patient as it involves laboratory analysis of obtained tissue.
• Possible minor discomfort or complications from the biopsy procedure used to obtain the tissue sample.

Benefits

• Provides specific and detailed genetic information.
• Helps in accurate diagnosis and prognosis.
• Guides targeted treatment decisions.

Recovery

• No recovery needed for the in situ hybridization itself.
• Patients may need to follow post-biopsy care instructions if a biopsy was performed.

Alternatives

• Polymerase Chain Reaction (PCR): Detects genetic material but may not provide spatial information like ISH.
• Comparative Genomic Hybridization (CGH): Detects chromosomal abnormalities but may be less specific.
• Next-Generation Sequencing (NGS): Offers broad genetic profiling but may be more complex and costly.

Patient Experience

• Patients will not experience sensations from the hybridization process as it is conducted in the lab.
• Mild discomfort may be experienced if a biopsy is performed to obtain the sample.
• Pain management and comfort measures for the biopsy will be provided as needed.