Test Catalog

Test ID: BCL2    
BCL-2 Immunostain, Technical Component Only

Useful For Suggests clinical disorders or settings where the test may be helpful

Classification of lymphomas

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For the initial technical component only immunohistochemical (IHC) stain performed, the appropriate bill-only test ID will be reflexed and charged (IHTOI). For each additional technical component only IHC stain performed, an additional bill-only test ID will be reflexed and charged (IHTOA).

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

BCL-2 is in a family of regulators of apoptosis, which together control the balance between pro- and antiapoptotic signals. BCL-2 protein acts as an inhibitor of apoptosis. It is normally expressed in mantle zone B cells and T cells, with an intense perinuclear cytoplasmic pattern, but it is not expressed in reactive germinal center B cells. In the majority of cases of follicular lymphoma, the BCL-2 gene is involved in a translocation with IgH, t(14;18)(q32;q21), leading to overexpression of the BCL-2 protein. Thus, BCL-2 expression in germinal center B cells supports a diagnosis of follicular lymphoma.

Interpretation Provides information to assist in interpretation of the test results

This test includes only technical performance of the stain (no pathologist interpretation is performed). Mayo Clinic cannot provide an interpretation of tech only stains outside the context of a pathology consultation. If an interpretation is needed, refer to PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case. All material associated with the case is required. Additional specific stains may be requested as part of the pathology consultation, and will be performed as necessary at the discretion of the Mayo pathologist.


The positive and negative controls are verified as showing appropriate immunoreactivity and documentation is retained at Mayo Clinic Rochester. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request. Contact 855-516-8404.


Interpretation of this test should be performed in the context of the patient's clinical history and other diagnostic tests by a qualified pathologist.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Age of a cut paraffin section can affect immunoreactivity. Stability thresholds vary widely among published literature and are antigen-dependent. Best practice is for paraffin sections to be cut fresh.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Choi WWL, Weisenburger DD, Greiner TC, et al: A New Immunostain Algorithm Classifies Diffuse Large B-Cell Lymphoma into Molecular Subtypes with High Accuracy. Clin Cancer Res 2009; 15:5594-5502

2. Hu S, Xu-Monette ZY, Tzankov A, et al: MYC/BCL2 Protein Coexpression Contributes to the Inferior Survival of Activated B-cell Subtype of Diffuse Large B-Cell Lymphoma and Demonstrates High-Risk Gene Expression Signatures: A Report from The International DLBCL Rituximab-CHOP Consortium Program. Blood 2013; 121(20):4021-4031

3. Iqbal J, Neppalli VT, Wright G, et al: BCL2 Expression is a Prognostic Marker for the Activated B-Cell-Like Type of Diffuse Large B-Cell Lymphoma. Journal of Clinical Oncology 2006; 24(6)961-968