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David Lacomis, MD HOW TO PROCESS A MUSCLE BIOPSY David Lacomis, MD HOW TO PROCESS A MUSCLE BIOPSY

David Lacomis, MD HOW TO PROCESS A MUSCLE BIOPSY - PowerPoint Presentation

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Uploaded On 2022-05-31

David Lacomis, MD HOW TO PROCESS A MUSCLE BIOPSY - PPT Presentation

ORIENTATION OF MUSCLE FIBERS Surgeon should Provide 2 3 pieces of muscle of at least 1 x 1 cm The piece on the L is a little small At least one piece Should be on a clamp preserves cross ID: 912660

biopsy piece processing specimen piece biopsy specimen processing cryostat sections muscle send place formalin flask freezing orientation pieces cross

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Slide1

David Lacomis, MD

HOW TO PROCESS A MUSCLE BIOPSY

Slide2

ORIENTATION OF MUSCLE FIBERS

Slide3

Surgeon should

Provide 2 – 3 pieces

of muscle of at least

1 x

1 cm.

The piece on the L

is a little small.

At least one piece

Should be on a clamp

(preserves cross-

striations)

normal paraffin

Slide4

Dividing the Specimen

Cut 3 mm off one of the clamped pieces and place immediately in EM fixative (

e.g

,

Karnovsky’s

)

Take the rest from the clamped piece and place in formalin to be later embedded in paraffin (cross section and longitudinal)

EM

Formalin/Par

Freeze

Slide5

Processing the Biopsy:

Cryostat Sections

Orienting the

specimen

Mounded gum

tragacanth

on a chuck

Use dissecting

Scope to confirm

Orientation of

Myofibers

if you

Are uncertain

Slide6

Processing the Biopsy:

Cryostat Sections

Mounting the specimen

Perpendicular to gum

Slide7

Processing the Biopsy:

Cryostat Sections

Freezing the specimen – 160 deg

CInner flask with isopentane or

methylbutane

Outer flask with liquid nitrogen

Grab chuck

with

tongs

, turn upside down

and plunge into center flask and swirl for about a minute

Slide8

Slide9

Processing the Biopsy:

Cryostat Sections

Slide10

Shipping Muscle Specimens

If it will arrive within a few hrs, send one piece on saline MOISTENED, not soaked, gauze or a

telfa pad, place in a ziplock

bag, and keep cool (use cooler with icewater) but do not freeze.Send overnight specimens after freezing in plenty of dry ice

Send the other piece in formalin or divide for EM too if possible

If there is a 3

rd

piece, send it fresh with the cooled specimen (or frozen for overnight)

http://neuro.pathology.pitt.edu/webstuff/NeuromuscularProcess.html