PROCEDURES FOR
MUSCLE BIOPSY
1. It is recommended that the clinician discuss the case with
one of the neuropathologists before the biopsy is performed. This allows the
neuropathologist to inform the laboratory if any special procedures are needed
for that specimen. Dr. Eun-Sook Cho (telephone: (973) 972-4145) and Dr. Leroy
Sharer (telephone: (973) 972-4770) can be contacted for this.
2. The referring hospital should notify the Neuropathology
Laboratory of the date and time of the biopsy at least one day prior to the
procedure. This allows the technician time to prepare the laboratory to accept
the biopsy. Contact the Neuropathology Laboratory (telephone: (973) 972-7167).
In case the specimen comes from a patient with a BIOHAZARD condition, the Neuropathology
Laboratory should be so notified.
3. Should the biopsy be performed at an institution other than
University Hospital, arrangements should be made through the laboratory of the
referring institution and a
surgical pathology accession number should be assigned to the specimen. This
number will serve as a reference in both the final report and the bill.
4. A request form and written clinical history should accompany
the specimen. Include pertinent laboratory findings and the name and telephone
number of the physician
responsible for the case, as well as the reason for performing the biopsy (i.e.,
clinical diagnosis).
5. The muscle should be carefully selected according to the
following guidelines:
a. In acute and subacute conditions
the most affected muscle should be biopsied. In chronic disease processes, a
moderately affected muscle should be biopsied
rather than those that are severely affected. It is preferable
to biopsy those muscles in which fiber type distribution has been established
(e.g. biceps, quadriceps).
b. Muscles with a recent history
of trauma, including electromyogram needle insertion (EMG) and intramuscular
injection, should be avoided.
c. The biopsy should be taken
from an area of muscle away form the musculotendinous junction.
6. The muscle biopsy should be taken with great care to avoid
any excess mechanical trauma to the specimen, to maintain the orientation of
the muscle fibers and to prevent the contraction of the biopsied muscle. (Muscle
clamps are not to be used.) The following should be observed:
a. When infiltrating the skin
with a local anesthetic (without epinephrine), it is important to avoid infiltrating
the muscle itself.
b. Following blunt dissection,
a cigar shaped strip of muscle at least 2.5 cm long and 1.0 cm wide should be
removed with minimal handling.
c. Do not clamp, suture, or
tie the muscle to a tongue depressor, or any other object.
7. The biopsied muscle should be prepared in the following
manner as quickly as possible to avoid deterioration of enzymatic reactions:
a. The muscle should be placed
loosely on saline moistened gauze.
b. The biopsy, wrapped with
the saline moistened gauze, should be placed in a small empty container (it
should never float in saline).
c. This container should, in
turn, be placed in a Styrofoam box with regular ice (NOT DRY ICE).
8. The clearly labeled (including BIOHAZARD, if applicable)
muscle biopsy should be immediately delivered to this address:
Neuropathology Laboratory
Medical Science Building, C-525
185 South Orange Avenue
Newark, NJ
Telephone (973) 972-7167
and handed in person
to one of the technicians. The specimen should not be kept for regular delivery
of surgical specimens since immediate processing is essential for
histochemistry and election microscopy.
NOTE:
Muscle Biopsies should
be received between 9:00 a.m. and 2:00 p.m. - Monday through Wednesday.
Thursday and Friday should be avoided to ensure proper processing without delay
over a weekend.
BIOHAZARD SPECIMEN
If the specimen is from a patient with any biohazardous infection (for example,
hepatitis B virus, HIV, etc., this information should be given to our laboratory
at the time that service is arranged (see #2 above). The specimen should also
be clearly labeled "BIOHAZARD" in red.
