DERMATOPATHOLOGY

Michigan Medicine Laboratories (MLabs) offers specialized dermatopathology consultation services through Michigan Medicine’s Dermatopathology Molecular Diagnostic Laboratory (DPML), including state-of-the-art molecular diagnostic testing for melanocytic neoplasms and other solid tumors.

The tests contribute to more precise diagnoses of challenging, atypical lesions that cannot be definitively classified as benign or malignant using histopathological criteria alone. Molecular analysis may allow for more precise risk prognostication, avoiding unnecessarily aggressive treatment of low-risk lesions while supporting appropriate surgical management and staging of high-risk lesions. Tests using formalin-fixed paraffin embedded material are available to aid in the diagnosis of histologically ambiguous melanocytic and other types of solid tumors, and include:

• Multiprobe fluorescence in situ hybridization (FISH) for Melanoma
• FISH for Malignancy: single probe CDKN2A, BAP1, or MYC
• Chromosomal Microarray Analysis for melanoma (Comparative Genomic Hybridization, CGH microarray, SNP microarray)
• Chromosomal Microarray Analysis for solid tumors (Comparative Genomic Hybridization, CGH microarray, SNP microarray)

RENAL PATHOLOGY

Specialized testing and a depth of expertise are needed to support accurate and comprehensive diagnoses of the range of diseases that can impact native and transplanted kidneys. Michigan Medicine Laboratories (MLabs) Renal Pathology Service processes more than 500 cases each year, analyzing needle biopsies from adult and pediatric kidneys and renal allografts.

An extensive panel of tests are typically performed, including:

• Hematoxylin and eosin (H&E) stain
• Periodic Acid-Schiff (PAS)
• Trichrome
• Silver stains for light microscopy
• Immunofluorescence to detect immune deposits
• Electron microscopy to evaluate conditions such as proteinuria (nephritic syndrome), nephritis including rapidly progressive glomerulonephritis, renal failure, vascular disease, and acute and chronic transplant rejection

Successful interpretation of specimens requires carefully correlating clinical history with laboratory data. Therefore, it is important that each renal biopsy received be accompanied by a comprehensive clinical history. Clinicians submitting biopsies are typically contacted with a preliminary diagnosis within 24-48 hours of receipt. A more immediate response is provided when the diagnosis is urgent.