Abstract:
Background: Indiana University (IU) initiated fluorescence in situ hybridisation (FISH)
methodology for Burkitt Lymphoma (BL) to advance the accuracy and speed of diagnosis
in the AMPATH Reference Laboratory at Moi Teaching and Referral Hospital (MTRH) in
Eldoret, Kenya. Standard diagnostic testing for BL at MTRH includes morphology of the
biopsy specimen or aspirate and limited immunohistochemistry panels.
Methods: Tumour specimens from 19 children enrolled from 2016 to 2018 in a pro spective study to improve the diagnosis and staging of children with suspected BL were
evaluated. Touch preps from biopsy specimens or smears from fine needle aspiration
were collected, stained with Giemsa and/or H&E and reviewed by pathologists to render
a provisional diagnosis. Unstained slides were stored and later processed for FISH. Dupli cate slides were split between two laboratories for analysis. Flow cytometry results were
available for all specimens. Results from the newly established FISH laboratory in Eldoret,
Kenya were cross-validated in Indianapolis, Indiana.
Results: Concordance studies found 18 of 19 (95%) of specimens studied yielded analys able FISH results for one or both probe sets (MYC and MYC/IGH) in both locations. There
was 94% (17/18) concordance of results between the two FISH laboratories. FISH results
were 100% concordant for the 16 specimens with a histopathological diagnosis of BL and
two of three non-BL cases (one case no result in IU FISH lab). FISH was similarly concor dant with flow cytometry for specimens with positive flow results with the exception of a
nasopharyngeal tumour with positive flow results for CD10 and CD20 but was negative
by FISH. The modal turn-around time for FISH testing on retrospective study specimens
performed in Kenya ranged between 24 and 72 hours.
