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Neuropathology is sometimes asked to handle skin biopsies in children. These are mostly done for two reasons:

1)  EM evaluation for neuronal ceroid lipofuscinosis (NCL)
2)  Skin fibroblast cultures for work-up of metabolic diseases (including mitochondrial)

The skin biopsy may also accompany a muscle biopsy in the work up of DERMATOMYOSITIS AS WELL. In this case a small portion is submitted for EM embed and hold (see below) and the rest for paraffin embedding to evaluate vasculitis.

Handling

1)  If the biopsy is for NCL and requests only EM, split the punch biopsy in two and place in EM fixative. Each half of the biopsy should contain epidermis and dermis. It is best to contact the EM lab to get the fixative during regular working hours. Phone 647-9658.

You will have to sign out TWO reports:

  • A general Path report with gross: sign out ASAP (Dx: “Skin, biopsy: SPECIMEN SENT TO EM” )
  • A Procedure report after the EM micrographs are reviewed

2)  If BOTH EM and fibroblast culture is requested:

As above, except one half of the biopsy will go to fibroblast cultures
(Dx: “Skin, biopsy: SPECIMEN SENT TO EM AND FOR FIBROBLAST CULTURES”)

The part for fibroblast cultures is placed in sterile PBS.

HANDLE IN STERILE FASHION (use two sterile scalpel blades)

  • Tubes of sterile PBS are available in room #2317. This is the room where we take specimens to be accessioned at CH
    • the sterile PBS is in the refrig in the back of the room
  • Be sure to involve Heather Ciccio (Childrens Tissue coordinator pager 412-572-5673), phone 412-692-6855. Heather handles the coordination of getting the biopsy to the culture lab and she will follow up on results of the culture (“growth/no growth).

OR contact one of the PAs or the Histology Supervisor

  • Dan Galvis (PA): Pager - 412-571-7117
  • Bill Devine (PA): Pager - 412-572-2426
  • Lori Schmidt, Histology Supervisor: Office - 412-692-6856; Pager - 412-565-8056
  • You will need to sign out a general report indicating the disposition of the tissues in the diagnostic line (Skin for EM and fibroblast cultures”) and an EM Procedure report which may be “Embed and hold” or evaluation of micrographs depending on the clinical requests.

3) If fibroblast cultures ONLY – see above (#2)

DO NOT HESITATE TO PAGE ANYONE TO BE SURE THE SPECIMEN IS HANDLED CORRECTLY.