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Test Code 23FBG Fibroblast Growth Factor-23 (FGF23), In Situ Hybridization


Additional Testing Requirements


If additional interpretation or analysis is needed, request PATHC / Pathology Consultation along with this test.



Shipping Instructions


Attach the green pathology address label included in the kit to the outside of the transport container.



Necessary Information


A pathology/diagnostic report and a brief history are required.



Specimen Required


Supplies: Pathology Packaging Kit (T554)

Specimen Type: Formalin-fixed, paraffin-embedded tissue block

Specimen Volume: Entire block

 

Specimen Type: Tissue slides

Slides: 5 Unstained glass, positively charged slides with 5 (+ or -1)-microns formalin-fixed, paraffin-embedded tissue


Useful For

Assessing fibroblast growth factor-23 (FGF23) expression

Method Name

In Situ Hybridization (ISH)

Reporting Name

Fibroblast Growth Factor-23, ISH

Specimen Type

Special

Specimen Stability Information

Specimen Type Temperature Time Special Container
Special Ambient (preferred)
  Refrigerated 

Reject Due To

Wet/frozen tissue
Cytology smears
Nonformalin fixed tissue
Nonparaffin embedded tissue
Noncharged slides
ProbeOn slides
Reject

Clinical Information

Fibroblast growth factor-23 (FGF23) is a phosphaturic hormone that acts on the proximal renal tubules to block phosphate reuptake. Production of FGF23 by a particular mesenchymal tumor, phosphaturic mesenchymal tumor, is responsible for the great majority of cases of tumor-induced osteomalacia.

Interpretation

This test, when not accompanied by a pathology consultation request, will be answered as either positive or negative. If additional interpretation or analysis is needed, request PATHC / Pathology Consultation along with this test.

Cautions

Age of a cut paraffin section can affect immunoreactivity. Stability thresholds vary widely among published literature and are antigen dependent. Best practice is for paraffin sections to be cut within 6 weeks.

Clinical Reference

1. Carter JM, Caron BL, Dogan A, Folpe AL. A novel chromogenic in situ hybridization assay for FGF23 mRNA in phosphaturic mesenchymal tumors. AM J Surg Pathol. 2015;39:(1)75-83

2. Bhattacharyya N, Chong WH, Gafni RI, Collins MT. Fibroblast growth factor 23: State of the field and future directions. Trends Endocrinol Metab. 2012;23(12):610-618

3. Graham RP, Hodge JC, Folpe AL, et al. A cytogenetic analysis of 2 cases of phosphaturic mesenchymal tumor of mixed connective tissue type. Hum Pathol. 2012;43(8):1334-1338

4. Graham R, Krishnamurthy S, Oliveira A, Inwards C, Folpe AL. Frequent expression of fibroblast growth factor-23 (FGF23) mRNA in aneurysmal bone cysts and chondromyxoid fibromas. J Clin Pathol. 2012;65(10):907-909

5. Bahrami A, Weiss SW, Montgomery E, et al. RT-PCR analysis for FGF23 using paraffin sections in the diagnosis of phosphaturic mesenchymal tumors with and without known tumor induced osteomalacia. Am J Surg Pathol. 2009;33(9):1348-1354

6. Folpe AL, Fanburg-Smith JC, Billings SD, et al. Most osteomalacia-associated mesenchymal tumors are a single histopathologic entity-an analysis of 32 cases and a comprehensive review of the literature. Am J Surg Pathol. 2004;28(1):1-30

Method Description

In situ hybridization on sections of paraffin-embedded tissue.(Unpublished Mayo method)

Day(s) Performed

Monday through Friday

Report Available

5 to 8 days

Specimen Retention Time

Until staining is complete

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

88365-Primary

LOINC Code Information

Test ID Test Order Name Order LOINC Value
23FBG Fibroblast Growth Factor-23, ISH 104259-7

 

Result ID Test Result Name Result LOINC Value
620250 Interpretation 50595-8
620251 Participated in the Interpretation No LOINC Needed
620252 Report electronically signed by 19139-5
620253 Material Received 81178-6
620254 Disclaimer 62364-5
620255 Case Number 80398-1

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send a Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request (T763) with the specimen.