Overview
The Victorian Cancer Cytogenetics service is a fully NATA/RCPA accredited laboratory which provides a state wide service for cancer cytogenetic analysis.
Cytogenetics has become an integral part of the management of haematological and other malignancies by providing important diagnostic and prognostic information. As a marker of disease status cytogenetics can be used to assess remission or relapse, including the monitoring of patients post bone marrow transplantation.
How to Contact Us
The department is located on the 2nd floor of St.Vincent's Hospital, Inpatient Services Building.
Should any questions arise regarding a specimen, test, or a result, please contact the VCCS on
9288 4154 for consultation with the director: Assoc.Prof. Lynda Campbell or the principal scientist: Fran O’Malley.
Cytogenetic tests performed by VCCS
 G-Banded Chromosome analysis
 Fluorescence In-situ Hybridisation (FISH) analysis (see attached list of clinical settings )
 M Band and M FISH analysis (where relevant)
 Paraffin Embedded Tissue (PET) FISH (after consultation)
Specimen Delivery to VCCS
All specimens are to be addressed and delivered to:
Pathology Specimen Reception, Att’n: Victorian Cancer Cytogenetics Service
2nd Floor, Inpatient Services Building
St. Vincent’s Hospital
Princes Street
Fitzroy, 3065
Telephone: 9288 4154.
 Specimens sent Monday to Friday should reach the department no later than 5.00p.m.
 If taken later in the day, keep specimen at room temperature (RT) and send to department the next morning.
 Ensure specimen is not exposed to extremes of temperature during transit.
NOTE: Do NOT place on ice!
 Specimens taken late Friday may be sent overnight, to arrive on Saturday.
 If taken at the weekend or on a Public Holiday, keep the specimen at RT; send first thing the next working day.
 New leukaemia samples must be handled on the same day as obtained . Therefore, if taken after hours, contact St. Vincent’s Hospital for the pathologist/scientist on call.

Urgent Results
If an urgent result is required, please follow-up the despatch of the specimen with a telephone call to the department and the specimen will be processed more rapidly.
An urgent result may be provided within 48 hours. Completed analysis with banding should take no more than 1 week.
Specimen types accepted by VCCS
 Bone marrow
 Peripheral blood
 Solid Tumour (see attached list of accepted tumour types )
 Lymph node
 Trephine
 Paraffin Embedded Tissue (PET) (after consultation)
Minimum Specimen Labelling Requirements
 Label sterile tube with patient’s name (surname and first name), sex, date of birth, UR number, referring hospital, date specimen taken, nature of request.
 Place in biohazard bag together with completed interhospital referral form (obtainable from
VCCS).
Sample Collection
Bone Marrow
 Bone marrow (0.5 – 1.0mL) is collected into a sterile 10mL tube containing liquid Na Hep.
Commercially available tubes are NOT generally suitable because of the difficulty in adequately mixing the small specimen volume with the dry heparin coating on the tube.
 Bone marrow collection tubes are available from the VCCS. These are sterile, plain 10mL tubes containing 100 IU of liquid Na Hep. They must be stored at 4 o C until used.
 Supply of these tubes can be requested by telephone and are to be picked up by courier from cytogenetics department. All pick-up arrangements are the responsibility of the requesting institution unless prior arrangements have been made with the VCCS.
Blood Specimens
 Peripheral blood (5-10mL) is collected into a sterile 10mL tube containing SODIUM HEPARIN
(Na Hep). These tubes are commercially available, but if unobtainable a sterile plain 10mL tube with 100IU of liquid sodium heparin added, will suffice.
 In the absence of Na Hep tubes, LITHIUM HEPARIN without gel is acceptable (although not optimal).
 EDTA tubes are NOT acceptable.
Trephine
 In the absence of adequate aspirated bone marrow specimen, a small piece of trephine may be sent in the same collection tube as for bone marrow or blood but with a covering of tissue culture medium for transport.
 As trephine cultures are often unsuccessful, a preferred tissue for culture may be peripheral blood (PB) for (i)lymphoproliferative disorders OR (ii)acute leukaemias, if there is a significant abnormal cell population in PB.

Lymph Node or Solid Tumours
 Fresh/Unfixed lymph node and tumour specimens (minimum size of 5mm 3 ) are collected into sterile tubes with a complete covering of either tissue culture medium (RPMI 1640) or phosphate buffered saline (PBS) or viral transport medium.
 The specimen should be placed into transport medium immediately after biopsy and forwarded to the VCCS as soon as possible. The specimen must not be refrigerated.
 In the event of samples needing to sit overnight (i.e. can’t be forwarded same day), the specimen should be cut into small pieces, under sterile conditions, to enhance the exposure to nutrients in the tissue culture medium and stored at room temperature. The sample should be sent as soon as possible the following day.
 Please note that it is rare to obtain a successful cytogenetic analysis from a lymph node that is not received on the day of collection.
 Specimens older than 24 hours will not be accepted for processing.
 Please see requirements for tumour specimens accepted by the VCCS for more details.
FISH on paraffin-embedded tissue
 See attached referral form for sending FISH on paraffin-embedded tissue to VCCS.
Mission Statement
We aim to provide a comprehensive cancer cytogenetics service to the State of Victoria with a commitment to quality and efficiency of service. We are also committed to providing education and to continuing research in the areas of cancer cytogenetics and molecular genetics.

 ALL: Adult (B- & T-cell), Paediatric (B- & T-cell)
 Alveolar rhabdomyosarcoma
 Anaplastic large cell lymphoma
 AML: ?APL, ?t(8;21), M4Eo
 Burkitt lymphoma or BLL
 CLL
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 CML: All new cases, Failed cytogenetic result
 Ewing tumours
Follicular lymphoma
HES or SM with eosinophilia
MALT lymphoma
Mantle cell lymphoma
Multiple myeloma: with cytoplasmic Ig staining
Neuroblastoma
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Myelodysplastic syndromes
Myeloproliferative disorders with eosinophilia
 Myxoid and round cell liposarcomas
 Synovial sarcomas

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Solid tumour specimens do not form a large part of our service but they are extremely labour-intensive as they require prolonged and multiple cultures. The only cases that will be processed will be those where the following diagnoses are considered likely:
Ewing tumours
Synovial sarcomas
Myxoid liposarcomas
Rhabdomyosarcomas
Desmoplastic small round cell tumours
Wilm tumours
Specimens should be:
 From a viable area of tumour.
 Specimens taken from areas of necrosis or normal tissue or from a previously heavily irradiated area are not appropriate for cytogenetic analysis of the tumour.
 Kept sterile at all times.
 At least 0.5cm
3 in size.
 Fine needle aspirates and very small samples will not be processed.
 Placed in sterile, clearly labelled containers containing RPMI, PBS or viral transport medium and kept at room temperature.
 Sent promptly.
 Samples arriving more than 24 hours after collection will not be processed.
 Delivered Monday to Friday to the laboratory, before 4pm if possible to:
Attention: Victorian Cancer Cytogenetics Service
Specimen Reception
2 nd floor In-patient Services Building
St Vincent’s Hospital
Victoria Parade, Fitzroy 3065
(03) 9288-4154

All referrals for paraffin-embedded tissue FISH must be discussed directly with either A/Prof Lynda Campbell (03 9288-4150) or Mrs Fran O’Malley (03 9288-
4151) prior to sending specimens.
Requirements:
1.
The following 2 micron sections of tissue on positively charged slides (as per immunohistochemistry), clearly labelled with patient name and section thickness must be sent: a) 4 patient slides. b) 1 H&E stained section adjacent to the sections intended for FISH with a marker indicating the optimal region for FISH – i.e. the region with the most concentrated area of tumour. c) 4 slides of normal tissue corresponding to the malignant tissue section to serve as a negative control. For example, if a section of lymph node is sent for FISH to determine the nature of the lymphoma, a section of normal lymph node is also needed. NB: this does not need to be from the same patient.
IMPORTANT NOTES:
 Section thickness should be labelled on all slides. Sections greater than
2µm thickness will not be accepted for processing.
2.
 De-calcified sections are not suitable for this FISH test.
Request slip indicating:
 the clinical notes,
 possible diagnosis,
 preferred FISH probe, if known
 tissue type.
Results will be available within 2-4 weeks of receipt of specimen. If a result is required urgently, please discuss directly with the laboratory.
Please deliver all specimens to:
Attention: Victorian Cancer Cytogenetics Service
Specimen Reception,
2 nd floor Inpatient Services Building
St Vincent’s Hospital, Victoria Parade, Fitzroy 3065
Tel: (03) 9288-4154
Email: Lynda.campbell@svhm.org.au
or
Fran.omalley@svhm.org.au