In a recent needs assessment questionnaire conducted by the College of American Pathologists, a need for understanding the handling of peripheral nerve biopsies was identified. Reference laboratories reported that clinical history and electrophysiologic data are very helpful, both in planning the handling of the biopsy and in interpreting the findings. Understanding the clinical differential diagnosis and the relationships between the differential diagnosis and the use of specialized studies often helps in the initial handling of peripheral nerve biopsies, whether evaluated locally or referred to a specialized laboratory. In this paper, we offer some general guidelines for handling nerve biopsies, including the rationale for the studies commonly used to evaluate them. With this background, decisions may be made about handling specimens that are specific for the clinical situation and allow for the highest diagnostic yield and fastest turnaround times.
Diagnostic tissue is obtained in most instances.
As a part of the College of American Pathologists Practical Topics in Neuropathology series, the following report summarizes the pathologist's role in the procurement, preparation, and interpretation of these important specimens.