Clinics and Departments

Laboratory Services

Lab Dept:

Anatomic Pathology

Test Name:

IRON, LIVER TISSUE

General Information

Lab Order Codes:

FELI

Synonyms:

FE, Liver; Hepatic Iron Concentration; Hemochromatosis; Total Iron, Liver Tissue; Hepatic Iron Index

CPT Codes:

83540 – Iron

Test Includes:

Liver tissue iron measured in mcg/g dry wt and iron index measured in mcmol/g/year.

Logistics

Test Indications:

Diagnosis of hemochromatosis

Lab Testing Section:

Anatomic Pathology - Sendouts

Referred to:

Mayo Medical Laboratories (MML Test# FET/8350)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6560

Test Availability:

Monday - Saturday

Turnaround Time:

2 - 5 days, 3 - 6 days if repeat testing is required, performed Monday - Friday

Special Instructions:

Age is required on request form to calculate the iron index. Blocks will be returned two weeks after the analysis is complete unless requested earlier.

Specimen

Specimen Type:

Tissue, liver (fresh)

Paraffin block is also acceptable if not more than 1 or 2 cuts have been made to it for slides.

Container:

Mayo fresh tissue metal-free specimen vial (blue label) (supply T173) supplied from Mayo Medical Laboratories

Any specimen vial other than a Mayo metal-free vial used should be plastic, leached with 10% nitric acid for two days, rinsed with redistilled water, and dried in clean air.

Draw Volume:

Minimum: 2 mg liver tissue

Processed Volume:

Same as Draw Volume

Collection:

This is typically a piece of tissue from a 14 -gauge needle biopsy at least 0.5 cm long. If an 18-gauge needle is used, the tissue must be at least 1 cm in length. The 18-gauge needle produces a specimen that is thin and fragile and difficult to remove from paraffin.

Special Processing:

Lab Staff: Send fresh specimen refrigerated. Send paraffin blocks at room temperature. Forward promptly.

Patient Preparation:

Physician preference

Sample Rejection:

Fresh specimen not in metal-free container; mislableled or unlabeled specimen

Interpretive

Reference Range:

Males:

200 - 2400 mcg/g dry weight

Females:

400 - 1600 mcg/g dry weight

IRON INDEX (> or = 13 years:

<1.0 mcmol/g/year

Note: Reference values have not been established for patients less than 13 years of age.

Critical Values:

N/A

Limitations:

Formalin-fixed, paraffin-embedded tissue can be used when histiologic examination including iron stains are requested, in addition to the hepatic iron concentration and calculated Hepatic Iron Index. However, fresh or frozen tissue is preferred.

A minimum of 2 mg of liver tissue is required for analysis. This is typically a piece of tissue from a 14-gauge needle biopsy at least 0.5 cm long. Recently it has become popular to use an 18-gauge needle for biopsy. This produces a specimen that is thin and fragile and, therefore, more difficult to recover from paraffin. If an 18-gauge needle biopsy is performed, this tissue must be at least 1 cm in length and submitted in paraffin.

Paraffin blocks from which many slides have been previously cut often appear to contain sufficient quantity of tissue, however, the specimen is often very thin and <2 mg in weight.

Methodology:

Perkin-Elmer ELAN 6100 by Inductively Coupled Plasma/Mass Spectrometry (ICP/MS)

References:

Mayo Medical Laboratories (May 2011)

Updates:

5/23/2011: Reference range update adding comment that ranges have not been established for patient <13 years of age.



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