Clinical Neuropathology Laboratory

Laboratory overview

The department is open from 8.30am to 5pm, Monday to Friday.

As one of the busiest departments of its type in the country, the Department of Clinical Neuropathology has connections with hospitals and scientific institutions in the UK and abroad. Our close association with King’s College London Medical School and our function as a diagnostic referral centre puts us in a unique position to provide a high-quality, wide-ranging diagnostic service and to carry out research into disease of the nervous system.This is a UKAS accredited medical laboratory (UKAS No 8620)  accredited to ISO15189:2012 for the tests listed in the schedule of accreditation available on the UKAS website

We also provide clinical diagnosis for the MRC London Brain Bank for Neurodegenerative Diseases.

Please see our user guide below for protocols and packaging and delivery instructions for various types of biopsies.

Biopsy and sample analysis

Check our target turnaround times for each specimen type (in our user guide) or contact us for more information about any of our services.

Brain and pituitary biopsies

We have vast experience in the diagnosis of brain tumours using modern facilities and classification, and collaborating with paediatric and adult neuro-oncology, neuro-radiology, and neurosurgery and pituitary services. More than 650 brain and 100 pituitary biopsies, most of which are from tumours, are sent to us annually. We provide an intra-operative (smear and frozen section diagnosis) provisional report within 24 hours and, in most cases, a complete diagnosis with immunohistochemical stains in 48 to 72 hours.

Cerebrospinal fluid (CSF) cytology

We receive around 150-200 CSF samples for cytology each year. Samples need to be sent as soon as possible after being taken.

Muscle and nerve biopsies

As a referral centre for muscle and nerve diseases we receive around 250 muscle and around 30 nerve biopsies each year. See our protocol in our user guide for sending muscle and nerve biopsies to the department.

Intra-Epidermal Nerve Fibre Density analysis (IENFD)

The department receives more than 200 cases per year for IENFD analysis. See our protocol in our user guide for more about the technique and instructions for sending samples.

Epilepsy

We receive around 20 specimens a year from surgery for epilepsy. There is close association between neurophysiologist surgeons, radiologists and neuroradiologists through multi-disciplinary meetings and research projects.

Molecular Pathology

The department currently provides around 400 molecular pathology tests per annum. See our protocol in our user guide for Molecular Pathology Referrals for instructions on sending samples.

Key programmes

Brain Bank (neurodegenerative diseases)

The department provides clinical diagnosis for the MRC London Neurodegenerative Diseases Brain Bank based at the Institute of Psychiatry, King's College London.

We receive about 125 donated brains every year. There are regular brain cut demonstrations and comprehensive studies of neurodegenerative diseases. The neuropathologists contribute in studies and investigation in many research projects in the neuro-degeneration field, including motor neurone disease and fronto-temporal dementia.

Autopsies/forensic neuropathology

We have excellent knowledge and experience in neurologically related autopsy examinations (including the diagnosis of Creutzfeldt-Jakob disease) and in forensic neuropathology, particularly for head injury. Our services are offered to HM Coroners and forensic pathologists in the South East and Midlands. The department also co-ordinates research projects and teaching courses in traumatic neuropathology.

Post-mortems may be performed on request and are reported in three parts – a full autopsy report, a macroscopic brain description report and a full microscopy report, where applicable.

Appropriate consent must be obtained to meet all legal requirements before any investigations can be carried out (to reach a diagnosis) and for any retention of tissues (including the brain) for research, teaching and training. It is at the pathologist’s discretion whether they proceed with the autopsy, taking into account the level of consent available.

Information for internal KCH users is detailed in the Guidelines for Users of Clinical Neuropathology Services document available via the KCH Intranet (Kwiki Site)

Information for referrals to the department can be found on the KCH website