RE: EM - Histology use

From:"Morken, Tim - Labvision"

EM has declined since the '80's primarily due to the rise of
immunochemistry. EM is used primarily for tumor dx and kidney disease dx.
While all kidney disease uses EM, very few tumor cases go to EM - on the
order of 5%. IHC is much cheaper and more useful that EM in most cases for
tumor Dx, plus it doesn't require a very expensive instrument and a
specially trained tech, not to mention a pathologist trained in EM
interpretion. EM is still used for kidney disease, but there is not enough
of that to put an EM in even most regional hospitals. When I started in EM
in 1981 my caseload was about 50/50 for tumor/kidney dx. When I left the EM
lab in 1993, it had gone to 10 percent tumor and 90 percent kidney work.

The only other work for EM is viral identification, but for that you need a
dedicated em (beacuse viral work contamiates the EM) and an expert in viral
identification with em negative staining - of which there are few.

Tim Morken
Lab Vision
Fremont, CA

-----Original Message-----
From: Ephram Shizgal []
Sent: Monday, June 30, 2003 4:03 PM
Subject: EM - Histology use

I'm hoping that Histonetters will be able to clarify a question I have:

What are the primary reasons that Electron Microscopy is not used
extensively in Histology/Pathology?

Is it related more to the goals of histology and pathology labs or to the
challenges associated with EM technology (price, size, complexity of EM)?

Ephram Shizgal

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