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Test ID: IMTF Inflammatory Myofibroblastic Tumors (IMT), 2p23 (ALK) Rearrangement, FISH, Tissue

Useful For

Supporting the diagnosis of inflammatory myofibroblastic tumor when used in conjunction with an anatomic pathology consultation

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_PBCT Probe, +2 No, (Bill Only) No
_PADD Probe, +1 No, (Bill Only) No
_PB02 Probe, +2 No, (Bill Only) No
_PB03 Probe, +3 No, (Bill Only) No
_IL25 Interphases, <25 No, (Bill Only) No
_I099 Interphases, 25-99 No, (Bill Only) No
_I300 Interphases, >=100 No, (Bill Only) No

Testing Algorithm

This test does not include a pathology consult. If a pathology consultation is requested, PATHC / Pathology Consultation should be ordered and the appropriate FISH test will be ordered and performed at an additional charge.


This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results.


Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

ALK, (2p23), IMT, FISH, Ts

Specimen Type


Shipping Instructions

Advise Express Mail or equivalent if not on courier service.

Necessary Information

1. A pathology report is required in order for testing to be performed. Acceptable pathology reports include working drafts, preliminary pathology or surgical pathology reports.

2. A reason for testing must be provided. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

Specimen Required

Submit only 1 of the following specimens:


Specimen Type: Tissue

Preferred: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.


Acceptable: Slides

Collection Instructions: Four consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.

Specimen Minimum Volume

Two consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.

Specimen Stability Information

Specimen Type Temperature Time Special Container
Tissue Ambient (preferred)

Clinical Information

Inflammatory myofibroblastic tumor (IMT) is a distinctive lesion composed of myofibroblastic spindle cells accompanied by an inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils which occur primarily in the soft tissue and viscera of children and young adults. They may arise in any anatomical site including lung, soft tissue, retroperitoneum, and bladder.


The genetic mechanisms underlying IMT pathogenesis are only partially known, but cytogenetic analyses have disclosed chromosomal rearrangements involving the ALK gene at 2p23. Studies support that identification of ALK gene rearrangement is useful to differentiate IMTs from other spindle cell neoplasms of soft tissue and viscera.

Reference Values

An interpretive report will be provided.


A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal cutoff for the ALK probe set.


A positive result is consistent with a subset of inflammatory myofibroblastic tumor (IMT).


A negative result suggests that an ALK gene rearrangement is not present but does not exclude the diagnosis of IMT.

Clinical Reference

1. Coffin CM, Fletcher JA: Chapter II: Inflammatory myofibroblastic tumour. In World Health Organization Classification of Tumors. Pathology and Genetics of Tumours of Soft Tissue and Bone. Edited by CDM Fletcher, KK Unni, F Mertens. Lyon, IARC Press, 2002, pp 91-93

2. Sukov WR, Cheville JC, Carlson AW: Utility of ALK-1 protein expression and ALK rearrangements in distinguishing inflammatory myofibroblastic tumor from malignant spindle cell lesions of the urinary bladder. Mod Pathol 2007 May;20(5):592-603

3. Tsuzuki T, Magi-Galluzzi C, Epstein JI: ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder. Am J Surg Pathol 2004;28:1609-1614

4. Li XQ, Hisaoka M, Shi DR: Expression of anaplastic lymphoma kinase in soft tissue tumors: an immunohistochemical and molecular study of 249 cases. Hum Pathol 2004 Jun;35(6):711-721

5. Griffin CA, Hawkins AL, Dvorak C, et al: Recurrent involvement of 2p23 in inflammatory myofibroblastic tumours. Cancer Res 1999;59:2776-2780

Day(s) and Time(s) Performed

Samples processed Monday through Sunday. Results reported Monday through Friday 8 a.m. to 5 p.m. CT

Analytic Time

7 days

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

88271x2, 88291 – DNA probe, each (first probe set), Interpretation and report

88271x2 – DNA probe, each; each additional probe set (if appropriate)

88271x1 – DNA probe, each; coverage for sets containing 3 probes (if appropriate)

88271x2 – DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271x3 – DNA probe, each; coverage for sets containing 5 probes (if appropriate)

88274 w/modifier 52 – Interphase in situ hybridization, <25 cells, each probe set (if appropriate)

88274 – Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)     

88275 – Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
IMTF ALK, (2p23), IMT, FISH, Ts 78205-2


Result ID Test Result Name Result LOINC Value
52171 Result Summary 50397-9
52173 Interpretation 69965-2
54587 Result 62356-1
CG747 Reason for Referral 42349-1
52174 Specimen 31208-2
52175 Source 31208-2
52176 Tissue ID 80398-1
52177 Method 49549-9
55029 Additional Information 48767-8
53828 Disclaimer 62364-5
52178 Released By 18771-6
Mayo Clinic Laboratories | Gastroenterology Catalog Additional Information: