Neuromuscular Laboratory, (612) 873-2175

Specimen Preparation/ Submission Procedures for
Muscle and Nerve Biopsies

Please note that the following instructions are for specimens collected within a 3-hour delivery time of the downtown area of Minneapolis. If you are sending from outside of this area see General Instruction II.

I. General Instructions for Specimens Collected within a 3-hour Delivery of Minneapolis, MN

Muscle Specimens

1. Send two unfixed muscle pieces, lying on a tongue blade, wrapped in saline-moistened gauze on wet ice for immediate delivery. Recommended size: 3 to 5 mm in diameter by 1 cm in length for each.

2. Send a third muscle piece that is held at resting length by sutures on a piece of tongue blade immersed in EM fixative. Size: 2 mm in diameter.

3. If biochemical studies are anticipated, additional muscle samples must be quickly frozen in liquid nitrogen and sent on dry ice.

Nerve Specimens

1. Send one piece of nerve in saline-moistened gauze. Size: up to 1 cm in length

2. Send a second piece in 3% glutaraldehyde fixative at room temperature , labeling the proximal end of the nerve. Size: 2 cm in length.

Billing
We will bill the institution, the patient, or a third party directly; the ordering physician should specify and provide the pertinent information. Insurance demographics for the patient need to be sent along with the specimen in order to provide correct billing information for our billing system.

Please call 612-873-2175, with any billing questions regarding pricing, CPT codes and tests performed.

Shipment
Specimens must be received in the Lab as soon as possible, and preferably not more than one hour after excision. See laboratory hours of service.

For local complimentary service (provided by HCMC)within the six county metro area, call Street Fleet at 612-623-9999. Send the specimens and the Pathology Request Form to:

HCMC Neuromuscular Laboratory
825 South 8th Street, Suite LL-05
Minneapolis, MN 55404

II. General Instructions for Specimens Collected Outside of the Minneapolis Metro Area

Before the procedure is started, assemble the following items:
(the Neuromuscular Lab will send you the items in blue if they are not available in your lab.)

Muscle Specimens

1. Send two unfixed, frozen muscle pieces, 3 to 5 mm in diameter by 1cm in length for each. See below for freezing techniques. See above illustration.

2. Send a third muscle piece that is held at resting length by sutures on a piece of tongue blade (see above illustration), and immersed in EM fixative. Size: 2 mm in diameter.

Nerve Specimens

1. Send one piece of nerve, up to 1 cm in length in neutral buffered formalin. See illustration above for appropriate size.

2. Send a second piece in 3% glutaraldehyde fixative at room temperature, labeling the proximal end of the nerve. Size: 2 cm in length.

Michel's Transport Media (only used after consultation with lab at 612-873-2175)

1. Michel's transport medium may be obtained by calling the EM lab at 612-873-2175 or it can be ordered through Newcomer Supply, Middleton, WI, 608-831-7888, catalog number 1242.

2. Place two unfixed muscle specimens in Michel's transport media. The recommended size is 3-5 mm in diameter by 1 cm in length for each.

Freezing Techniques

Ideal Freezing Technique Pour 2-methylbutane into a metal cup. Float the cup in liquid nitrogen. Chill the 2-methylbutane until syrupy and 2-methylbutane crystals are being formed. Immerse the mounted specimen (see Illustration) into the nearly frozen 2-methylbutane for 20-30 seconds. Place the specimen in a pre-chilled vial in the dry ice filled Styrofoam chest.

Alternative Freezing Methods

If 2-methylbutane is not available: Place each specimen lengthwise on a small piece of tongue depressor and freeze in liquid nitrogen. Then place in a vial in the dry ice filled Styrofoam chest.
If liquid nitrogen is not available: Place specimens on dry ice. When frozen, place in a pre-chilled vial in the dry ice filled Styrofoam chest.

Note: Once a specimen is frozen, it must remain frozen.

Billing

We will bill the institution, the patient, or a third party directly; the ordering physician should specify and provide the pertinent information. Insurance demographics for the patient need to be sent along with the specimen in order to provide correct billing information for our billing system.

Please call 612-873-2175, with any billing questions regarding pricing, CPT codes and tests performed.

Instructions for Shipping Neuromuscular Specimens

Place vials containing frozen specimens into a Styrofoam chest that contains 7 to 10 lbs of dry ice. Place unfrozen specimens in a separate cool pack (do not place unfrozen specimens in the dry ice Styrofoam shipper). Place each into separate shipping boxes. Place the completed Pathology Request Form in one of the shipping boxes.

It is important that you call the laboratory and tell them you are sending a specimen.

Address the boxes as shown below:

Lab phone: 612-873-2175 (7:00am to 4:30pm) or 612-873-3001 after hours.