Hematologic Malignancy Evaluation
       • Histology/ Morphology (Least sensitive)
          – What the cells look like
       • Immunohistochemistry (IHC)
           – Staining the cells to identify specific markers
       • Flow cytometry
          – Looks at individual cells based on staining for specific markers
       • Cytogenetics
          – Karyotype
          - FISH analysis
       • Molecular studies (Most sensitive)
          – Identifying abnormal genes and/or gene products
                                                                               TRAINING & DEVELOPMENT  |  2  .
      Types of Cytogenetic Analysis
      • Karyotype vs. FISH
          Karyotype- is the characterization of structural and numerical changes in 
            chromosomes while cells are dividing. They are displayed as a systematized 
            arrangement of chromosome pairs in descending order of size.
          FISH (Fluorescent in situ hybridization)- 
              • A molecular cytogenetic technique using fluorescent probes that bind to a 
               specific part of a chromosome
              • Used to detect the presence or absence of specific DNA sequences on 
               chromosomes
                                                                          TRAINING & DEVELOPMENT  |  3  .
     Normal Karyotype
                                                            TRAINING & DEVELOPMENT  |  4  .
      Chromosomal Banding
      Giemsa staining (or G-banding)
      of chromosomes reveals 
      characteristic patterns of 
      horizontal bands like bar codes.
                                                                         TRAINING & DEVELOPMENT  |  5  .
     Chromosome Definitions
                                                            TRAINING & DEVELOPMENT  |  6  .