Accurate identification of the amyloid fibril protein is the critical first step in the diagnostic pathway for any patient with amyloidosis.
Service Overview
The Jack O’Neill Amyloidosis Laboratory at the National Amyloidosis Centre (NAC) offers a comprehensive clinical diagnostic service for amyloid fibril typing.
The laboratory is UKAS accredited (Medical Laboratory No. 9878), a full list of accredited services is available on the UKAS website.
Histology and Fibril Typing Methods
To confirm amyloid deposition, we perform haematoxylin and eosin (H&E) staining alongside Congo red staining. Fibril typing is conducted using a panel of specialised antibodies targeting various amyloid fibril proteins. These immunohistochemical methods are specifically optimised for amyloid fibril identification.
In cases where immunohistochemistry is inconclusive or where further diagnostic clarity is required, samples undergo advanced analysis via laser capture microdissection (LCM) followed by mass spectrometry and proteomic analysis. (LCMS). This sophisticated technique provides highly accurate determination of the amyloid fibril type.
Histopathology Tests available:
- Congo red staining and Heamatoxylin & Eosin staining for all samples.
- Amyloid typing by Immunohistochemistry (IHC)
- Amyloid typing by laser capture mass spectrometry to confirm interpretation of IHC results or where the IHC is equivocal, with no immunospecific staining
Advisory Services and Clinical Advice:
The laboratory personnel and Consultants can be contacted for advice including:
- clinical indication and choice of appropriate tests
- advice on individual clinical cases
- professional judgment on the interpretation of the results of examination
- invoicing and charges
How to request fibril typing
UK Requests
- Complete the histology fibril typing request form.
- Email the completed form to [email protected]
File
UK Histology Fibril Typing Request Form.pdf
Requests outside of the UK
Our service for an overseas histology review and fibril typing is chargeable at £1500 per case for whole sample processing and report.
If you wish to proceed, please:
- Complete the histology fibril typing request form.
- Email the completed form to [email protected]
Please note that payment must be received before the sample is sent.
Due to UK customs regulations, returning samples overseas can be difficult. If you are submitting a tissue block, please confirm in the form that you give permission for the National Amyloidosis Centre (NAC) to retain the block in its archive. This helps avoid loss or destruction.