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Molecular Testing for Nodular Fasciitis

Last updated March 2, 2017


What are other Names for this Test? (Equivalent Terms)

  • Gene Mutation Analysis for Nodular Fasciitis
  • Test for Molecular Diagnosis of Nodular Fasciitis

What is Molecular Testing for Nodular Fasciitis? (Background Information)

  • Molecular Testing for Nodular Fasciitis is a genetic test that is helpful in confirming a diagnosis of nodular fasciitis. It is also subsequently useful in taking treatment decisions
  • Nodular fasciitis is a benign, rapidly-growing mass that frequently affects the upper extremities (hands). It commonly affects children and adults between the age ranges of 10-40 years
  • This benign tumor reduces in size after a certain period of rapid growth (usually lasting 6 weeks), during which time it can cause severe anxiety to both the healthcare seeker and provider

The cause of nodular fasciitis is due to genetic mutations. Currently, studies indicate defects in the following genes:

  • MYH9-USP6 causing chromosomal translocation abnormality namely t(17;22)(p13;q13)

The above genetic abnormality can be detected using molecular studies, which may play a significant role in identifying the tumor type, and in some cases, helping the healthcare provider take appropriate treatment decisions.

The molecular testing, in general, can be performed using a variety of methods. Some of these methods include:

  • In situ hybridization technique, such as fluorescence in situ hybridization (FISH)
  • Immunohistochemistry (IHC)
  • Next-generation sequencing (NGS)
  • Polymerase chain reaction (PCR)
  • Comparative genomic hybridization (CGH)
  • Karyotyping including spectral karyotyping
  • mRNA analysis
  • Tissue microarrays (TMAs)
  • Southern blot test
  • Northern blot test
  • Western blot test
  • Eastern blot test

The methodology used for nodular fasciitis may vary from one laboratory to another. 

Note: Molecular testing has limitations due to the molecular method and genetic mutational abnormalities being tested. This can affect the results on a case-by-case basis. Consultation with your healthcare provider will help in determining the right test and right molecular method, based on individual circumstances.

What are the Clinical Indications for performing the Molecular Testing for Nodular Fasciitis Test?

Molecular Testing for Nodular Fasciitis is undertaken in the following situations: 

  • To assist (and in some cases, confirm) the initial diagnosis of nodular fasciitis
  • To distinguish other tumors/conditions that have similar histological features, when examined by a pathologist under the microscope
  • To help in determining treatment options
  • To confirm recurrence of the tumor: Tumor recurrence can either be at the original tumor site, or at a distant location (away from the initial site)

How is the Specimen Collected for Molecular Testing for Nodular Fasciitis?

Following is the specimen collection process for Molecular Testing for Nodular Fasciitis:

The specimen sample requirements may vary from lab to lab. Hence, it is important to contact the testing lab for exact specimen requirements, before initiating the testing process.

  • Sample required:
    • Fresh tumor tissue during biopsy
    • Formalin-fixed paraffin-embedded solid tumor tissue (FFPE tumor tissue), often referred to as paraffin block of the tumor
    • Unstained tissue slides
  • Process of obtaining the sample: As outlined by the laboratory testing facility
  • Preparation required: As outlined by the laboratory testing facility

Note:

  • Depending on the location of testing, it may take up to 2 weeks’ turnaround time, to obtain the test results
  • Occasionally, additional samples may be required to either repeat the test or to perform follow-up testing
  • Many hospitals preserve the paraffin blocks for at least 7 years. In general, older paraffin blocks (over 5 years) may affect the detection of specific mutations, due to degradation of the tumor specimen over time

Cost of Molecular Testing for Nodular Fasciitis:

  • The cost of the test procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities
  • In many cases, an estimate may be provided before the test is conducted. The final amount may depend upon the findings during the test procedure and post-operative care that is necessary (if any)

What is the Significance of the Molecular Testing for Nodular Fasciitis Result?

The significance of Molecular Testing for Nodular Fasciitis is explained:

  • Presence of a positive test result helps aid, and in some cases, confirm the diagnosis of nodular fasciitis
  • The result can help exclude other tumors with similar histological features
  • It can help determine the prognosis of the patient
  • In some cases, the test results may help in taking treatment decisions

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Many laboratories may not have the capability to perform this test. Only highly-specialized labs with advanced facilities and testing procedures perform this test
  • Additional mutations are still being discovered in many of these tumors. This may further contribute towards tumor diagnosis and treatment. Please consult with your healthcare provider for any information updates

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

What are some Useful Resources for Additional Information?

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/nodular-fasciitis/

Please visit our Laboratory Procedures Center for more physician-approved health information:

http://www.dovemed.com/common-procedures/procedures-laboratory/

References and Information Sources used for the Article:

https://ghr.nlm.nih.gov/primer/testing/genetictesting (accessed on 02/17/2017)

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5806a1.htm (accessed on 02/17/2017)

http://www.nature.com/gim/journal/v10/n5/full/gim200852a.html (accessed on 02/17/2017)

http://pediatrics.aappublications.org/content/106/6/1494 (accessed on 02/17/2017)

https://www.ncbi.nlm.nih.gov/pubmed/27271298 (accessed on 02/17/2017)

http://www.nature.com/labinvest/journal/v91/n10/full/labinvest2011118a.html (accessed on 02/17/2017)

http://www.mayomedicallaboratories.com/test-catalog/Overview/58104 (accessed on 02/17/2017)

Helpful Peer-Reviewed Medical Articles:

Carrano, A. V., et al. Measurement and purification of human chromosomes by flow cytometry and sorting. Proceedings of the National Academy of Sciences 76, 1382–1384 (1979)

Drets, M. E., & Shaw, M. W. Specific banding patterns of human chromosomes. Proceedings of the National Academy of Sciences 68, 2073–2077 (1971)

Druker, B. J. Perspectives on the development of a molecularly targeted agent. Cancer Cell 1, 31–36 (2002)

Parra, I., & Windle, B. High resolution visual mapping of stretched DNA by fluorescent hybridization. Nature Genetics 5, 17–21 (1993) doi:10.1038/ng0993-17

Pinkel, D., et al. High resolution analysis of DNA copy number variation using comparative genomic hybridization to microarrays. Nature Genetics 20, 207–211 (1998) doi:10.1038/2524

Speicher, M. R., et al. Karyotyping human chromosomes by combinatorial multi-fluor FISH. Nature Genetics 12, 368–375 (1996) doi:10.1038/ng0496-368

Erickson-Johnson, M. R., Chou, M. M., Evers, B. R., Roth, C. W., Seys, A. R., Jin, L., ... & Oliveira, A. M. (2011). Nodular fasciitis: a novel model of transient neoplasia induced by MYH9-USP6 gene fusion. Laboratory investigation, 91(10), 1427-1433.

Cheah, A. L., Goldblum, J. R., & Billings, S. D. (2013, February). Molecular diagnostics complementing morphology in superficial mesenchymal tumors. In Seminars in diagnostic pathology (Vol. 30, No. 1, pp. 95-109). WB Saunders.

Hollmann, T. J., & Hornick, J. L. (2011). INI1-deficient tumors: diagnostic features and molecular genetics. The American journal of surgical pathology, 35(10), e47-e63.

Flanagan, A. M., Delaney, D., & O’Donnell, P. (2010). The benefits of molecular pathology in the diagnosis of musculoskeletal disease. Skeletal radiology, 39(2), 105-115.

Na, K. Y., Kim, H. S., Sung, J. Y., Park, W. S., & Kim, Y. W. (2013). Papillary carcinoma of the thyroid gland with nodular fasciitis-like stroma. Korean journal of pathology, 47(2), 167-171.

Amary, M. F., Ye, H., Berisha, F., Tirabosco, R., Presneau, N., & Flanagan, A. M. (2013). Detection of USP6 gene rearrangement in nodular fasciitis: an important diagnostic tool. Virchows Archiv, 463(1), 97-98.

Oliveira, A. M., & Chou, M. M. (2014). USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Human pathology, 45(1), 1-11.

Coyle, J., White, L. M., Dickson, B., Ferguson, P., Wunder, J., & Naraghi, A. (2013). MRI characteristics of nodular fasciitis of the musculoskeletal system. Skeletal radiology, 42(7), 975-982.

de Carli, M. L., Fernandes, K. S., dos Santos Pinto Jr, D., Witzel, A. L., & Martins, M. T. (2013). Nodular fasciitis of the oral cavity with partial spontaneous regression (nodular fasciitis). Head and neck pathology, 7(1), 69-72.

Wagner, L. M., Gelfand, M. J., Laor, T., Ryckman, F. C., Al-Ghawi, H., & Bove, K. E. (2011). A welcome surprise: nodular fasciitis presenting as soft tissue sarcoma. Journal of pediatric hematology/oncology, 33(4), 316-319.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: March 2, 2017
Last updated: March 2, 2017