FISH - t(11;22) Test
About FISH - t(11;22) Test
| Field | Value |
|---|---|
| Also Known As | FISH for t(11;22) translocation, EWSR1 rearrangement FISH, Ewing sarcoma FISH, EWS-FLI1 translocation test |
| Sample Type | Bone marrow (sodium heparin tube) or peripheral blood (EDTA tube) |
| Fasting Required | No fasting required |
| Report Time | 10 days |
| Recommended For | Children, adolescents, and young adults with suspected Ewing sarcoma or peripheral neuroectodermal tumour (PNET); also used for Emanuel syndrome carrier detection |
| Price | Starting at ₹7,000 |
What is a FISH - t(11;22) Test?
The FISH - t(11;22) test is a specialised molecular test that looks for a specific chromosomal change called the t(11;22) translocation. This translocation occurs when chromosome 11 and chromosome 22 exchange pieces of genetic material, creating an abnormal fusion gene linked to certain cancers. The test is commonly requested for patients with suspected Ewing sarcoma or related tumours. Also known as the EWSR1 rearrangement FISH test, it uses fluorescent probes to detect this genetic change in bone marrow or peripheral blood samples.
What Does a FISH - t(11;22) Test Measure?
The FISH - t(11;22) test procedure identifies genetic changes at the cellular level using fluorescent-labelled DNA probes. Here is what the test analyses:
| Component | What It Looks For |
|---|---|
| EWSR1 gene rearrangement (22q12) | Checks whether the EWSR1 gene on chromosome 22 has broken apart and fused with the FLI1 gene on chromosome 11 |
| Signal pattern in cells | In normal cells, two fused (yellow) signals are seen; in abnormal cells, a split signal (one green, one orange) indicates the translocation |
| Percentage of abnormal cells | At least 100 non-overlapping cells are examined; more than 30% showing split signals is considered a positive result |
Why is a FISH - t(11;22) Test Done?
Doctors request this test when a patient's symptoms or biopsy findings point to a specific group of tumours. The following sections outline when and why the FISH - t(11;22) test may be ordered.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to request this test, particularly in children and young adults:
- Persistent bone pain or tenderness, especially in the arms, legs, chest, or pelvis
- Visible swelling or a lump near a bone or soft tissue
- Numbness or weakness, particularly when a tumour develops near the spine
- Unexplained weight loss
- Fever without a clear cause
- Unusual fatigue or tiredness
Conditions This Test Can Help Detect
This test helps identify a range of tumours and genetic conditions, including:
- Ewing's sarcoma, one of the more common bone and soft tissue cancers in children and young adults
- Peripheral primitive neuroectodermal tumour (PNET), in which EWSR1 rearrangement is the primary genetic change
- Desmoplastic small round cell tumour, associated with EWSR1 fused with the WT1 gene
- Clear cell sarcoma and extraskeletal myxoid chondrosarcoma, also linked to EWSR1 rearrangements
- Emanuel syndrome, a rare chromosomal disorder that can be detected in known carriers of the balanced t(11;22) translocation
How to Prepare and What to Expect
Preparation for the FISH - t(11;22) test is straightforward, but bringing the right documentation and following a few practical steps will help ensure accurate results.
Do You Need to Fast?
No fasting is required for this test. You can eat and drink normally before your appointment.
Practical Tips Before Your Test
Keep the following in mind before attending your sample collection appointment:
- Bring a detailed clinical history, including your symptoms, previous test results, and family history, as this is required for the test
- Carry any previous imaging reports, such as X-rays, CT scans, or MRI scans, as these assist the clinician in contextualising results
- Inform your doctor about all current medications, supplements, or known allergies, particularly bleeding disorders, before the bone marrow sample is collected
- Wear comfortable, loose clothing that allows easy access to the arm or the site from which the bone marrow sample will be taken
- Stay well hydrated on the day of sample collection
Step-by-Step Procedure
This test requires two sample types: bone marrow or peripheral blood. Both are collected at the Lupin Diagnostics centre.
Bone Marrow Sample:
- A doctor or trained specialist cleans the collection site, typically the hip bone, and administers a local anaesthetic to minimise discomfort.
- A needle is carefully inserted into the bone marrow space, and a small sample (approximately 3 ml) is drawn into a sodium heparin (green-top) tube.
- The site is dressed, and you are monitored briefly before being discharged.
Peripheral Blood Sample:
- A trained phlebotomist cleans the skin on your inner arm and locates a suitable vein.
- A small blood sample (approximately 3 ml) is collected into an EDTA (lavender-top) tube.
- The needle is removed, a small bandage is applied, and the sample is labelled.
- Both samples are stored refrigerated (between 2 and 8 degrees Celsius) and dispatched to the laboratory promptly.
- In the laboratory, fluorescent probes are applied to the cells. Technologists examine at least 100 cells per sample and record the percentage showing the translocation signal.
- A pathologist reviews the findings and prepares your interpretive report, which is delivered within 10 days.
Factors That Can Affect Accuracy
The following factors may affect the reliability of your results:
- Poor quality or insufficient tumour cell representation in the sample
- Delay in delivering samples to the laboratory beyond the acceptable window of 24 to 48 hours
- Use of fixatives other than standard formalin, which may interfere with probe binding
- Inadequate identification of target cell areas during analysis
- Technical experience and expertise of the laboratory team performing the FISH analysis
Understanding Your FISH - t(11;22) Test Results
Your results should always be reviewed alongside imaging findings, histopathology, and your full clinical picture. A trained oncologist or pathologist is best placed to interpret what the findings mean for you.
| Parameter | Normal (Negative) | Positive Finding |
|---|---|---|
| EWSR1 Rearrangement | No rearrangement detected | Rearrangement detected |
| Abnormal Cells with Split Signals | Typically less than 10–20% of cells examined* | Typically above the laboratory cutoff* |
*The exact cutoff depends on the laboratory's validation studies and the FISH probe used.
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
A negative result means no EWSR1 rearrangement was found in the cells tested. However, this does not completely rule out a neoplastic (cancer-related) disorder.
A positive result means the translocation was detected and is consistent with Ewing sarcoma or a related tumour type.
How to Maintain Healthy Levels
This test detects a specific genetic change in cells and is not influenced by lifestyle choices. However, the following general steps are worthwhile:
- Report any persistent bone pain, swelling, or unexplained lumps to a doctor promptly, as early evaluation leads to timely diagnosis
- Attend all follow-up consultations your doctor recommends after receiving your results
- Discuss any concerns about your results openly with your oncologist or specialist, who can guide next steps
Lupin Diagnostics FISH - t(11;22) Test Price
The FISH - t(11;22) test cost at Lupin Diagnostics starts at ₹7,000. This test requires a visit to a Lupin Diagnostics centre; home collection is not available for this test, given the specialised nature of bone marrow sample collection.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 7000 |
| CHENNAI | 7000 |
| HYDERABAD | 7000 |
| KOLKATA | 7000 |
| NAVI MUMBAI | 7000 |
| PUNE | 7000 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Booking your FISH - t(11;22) test online with Lupin Diagnostics is a simple process:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection by trained specialists.
- Receive your report via email or WhatsApp within 10 days of sample collection.
Frequently Asked Questions
The FISH - t(11;22) test detects a chromosomal change linked to Ewing sarcoma, peripheral primitive neuroectodermal tumour (PNET), and other related cancers. It is also used for Emanuel syndrome carrier detection in families with a history of this chromosomal condition.
This test is typically recommended for children, adolescents, and young adults where imaging or biopsy findings suggest Ewing sarcoma or a related small round cell tumour. It may also be requested for couples with a history of recurrent pregnancy loss or for families investigating a possible Emanuel syndrome diagnosis.
For the Lupin Diagnostics FISH - t(11;22) test, two samples are required: a bone marrow aspirate collected in a sodium heparin tube and a peripheral blood sample collected in an EDTA tube. Both samples are collected at the centre by trained professionals.
The report is delivered within 10 days of sample collection at Lupin Diagnostics. This reflects the time required for careful laboratory processing, cell analysis, and pathologist review.
A positive result means that the EWSR1 rearrangement was detected in 30% or more of the cells examined. This finding is consistent with Ewing sarcoma or a related tumour type. Your oncologist will advise on the appropriate next steps based on the full clinical picture.
No. A negative result means the translocation was not detected in the sample tested, but it does not exclude all neoplastic disorders. Your doctor may recommend additional molecular tests, such as RT-PCR or next-generation sequencing, if clinical suspicion remains high.
No fasting is needed before this test. You can eat and drink as usual on the day of your appointment. The most important preparation step is bringing a complete clinical history, including previous imaging and biopsy reports, to your centre visit.
FISH - t(11;22) Test
