Specimen Collection & Transport
Muscle Biopsy Consultation Kit Instructions
Muscle biopsies are performed in the evaluation of patients with neuromuscular or metabolic disease.
These specimens require highly specialized tissue handling and staining procedures and interpretation by a neuromuscular pathologist. A comprehensive panel of enzyme histochemistry and special stains is performed on all specimens.
The best value for the patient is achieved when the treating physician provides pertinent clinical information, the surgeon removes an adequate specimen, and the local pathology laboratory packs the specimen properly and ships it promptly. Our Muscle Biopsy Consultation Kit provides the necessary materials to ensure specimen integrity during shipment to our laboratories.
Specimen Collection & Transport
Overview
Whenever possible, biopsies should be scheduled Monday–Thursday.
If the biopsy must be performed on a Friday, or if the specimen is originating from outside the continental United States, ask the local pathology laboratory to contact the Surgical Pathology Desk for additional information.
Muscle biopsies are performed in the evaluation of patients with neuromuscular or metabolic disease. The procedure is requested by the treating physician, usually a neurologist or rheumatologist, and performed by a surgeon.
These specimens require highly specialized tissue handling and staining procedures and interpretation by a neuromuscular pathologist. A comprehensive panel of enzyme histochemistry and special stains is performed on all specimens. Additional studies, including electron microscopy and immunohistochemistry for dystrophy-associated antigens, will be performed at the discretion of the neuromuscular pathologist based upon the light microscopic findings and clinical information provided.
The best value for the patient is achieved when the treating physician provides pertinent clinical information, the surgeon removes an adequate specimen, and the local pathology laboratory packs the specimen properly and ships it promptly.
Peripheral nerve biopsies are often performed at the time of muscle biopsy. Nerve biopsies have different handling requirements; see our Nerve Biopsy Consultation Kit Instructions for details.
Requisition
Prior to requesting a biopsy, the treating physician should obtain and complete a Muscle / Nerve Surgical Requisition.
Fill the form out completely and provide it to the surgeon prior to the date of surgery.
Specimen Requirements
The surgeon should be instructed to place the specimen on Telfa gauze moistened with saline and to deliver the specimen promptly to the Pathology Laboratory.
A completed Muscle / Nerve Surgical Requisition should accompany the specimen.
Adult Specimens
Specimen type:
Longitudinal muscle
Diameter:
0.8 – 1.0 cm
Length:
2.5 – 3.0 cm
Pediatric Specimens
Specimen type:
Longitudinal muscle
Diameter:
0.5 cm
Length:
2 cm
*If initial sample is too small, additional should be taken.
Whenever possible, biopsies should be scheduled Monday–Thursday.
If the biopsy must be performed on a Friday, or if the specimen is originating from outside the continental United States, ask the local pathology laboratory to contact the Surgical Pathology Desk for additional information.
The specimen must not be immersed in saline.
Muscle clamps should not be used, unless they are required by the surgeon.
Shipping Preparation
Fresh specimens should be shipped for arrival in our laboratory prior to 5 p.m. by same day or overnight courier service.
Contact the Surgical Pathology Desk to alert the lab for any case expected to arrive on a Saturday.
1. Wrap the tissue in a saline-moistened Telfa pad, and place it in a screw cap container.
Biopsies from separate sites should be placed in separate specimen containers, but shipped in one shipping container.
2. Label all specimen parts with two of three patient identifiers:
- Patient name
- Date of birth
- Social security number
3. Place specimen container(s) in a sealable plastic bag with an absorbent pad.
4. Place the bagged container with the specimen in the Styrofoam shipping container with sufficient wet ice or cold packs to keep the specimen at 4–8˚C for 24–48 hours.
Do not freeze.
5. Place the Styrofoam container into the green shipping box.
6. Before sealing the box for shipment, include the completed requisition on top of the Styrofoam container.
Do not place the requisition inside the Styrofoam container.
If a nerve biopsy was performed during the same procedure and is being shipped separately, please indicate on the requisition.
9. Affix the provided shipping label to the green box.
- Ship the specimen Next-Day Air to:
Cleveland Clinic Laboratories
L15 – Pathology & Laboratory Medicine
2119 E 93rd Street
Cleveland, OH 44106
Laboratory Contact Information
Surgical Pathology Desk
216.444.2836
Contact the Surgical Pathology Desk for technical tissue handling and shipping questions.
Neuromuscular Pathology Secretary
216.444.2843
Contact the Neuromuscular Pathology Secretary to arrange to speak with a hematopathologist regarding medical pathology questions, including specific tests offered, their indications, and interpretations.