MUSCLE BIOPSY SERVICES OFFERED BY THE NJMS/UNIVERSITY HOSPITAL
NEUROPATHOLOGY LABORATORY

Skeletal Muscle Biopsy:  A full range of pathology services is available for skeletal muscle biopsies. The Laboratory receives fresh, unfixed muscle, ideally sent to the Laboratory on ice and kept moist on saline-soaked gauze. The technicians in the Laboratory accession the specimen and divide it, with a portion snap frozen in isopentane cooled by liquid nitrogen, another portion fixed in formalin for paraffin embedding, and a small portion fixed in glutaraldehyde, retained for possible plastic embedding and electron microscopy, if indicated. If the specimen is large enough, a portion is frozen in liquid nitrogen and kept at -80E C for possible further study, as indicated (usually sent to a reference laboratory on dry ice, with appropriate labeling of the container).

      A. Standard stains/reactions done on all muscle biopsy cases:
           1. Frozen sections for H&E and Engel’s modified trichrome stain
           2. Paraffin sections for H&E and Masson trichrome stain.
           3. Frozen sections for histochemistry:
                 Myofibrillar ATPase reactions (done at pH 4.3, 4.6 and 9.4)
                 NADH-Tetrazolium reductase (NADH-Tr)
                 Alkaline Phosphatase
                 Esterase

      B. Histochemical stains, done on frozen sections, as needed:
           Succinic dehydrogenase (SDH)
           Cytochrome C oxidase (COX)
           Combined SDH/COX
           Myophosphorylase
           Branching enzyme
           Myoadenylate deaminase (MAD)
           PAS
           Diastase digested PAS
           Acid phosphatase
           Oil Red O for lipid
           Congo red (for inclusion body myositis [IBM], viewed with fluorescence microscopy)

      C. Antibodies available for immunohistochemistry (performed in the Immunohistochemistry Laboratory, University Hospital) to the following antigens, done on
frozen sections:
           Carboxy Terminus of Dystrophin
           Amino Terminus of Dystrophin
           Mid-Rod Portion of Dystrophin
           Utrophin
           Alpha-Sarcoglycan (Adhalin)
           Beta-Sarcoglycan
           Gamma-Sarcoglycan
           Delta-Sarcoglycan
           Alpha-Dystroglycan
           Beta-Dystroglycan
           Dysferlin
           Caveolin-3
           Merosin (Laminin Alpha-2)
           Emerin
           Major Histocompatibility Complex Class I (MHC Class I, HLAabc)

      D. Immunofluorescence, as needed (for immunoglobulins IgG, IgA and IgM, fibrinogen and complement [C3d], done in the Serology Laboratory [tel: 973.972.4088], University Hospital, on frozen sections prepared in the Neuropathology Laboratory