Brain biopsy

Specimen:

Stereotactic aspiration needle biopsy or biopsy from open craniotomy. 

Laboratory staff should be consulted before the biopsy procedure.

Method:

Fresh tissue:   for microbiology, frozen section, molecular studies. 

Fixed tissue: for light microscopy, immunohistochemistry and electron microscopy (special fixative);  for infective, metabolic and degenerative and diffuse conditions adequate tissue should be taken to permit electron microscopy and biochemical studies.

Application:

Frozen section for intra-operative diagnosis of malignancy and for assessment of adequacy of submitted specimen. 

Diagnosis of infectious, degenerative, vascular and metabolic diseases and investigation of epilepsy.

Interpretation:

The report by the pathologist will include lesion type and, if malignant, tumour grade.

Infective lesions may require immunoperoxidase, in situ hybridisation or histochemical staining for confirmation.

Diagnostic interpretation of tissue sample by light microscopy and special techniques by pathologists.

See Oligodendroglioma - FISH testing.

Reference:

Lewitt PA et al. In: Goetz CG ed. Textbook of Clinical Neurology. 2nd ed. Philadelphia: Saunders, 2003.