Re: Muscle Biopsy Clamps
|From:||Vinnie Della Speranza <firstname.lastname@example.org>|
thank you for sharing your muscle biopsy protocol with us. I am in complete agreement with your remarks regarding the value of requesting sufficient samples at biopsy.
you may be interested to know that I have achieved acceptable EM results by using 4% paraformaldehyde fixative which has allowed us to get by with one clamped specimen, in addition to the unfixed sample for enzyme histochemistry. This fixative eliminates the methanol contained in commercial formalin/formaldehyde solutions that can compromise EM. You may experience less resistance from clinicians if you can get by with only two samples.
Vinnie Della Speranza
Manager for Anatomic Pathology Services
Medical University of South Carolina
165 Ashley Avenue
Charleston, SC 29425
ph: (843) 792-6353
fax: (843) 792-8974
>>> <GregorLuck@aol.com> 03/31/01 08:57PM >>>
Peggy et. al.,
Our protocol (from Dr. Sumi @ U. of W. neuropath) requests the following for
neuropathathology workup on a muscle biopsy:
1. One biopsy "unclamped" for muscle enzyme histochemistry (Note, for
the reasons of clamp artifact and the desired uncrushed relaxation
of the fibers, as you noted.) This portion is snap frozen in a relaxed
state @ -160 degrees C. in Isopentane cooled by liquid nitrogen.
2. A 2nd biopsy in a clamp and allowed to fix in this state in 10%
NBF for 24 hours before resection of the "uncrushed" portion of the biopsy
from between the tines of the clamp(for routine L.M. if needed).
3. A 3rd biopsy (as in #2 above) but in Trump's fixative for E.M. if
Our feeling is that if the patient is going to undergo an open biopsy
procedure we should harvest all materials necessary for a complete and
definitve neuropathology assessment. The only time we compromise on these
specimen requirements are when the patient is a pediatric or a Shriner's
patient when there is concern for the amount of the muscle compromise to the
young patients. I understand that often not all three of these specimens are
necessary for diagnosis, but after getting the patient all the way into an
invasive surgical procedure, which is for the sole purpose of obtaining a
tissue diagnosis, I would advocate a multiple bx/fixative approach.
Deaconess Med Center
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