Service et Laboratoire de Neurologie, Centre de Référence des Neuropathies Périphériques Rares, CHU de Limoges, Limoges, France.
Acta Neuropathol. 2011 Mar;121(3):313-26. doi: 10.1007/s00401-011-0804-4. Epub 2011 Feb 4.
In many instances, nerve biopsy is not necessary in the diagnostic work-up of a peripheral neuropathy. However, histological examination of a tissue sample is still mandatory to show specific lesions in various conditions involving peripheral nerves. As there are fewer laboratories that examine human nerve samples, practitioners including neurologists and general pathologists may not be completely aware of the technical issues and data that are provided by nerve biopsy. Nerve biopsy is considered an invasive diagnostic method, although, its complications are by far less disabling than most of the disorders that lead to its indications. Nevertheless, the decision to perform a nerve biopsy has to be made on a case-by-case basis, and its results must be discussed between the pathologist and the clinician who is in charge of the patient's care. In this paper, we review the minimal technical requirements for proper peripheral nerve tissue analysis. Moreover, we provide data on the usefulness of nerve biopsy in various situations including abnormal deposits, cell infiltrates, link between peripheral neuropathy and monoclonal gammopathy, and numerous hereditary disorders.
在许多情况下，神经活检并不是周围神经病变诊断的必要手段。然而，为了显示各种涉及周围神经的疾病的特定病变，组织样本的组织学检查仍然是强制性的。由于检查人类神经样本的实验室较少，包括神经科医生和普通病理学家在内的医生可能并不完全了解神经活检提供的技术问题和数据。神经活检被认为是一种有创的诊断方法，尽管其并发症远不如导致其适应症的大多数疾病严重。然而，必须根据具体情况做出进行神经活检的决定，并且必须在负责患者护理的病理学家和临床医生之间讨论其结果。本文综述了适当的周围神经组织分析的最低技术要求。此外，我们还提供了神经活检在各种情况下的有用性的数据，包括异常沉积、细胞浸润、周围神经病变和单克隆丙种球蛋白病之间的联系以及许多遗传性疾病。
