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T-Cell Receptor Gene Rearrangement

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Also known as: T-cell Gene Clonality; TCGR; TCR Gene Rearrangement
Formal name: T-Cell Receptor Gene Rearrangement

At a Glance

Why Get Tested?

To help diagnose a T-cell lymphoma; sometimes to detect and evaluate residual cancer cells

When to Get Tested?

When a doctor thinks that you may have a T-cell lymphoma; when a doctor would like to assess whether treatment has been effective and/or whether lymphoma has recurred

Sample Required?

A bone marrow, tissue such as a lymph node (biopsy), or body fluid sample collected by your doctor; sometimes a blood sample drawn from a vein in your arm

Test Preparation Needed?

None

The Test Sample

What is being tested?

This test detects characteristic changes (rearrangements) in specific genes in T-cells. This information can be helpful in diagnosing a T-cell lymphoma.

T-cells are a type of lymphocyte (a kind of white blood cell, WBC) that helps to protect the body from infection. Rearrangements in certain parts of their DNA called receptor genes are a normal part of their development. These rearrangements are associated with the development of a large repertoire of diverse T-cells, allowing them to protect against many different kinds of infections. The final order in which the genes are rearranged is called a gene rearrangement profile. Within any normal population (sample) of T-cells, the cells and their gene rearrangement profiles are very diverse.

In lymphoma, the T-cells in affected tissue (such as blood, lymph node, or skin) are identical and their gene rearrangement profiles are likewise identical. Lymphomas arise when an abnormal T-cell begins to produce numerous identical copies of itself (clones). The cloned cells grow and divide uncontrollably, crowding out normal cells.

A T-cell receptor gene rearrangement test evaluates the T-cells in a person's sample to determine whether the majority of T-cell rearrangement profiles are diverse or identical. This information, along with clinical signs and symptoms and results of other laboratory tests, can help clarify a person's diagnosis, or evaluate for persistent or recurrent lymphoma.

Most non-Hodgkin lymphomas in the U.S. are B-cell lymphomas (about 85%), according to the American Cancer Society. Close to 15% are T-cell lymphomas. There are many different types of T-cell lymphomas, but each is rare.

For additional details about T-cells and this testing, read more.

How is the sample collected for testing?

A bone marrow, lymph node, or other tissue biopsy procedure is performed by a doctor or other trained specialist. Body fluid samples are obtained through collection of the fluid in a container by inserting a needle into the body cavity and aspirating a portion of the fluid with a syringe. Sometimes, a blood sample is obtained by inserting a needle into a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

Common Questions

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Leonard, D. G. B., Editor (© 2009). Molecular Pathology in Clinical Practice: Oncology: Springer Science + Business Media, LLC., New York, NY. Pp 195-201.

(© 1995-2012). Test ID: TCGR83122 T-Cell Receptor Gene Rearrangement, PCR, Blood. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/print/83122 through http://www.mayomedicallaboratories.com. Accessed July 2012.

Bahler, D. et. al. (Updated 2012 May). Lymphomas, T/NK-Cell - T/NK-Cell Lymphomas. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/LymphomasTCell.html#tabs=0 through http://www.arupconsult.com. Accessed June 2012.

Pinter-Brown. L. (Updated 2011 May 17). Cutaneous T-Cell Lymphoma Overview of CTCL. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/209091-overview through http://emedicine.medscape.com. Accessed June 2012.

Weissmann, D. (Revised 2006 May 18). Hematopathology, T-Cell Lymphomas. University of Medicine and Dentistry of New Jersey [On-line information]. Available online at http://pleiad.umdnj.edu/~dweiss/T-cell/T-cell.html through http://pleiad.umdnj.edu. Accessed July 2012.

Hodges, E. et. al. (2003) Diagnostic role of tests for T cell receptor (TCR) genes. Clin Pathol v 56:1-11 doi:10.1136/jcp.56.1.1 [On-line information]. Available online at http://jcp.bmjjournals.com/content/56/1/1.full through http://jcp.bmjjournals.com. Accessed July 2012.

Zhu, D. et. al. (2001). Detection of Clonal T-Cell Receptor-gamma Gene Rearrangement by PCR/Temporal Temperature Gradient Gel Electrophoresis. Am J Clin Pathol 2001;116:527-534 [On-line information]. PDF available for download at http://ajcp.ascpjournals.org/content/116/4/527.full.pdf through http://ajcp.ascpjournals.org. Accessed July 2012.

(Revised 2012 January 26). Non-Hodgkin Lymphoma American Cancer Society [On-line information]. Available online at http://www.cancer.org/Cancer/Non-HodgkinLymphoma/DetailedGuide/non-hodgkin-lymphoma-types-of-non-hodgkin-lymphoma through http://www.cancer.org. Accessed July 2012.

Kim, Y. (Revised 2011 October). Cutaneous T-Cell Lymphoma Facts. Leukemia and Lymphoma Society [On-line information]. PDF available for download at http://www.lls.org/content/nationalcontent/resourcecenter/freeeducationmaterials/lymphoma/pdf/cutaneoustcelllymphoma.pdf through http://www.lls.org. Accessed July 2012.

(Updated 2012 February 16). Leukemia - T-Cell. American Society of Clinical Oncology [On-line information]. Available online at http://www.cancer.net/patient/Cancer+Types/Leukemia+-+T-Cell through http://www.cancer.net. Accessed July 2012.

(2011 December). T-Cell Receptor (TCR) Gene Rearrangement. Quest Diagnostics [On-line information]. Available online at http://www.questdiagnostics.com/testcenter/testguide.action?fn=Leuk_Lymph/TH_T-Cell.htm&redirectFrom=search through http://www.questdiagnostics.com. Accessed June 2012.

Delves, P. (Revised 2008 September). Components of the Immune System. Merck Manual for Healthcare Professionals [On-line information]. Available online through http://www.merckmanuals.com. Accessed June 2012.

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