Re: FW: Muscle needle bx's


You will find quite a bit published about this in the Histonet Archives.

Below is a copy of what I wrote in Dec 2001, while still in Texas.

In my opinion, you will not get an adequate biopsy from a renal biopsy needle.
Indeed we tried this on some animals with no success; specimen being so small it
is almost impossible to orientate.

"I have been working with muscle biopsies since the late 70's, both needle and

There is one easy answer to all your questions: it all depends on the expertise
of the physician performing the technique. It is not as easy as it may sound or
indeed looks to perform a needle biopsy, so I would not suggest changing to this
without assurance that you are going to achieve adequate sampling.

My mentor, David Doyle, MD, in Glasgow perfected his technique on corpses before
using it on the living. We performed it on both adults, children and even
neonates with excellent results,- even on advanced Duchenne's muscular dystrophy
and end stage muscle.

It  was easy to obtain enough muscle for routine histochemistry,
immunohistochemistry, EM, biochemical anaylsis and Western Blotting. We used a
4mm needle for children (occasionally 3mm for neonates)  and 5mm needle for
adults. It is important that the needles are regularly sharpened.

Dr Doyle used to get multiple samples by rotating the needle and "cutting" two
or three times before withdrawing the needle. It is also possible to probe
again on several occasions, with minimal trauma. We did not apply suction, as is
the case here in Texas; never found a need for it.
I have indeed performed the technique on animal tissue with great results.

I have to say though, that I have not seen that same success rate by many others
outside Glasgow, and certainly now, most of our biopsies here are open.

It is equally important to have the sample orientated correctly by technical
staff before freezing. This may necessitate the biopsy being teased apart then
aligning all the fibers in the correct plane before attaching to cork and
snap-freezing; and this can cause some problems especially with very young

If I was answering this question from Glasgow, I would say that it is preferable
to perform needle biopsy, as there is less trauma to the muscle  (and the
patient) and the procedure can be performed on an out-patient basis in a clinic
setting, with only local anaesthesia.

However, unless you can be assured that, whoever is performing the surgery is
suitably adapt, and that your technical staff would be able to orientate the
specimen correctly, I would say stay away from needles and concentrate on
getting adequate samples by an open technique.

It should be added that needle biopsy is not suitable if wanting to assess motor
end-plates, as in myastheia gravis."

If there is anything else you need to know, don't hesitate to ask.

Ronnie Houston
Regional Histology Operations Manager
Bon Secours Hllath Partners Laboratories
5801 Bremo Road
Richmond, VA 23226

______________________________ Reply Separator
Subject: FW: Muscle needle bx's
Author:  Sharon Allen  at BSHSIBTW
Date:    5/27/02 12:39 PM

> -----Original Message-----
> From:   Sharon Allen
> Sent:   Monday, May 27, 2002 11:33 AM
> To:     histonet@pathology. swmed. edu (E-mail) > Subject:
Muscle needle bx's
> Hi,
> I would like information on doing needle bx's on muscles.  We are a >
Neuropathology Laboratory and have always done our muscle bx's using > muscle
clamps and freezing with isopentane/liquid nitrogen. Because
> the shortage of O.R. time caused by healthcare cutbacks (we have a 6
> waiting list), the neurologists are interested in doing needle bx's.
> have little to no information on freezing these specimens. We are
> to use the same needles used for renal bx's. I froze a couple of
> using a piece of cork, a coverslip and OCT (have used this for primi > babies
muscle bx's), but this is very awkward.
> I would appreciate any input into how to freeze these little guys,
> the bx's are taken down the muscle sheath or across, and the pro's
> con's of this method.
> Thanks for any help you can give me. >
> Sharon Allen
> Neuropathology Lab
> Health Science Centre
> Winnipeg, Manitoba, Canada

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