HISTOCHEMISTRY OF SENT-IN MUSCLE SPECIMEN - MAXIMUM

General Information

HLAB/HOL Code: MUSBI
UPHSM LIS Test #: 5334
Schedule: Monday - Friday
Testing Time: 7 days
Testing Lab: Mayo Labs

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume:
Temperature: Frozen
Tube Type: Muscle Biopsy specimens
Collection Info:
SEND SPECIMEN MONDAY, TUESDAY, OR WEDNESDAY ONLY.

Obtain the biopsy from a muscle that is definitely affected, but not so severely affected that much of it is replaced by fatty or fibrous
connective tissue. In addition, the involved muscle should not be one that has been traumatized by injections or by electromyographic
studies. Typically, the triceps, biceps, or vastus lateralis is chosen. (We find deltoid or gastrocnemius muscles less satisfactory and more subject to artifact.)

Excise a specimen approximately 1 cm by 0.5 cm with minimal trauma, by dissecting along the long axis of the muscle. Immediately after
removal, the specimen must be flash frozen. Plunge the specimen into a slurry of dry ice and acetone or into a slurry of dry ice and
absolute alcohol. It is important that at least 80% of the slurry should be dry ice, and the slurry must be stirred constantly to assure
that a uniform temperature of -70(C) is achieved. The immersion into the freezing solution is to last not more than is needed to completely
freeze the specimen, and during the period of immersion, the specimen should be swirled around in the slurry. The well frozen specimen has
a white, chalky color. Prolonged immersion in the quenching mixture should be avoided, as the specimen can become permeated by alcohol
or acetone. The total freezing time is usually <10 seconds. Im- mediately after this, the frozen specimen is removed and packed in dry
ice, or temporarily stored at -70 degrees C. The specimen must not thaw between the time of freezing and analysis. Send specimen frozen
in Tissue Specimen Bag (T303) on dry ice.

Due to the nature of testing to be done, we do not recommend the use of a muscle clamp or freezing the specimen using a mounting
media, i.e., OCT.  
NOTE: Please complete a "Muscle Histochemistry Information Sheet",  INCLUDING PERTINENT STUDIES, SUCH AS CREATINE KINASE
(CK) AND ELECTROMYOGRAPHIC STUDIES, THE CLINICAL DIAGNOSIS, NAME  OF MUSCLE, DATE OF BIOPSY, AND BRIEF CLINICAL HISTORY on a
"Pathology/Dermatopathology/Cytology Request Form"  and forward it with the specimen. This form is supplied by
Mayo Medical Laboratories. Requisitions for this specimen cannot  be processed unless the information requested is supplied.

Methods

Includes a battery of enzyme histochemical stains.
NOTE:
1. Immunofluorescence and electron microscopic studies are not done on sent in muscle biopsy specimens.
2. Contact Dr. Andrew Engel (Director of the Muscle Laboratory

CPT Codes

88305/Surgical pathology exam
88314/x3 ATPase acid alkaline stain
88314/Congo red stain
88314/Hematoxylin-and-eosin water soluble stain
88314/Oil red O stain
88314/Periodic acid-schiff stain
88314/TB ATPase alkaline stain
88314/Trichrome water soluble stain
88319/Acetate non-specific esterase stain
88319/Acid phosphatase stain
88319/Alpha-naphthyl stain
88319/Cytochrome oxidase stain
88319/NADH dehydrogenase stain
88319/Phosphorylase stain
88319/Succinic dehydrogenase stain



* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding
is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Reference Range

The laboratory will provide an interpretive report.

Additional tests reflexed as appropriate:
88342 IHC Initial Single Antibody Stain (MBS1)
88341 IHC, Each Add'l Antibody Stain (MBS2)