Evaluating diseases of the nerve and disorders that affect nerve function
Our consultative practice strives to provide the highest quality diagnostic consultative service, balancing optimal patient care with a cost-conscious approach that supports the rapid turnaround time for diagnostic results.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
SS2PC | SpecStain, Grp II, other | No, (Bill Only) | No |
COSPC | Consult, Outside Slide | No, (Bill Only) | No |
CUPPC | Consult, w/USS Prof | No, (Bill Only) | No |
CRHPC | Consult, w/Comp Rvw of His | No, (Bill Only) | No |
NTFPC | Teased Fiber | No, (Bill Only) | No |
IHPCI | IHC Initial | No, (Bill Only) | No |
IHPCA | IHC Additional | No, (Bill Only) | No |
LV4RP | Level 4 Gross and Microscopic, RB | No, (Bill Only) | No |
CSPPC | Consult, w/Slide Prep | No, (Bill Only) | No |
EM | Electron Microscopy | Yes, (Bill Only) | No |
A battery of enzyme histochemical stains or immunostains are performed; other tests can be performed as indicated at an additional charge. The reviewing neuromuscular pathologist will determine the need for additional testing.
Wet tissue for consultation: When adequate tissue is provided, routine testing will include teased fiber examination, Congo red stain, methyl violet stain, Masson's trichrome stain, leukocyte common antigen, luxol fast blue/PAS (periodic acid-Schiff) stain, KP-1 macrophage, methylene blue stain, hematoxylin and eosin stain, and Turnbull blue stain or Perl's Prussian blue stain.
Slides and blocks sent for consultation: Special stains and studies performed on the case should be sent with the case for review. In order to determine an accurate diagnosis, some of these stains or studies may be deemed to warrant repeat testing, at an additional charge, at the discretion of the reviewing Mayo Clinic neuromuscular pathologist. In addition, testing requested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing Mayo Clinic neuromuscular pathologist. For all consultations, ancillary testing necessary to determine a diagnosis is ordered at the discretion of the Mayo Clinic neuromuscular pathologist. An interpretation, which includes an evaluation of the specimen and determination of a diagnosis, will be provided within a formal pathology report.
For more information see Pathology Consultation Ordering Algorithm.
Nerve Biopsy Surgical Pathology Consultation and Review of Outside Material
NPPC
PNBX
Nerve Biopsy
Neuropathology Consultation
Neuropathology Examination of Tissue
Sural Nerve Biopsy
Vasculitis
A battery of enzyme histochemical stains or immunostains are performed; other tests can be performed as indicated at an additional charge. The reviewing neuromuscular pathologist will determine the need for additional testing.
Wet tissue for consultation: When adequate tissue is provided, routine testing will include teased fiber examination, Congo red stain, methyl violet stain, Masson's trichrome stain, leukocyte common antigen, luxol fast blue/PAS (periodic acid-Schiff) stain, KP-1 macrophage, methylene blue stain, hematoxylin and eosin stain, and Turnbull blue stain or Perl's Prussian blue stain.
Slides and blocks sent for consultation: Special stains and studies performed on the case should be sent with the case for review. In order to determine an accurate diagnosis, some of these stains or studies may be deemed to warrant repeat testing, at an additional charge, at the discretion of the reviewing Mayo Clinic neuromuscular pathologist. In addition, testing requested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing Mayo Clinic neuromuscular pathologist. For all consultations, ancillary testing necessary to determine a diagnosis is ordered at the discretion of the Mayo Clinic neuromuscular pathologist. An interpretation, which includes an evaluation of the specimen and determination of a diagnosis, will be provided within a formal pathology report.
For more information see Pathology Consultation Ordering Algorithm.
Varies
Biopsies from same site will be processed as 1 specimen. Biopsies from different sites require separate orders and separate specimen vials.
Examples:
1. Three (3) segments vials of left sural nerve are processed as 1 specimen, 1 order number.
2. One (1) left sural nerve and 1 left superficial peroneal nerve requires 2 separate orders.
Transport specimen per Nerve Biopsy Specimen Preparation Instruction (T580).
The following information is required:
1. Nerve Biopsy Patient Information (T458) is required, containing the following information:
-Tentative clinical diagnosis
-Name of nerve biopsied
-Date of biopsy
-Indication for nerve biopsy
2. A copy of the Neurology Clinical Notes and electromyography (EMG) results are required for testing.
All requisition and supporting information must be submitted in English.
Specimen Type: Nerve biopsy tissue, slides, or block
Collection Instructions: Prepare and transport specimen per Nerve Biopsy Specimen Preparation Instruction (T580). A Nerve Biopsy Kit (call 507-284-8065 to order) containing fixatives and buffer is available for an additional fee.
1. Nerve Biopsy Patient Information (T458) is required
2. Pathology/Cytology Information (T707)
4.5 cm biopsy
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Refrigerated (preferred) | ||
Frozen |
Evaluating diseases of the nerve and disorders that affect nerve function
A battery of enzyme histochemical stains or immunostains are performed; other tests can be performed as indicated at an additional charge. The reviewing neuromuscular pathologist will determine the need for additional testing.
Wet tissue for consultation: When adequate tissue is provided, routine testing will include teased fiber examination, Congo red stain, methyl violet stain, Masson's trichrome stain, leukocyte common antigen, luxol fast blue/PAS (periodic acid-Schiff) stain, KP-1 macrophage, methylene blue stain, hematoxylin and eosin stain, and Turnbull blue stain or Perl's Prussian blue stain.
Slides and blocks sent for consultation: Special stains and studies performed on the case should be sent with the case for review. In order to determine an accurate diagnosis, some of these stains or studies may be deemed to warrant repeat testing, at an additional charge, at the discretion of the reviewing Mayo Clinic neuromuscular pathologist. In addition, testing requested by the referring physician (immunostains, molecular studies, etc) may not be performed if deemed unnecessary by the reviewing Mayo Clinic neuromuscular pathologist. For all consultations, ancillary testing necessary to determine a diagnosis is ordered at the discretion of the Mayo Clinic neuromuscular pathologist. An interpretation, which includes an evaluation of the specimen and determination of a diagnosis, will be provided within a formal pathology report.
For more information see Pathology Consultation Ordering Algorithm.
Neuropathy is a common neurological complaint and a frequent source of morbidity in many patient populations. Direct investigation of small fiber involvement has been limited as most classical techniques (eg, electromyography, nerve conduction studies, and nerve biopsy) focus on large diameter nerve fibers and may be normal in patients with small fiber neuropathies.
Nerve biopsies provide information about nerve fibers and the interstitium of the nerve. Neuropathic abnormalities include decreased density of myelinated fibers, segmental demyelination, and axonal degeneration. Some possible interstitial abnormalities that affect nerves include necrotizing vasculitis and amyloidosis.
This consultation is for fixed tissue, slides, or blocks.
An interpretive report will be provided.
The clinical and neurological history is reviewed with the interpretation of the biopsy.
The histologic slides, special stains, and history, along with the physician's report are correlated by a neuromuscular pathologist. An interpretive report will be provided.
Poor fixation, orientation, and improper handling of the nerve tissue may hinder the neuromuscular pathologist's interpretation of the biopsy. For more information see Nerve Biopsy Specimen Preparation Instruction. Kits containing the proper tissue fixatives and buffers are available upon request.
1. Tracy JA, Dyck PJ, Klein CJ, Engelstad JK, Meyer JE, Dyck PJB: Onion-bulb patterns predict acquired or inherited demyelinating polyneuropathy. Muscle Nerve. 2019 Jun;59(6):665-670
2. Xu M, Pinto M, Sun C, et al: Expanded teased nerve fibre pathological conditions in disease association. J Neurol Neurosurg Psychiatry. 2019 Feb;90(2):138-140
3. Dyck PJB, Spinner RJ, Amrami KK, Klein CJ, Engelstad JK, Dyck PJ: MRI-targeted fascicular nerve biopsies of proximal nerves: historic reports and illustrative case reports. In: Dyck PJ, Dyck PJB, Engelstad JK, et al, eds. Companion to Peripheral Neuropathy: Illustrated Cases and New Developments. Elsevier; 2010:3-14
4. Dyck PJ, Dyck PJB, Engelstad J: Pathologic alterations of nerves. In: Dyck PJ, Thomas PK, eds. Peripheral Neuropathy, Vol 1. 4th ed. Elsevier; 2005:733-829
A battery of special stains and teased nerve fiber analysis will be performed if fixed tissue is provided. Nerve morphometry and electron microscopy to determine diameter size histograms and ultrastructural abnormalities may be performed based on a preliminary review by the neuropathologist.(Unpublished Mayo method)
Monday through Friday
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
88305 (if appropriate)
88313 (if appropriate)
88321 (if appropriate)
88323 (if appropriate)
88323-26 (if appropriate)
88325 (if appropriate)
88362 (if appropriate)
88348 (if appropriate)
88342 (if appropriate)
88341 (if appropriate)
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
PNBX | Peripheral Nerve Path Consult | In Process |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
601774 | Interpretation | 59465-5 |
601775 | Participated in the Interpretation | No LOINC Needed |
601776 | Report electronically signed by | 19139-5 |
601777 | Addendum | 35265-8 |
601778 | Gross Description | 22634-0 |
601779 | Material Received | 81178-6 |
601912 | Disclaimer | 62364-5 |
601823 | Case Number | 80398-1 |