SKELETAL MUSCLE BIOPSY
Before all cases discuss with one of the following Pathologists.
Dr Clinton Turner ext 22084 mob 021 774 210
Dr Amanda Charlton ext 22085 mob 027 201 0646
Dr Komal Srinivasa ext 21536 mob 020 4028 1972
If unavailable contact the LabPlus Histopathology laboratory on ext 22090 (internal), 09 307 4949 ext 22090 (external) before proceeding.
NB: These specimens must be received by the Auckland City Hospital, LabPlus, Histology lab 0800- 1600 hrs from Monday to Friday.
Muscle Biopsy Procedure
Get an adequate specimen. This should be non-traumatized, uninjected, not diathermied muscle from a mildly to moderately affected muscle group, preferably quadriceps, deltoid, triceps or biceps.
The requesting physician should be asked for guidance for selecting site. Correlation with MRI can be useful.
Adult specimens should measure at least 15x8x8mm, paediatric specimens are ideally at least 10x5x5mm (longest dimension parallel to muscle fibres) .
It is not necessary to send very large biopsies (>25mm) as the amount of muscle that can be frozen is small.
Avoid muscle near tendon insertions. Avoid areas near previous biopsy sites or muscles that have been recently injected or subjected to electromyographic examination. Most of the specimen should comprise muscle rather than fascia or fat.
There is no need to tie the specimen to a spatula or to pin it out.
The fresh tissue be should be carefully wrapped in a gauze lightly moistened with saline and placed in a specimen container. It should not be immersed in saline. DO NOT place into formalin.
The specimen should then be sent fresh and unfixed immediately.
Sending the specimen to the laboratory
If the specimen is being sent from clinic or theatre at Auckland City Hospital, it should be sent immediately to the Histopathology Laboratory. This is particularly the case for suspected metabolic muscle diseases where tissue needs to be frozen for respiratory chain enzyme within 10 minutes. Use the Orange request form for fresh tissue.
If the specimen is coming from outside Auckland City Hospital, the specimen container may be kept cool with wet ice but must not be frozen prior to reception in the histology laboratory. The specimen must be received within Laboratory working hours, 8am ? 4pm, Monday to Friday.
The biopsy should be suitably packaged and sent by track and trace courier. Transport by taxi is not recommended due to previous issues with specimens not being delivered to the appropriate part of the laboratory.
Clearly identify the outside of the package as:
URGENT: FRESH MUSCLE BIOPSY for HISTOLOGY. ATTENTION CUT UP ROOM.
Address:
Specimen reception
Level 3
Building 31, Gate 4
Grafton
Auckland City Hospital
On the specimen request form, clearly identify the name of the consultant physician, usually a Neurologist or Rheumatologist who has requested the biopsy.
Please phone the LabPlus histology laboratory 307 4949 ext 22090 prior to despatch so that we know to expect the biopsy and can track it down if it goes astray.