Test ID: 4993
Electron Microscopy
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Tumor identification
Diagnosing medical disorders such as storage diseases and Primary Ciliary Dyskinesia
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
Electron Microscopy
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Electron Microscopy, Not Renal
Electron Microscopy-WBC
EM (Electron Microscopy-Tissue)
Immotile Cilia Syndrome
Kartagener's
NCL (Neuronal Ceroid Lipofuscinosis)
Primary Ciliary Dyskinesia (PCD)
CADASIL Tissue Only - Do not send blood for genetic testing
Cerebral Autosomal Dominant Arteriopathy with Sub _ Cortical Infarcts and Leukoencepholopathy
CADASIL (for whole blood genetic mutation testing, see referral catalog)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
For non-tumor renal specimens, see 4986 Renal Biopsy, Electron Microscopy.
For muscle specimens, see HMAX/5338 Histochemistry of Sent-In Muscle Specimen Maximum.
For CADASIL genetic mutation testing on blood, see referral catalog.
Results will be provided by telephone. If needed, representative images showing diagnostic features will be sent.
Forms:
1. Electron Microscopy Patient Information Sheet in Special Instructions
2. If not ordering electronically, submit a Pathology/Cytology Request Form (Supply T246) with the specimen.
Specimen Type: Fixed wet tissue
Container/Tube: Electron Microscopy Kit (Supply T660) or leak-proof container
Specimen Volume: Entire specimen
Collection Instructions: Collect specimen according to the instructions in Electron Microscopy Procedures of Handling Specimens for Electron Microscopy in Special Instructions.
Additional Information: 5439 Surgical Pathology Consultation may be added if deemed necessary by the reviewing pathologist.
Specimen Type: Whole blood (Neuronal Ceroid Lipofuscinosis-NCL only)
Specimen must arrive within 48 hours of draw.
Container/Tube: Electron Microscopy Kit (Supply T660), green top (sodium heparin), or yellow top (ACD [solution B])
Specimen Volume: 5 mL
Collection Instructions:
1. Collect specimen according to the instructions in Electron Microscopy Procedures of Handling Specimens for Electron Microscopy in Special Instructions.
2. Do not transfer blood to other containers.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | Muscle tissue |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Ambient (preferred) | |
| Refrigerated | ||
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Crucial diagnostic information for the study of human disease may be provided by transmission and scanning electron microscopy. Often information of a confirmatory nature or of educational value to the clinician and pathologist can be obtained by this procedure.
In recent years, the technology involved in electron microscopy has progressed to the point where methods have become standardized and the instrumentation routine. The electron microscope is a fundamental tool in medical diagnostic and cellular pathobiological investigations, because it is at this instrument's level of resolution that most structural correlations with function and metabolism are visible.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
An interpretive report will be provided.
Interpretation Provides information to assist in interpretation of the test results
The images and case histories are correlated and interpreted by a pathologist who is an expert in the field of the suspected diagnoses.
Representative images are provided upon request.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Certain factors are necessary for interpretation of electron microscopic images as follows:
-Optimal fixation of viable and representative tissue is imperative.
-Tumor biopsies must be accompanied by a history, hematoxylin-and-eosin stained slides, and a paraffin block.
-The tissue submitted must have been viable at the time of fixation.
-Selection of tissue representative of the lesion is essential.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Damjanov I: Ultrastructural Pathology of Human Tumors. St. Albens, VT, Eden Press, Vol. 1, 1979, Vol. 2. 1980
Method Description Describes how the test is performed and provides a method-specific reference
The fixed tissues received are rinsed 3 times in 0.1 M sodium phosphate buffer, post-fixed, and stained in 1% osmium tetroxide. The tissues are then rinsed 3 times in distilled water, en bloc stained in 2% aqueous uranyl acetate (60 degrees C) for 30 minutes, and dehydrated in a graded series of ethanol and acetone. The tissues are subsequently infiltrated and embedded in epoxy resin. Semi-thin (1 micron) sections for light microscopy are cut with an ultramicrotome and stained with toluidine blue. Thin sections are cut with an ultramicrotome, post-stained with 0.3% aqueous lead citrate, and examined with a transmission electron microscope operated at an appropriate kV. Images are digitally captured and stored electronically. (McDowell EM, Trump BF: Histologic fixatives suitable for diagnostic light and electron microscopy. Arch Pathol Lab Med 1976;100:405-414)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; Varies
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
88348
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 18296 | Accession Number | N/A |
| 18297 | Referring Pathologist/Physician | 46608-6 |
| 18298 | Ref Path/Phys Address | In Process |
| 18299 | Place of Death: | 21987-3 |
| 18300 | Date and Time of Death: | 31211-6 |
| 18301 | Date of Autopsy: | In Process |
| 18302 | Specimen: | 31208-2 |
| 18303 | Material: | In Process |
| 18304 | Tissue Description: | 22634-0 |
| 18305 | Microscopic Description: | In Process |
| 18306 | Clinical History: | In Process |
| 18307 | Final Diagnosis: | 34574-4 |
| 18999 | Final Diagnosis: | 34574-4 |
| 18308 | Comment: | 48767-8 |
| 18309 | Revision Description: | In Process |
| 18310 | Signing Pathologist: | 19139-5 |
| 18311 | Special Procedure: | N/A |
| 18312 | SP Signing Pathologist: | N/A |
| 18313 | *Previous Report Follows* | N/A |
| 18314 | Addendum: | 35265-8 |
| 19191 | Addendum Comment: | 22638-1 |
| 18315 | Addendum Pathologist: | 19139-5 |
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