Director, Thomas W. Smith, MD  

 

The Neuropathology service provides skilled interpretation of specimens of brain, spinal cord, nerve and muscle (see below) and includes a wide range of both adult and pediatric CNS and neuromuscular disorders:   

 

1.         Evaluation of surgical specimens of neoplastic and non-neoplastic disorders of brain and spinal cord utilizing standard histology (hematoxylin-eosin) and when indicated or requested, special stains, immunohistochemistry, and electron microscopy. Molecular diagnostic testing of brain tumors (e.g. 1p/19q, EGFR-vIII, MGMT) can be performed (see Diagnostic Molecular Oncology service).

 

2.         Evaluation of brain and spinal cord autopsy specimens utilizing standard  histology and when indicated, special stains, immunohistochemistry and electron microscopy.

 

3.         Evaluation of muscle biopsies utilizing standard histology, enzyme histochemistry, immunohistochemistry and electron microscopy. If requested or indicated, biochemical analysis of frozen muscle specimens can be performed by appropriate reference laboratories.  Note: special procedures are required for the submission of muscle biopsies (see specific specimen requirements).

 

4.         Evaluation of nerve biopsies utilizing standard histology, thick sections and electron microscopy, and if indicated, immunohistochemistry and/or immunofluorescence. Special requests for nerve teasing can be performed by  an appropriate reference laboratory. Note: special procedures are required for the submission of nerve biopsies (see specific specimen requirements).

 

5.         Electron microscopic evaluation of diagnostic skin biopsies for metabolic or degenerative neurologic disorders. (See Dermatopathology service).

 

Diagnostic evaluation can be based on: 1) examination of previously processed specimens submitted by the referring hospital or physician including glass slides (H&E, other stains), electron photomicrographs, and other types of specimen images, and 2) examination of tissue specimens that require additional processing by UMMMC laboratories: fresh and frozen specimens, fixed specimens (formalin, glutaraldehyde, other fixatives), unstained slides, paraffin blocks.  

 

Clinical-pathologic correlation is critical for the proper interpretation of neurologic diseases, therefore we request that all specimens must be accompanied by appropriate clinical information.   This should include, if available, relevant data from the patient’s history and physical examination, laboratory studies, electrodiagnostic procedures, and neuroimaging studies.