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HelpTest ID CUT Copper, Liver Tissue
Specimen Required
Patient Preparation: Gadolinium is known to interfere with most metal tests. If gadolinium-containing contrast media has been administered a specimen should not be collected for 96 hours.
Supplies: Metal Free Specimen Vial (T173)
Container/Tube:
Preferred: Mayo metal-free specimen vial (blue label)
Acceptable: Paraffin block if no more than 1 or 2 cuts have been made to it for slides
Specimen Volume: 2 mg
Collection Instructions:
1. Two mg of liver tissue is required. This is typically a piece of tissue from a 22-gauge needle biopsy at least 2 cm long. If an 18-gauge needle is used, the tissue must be at least 1 cm in length.
2. Any specimen vial other than a Mayo metal-free vial used should be plastic, leached with 10% nitric acid for 2 days, rinsed with redistilled water, and dried in clean air.
Additional Information: Paraffin blocks will be returned 3 days after analysis is complete.
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.
Secondary ID
8687Useful For
Diagnosing Wilson disease and primary biliary cirrhosis using liver tissue specimens
Method Name
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Reporting Name
Copper, Liver TsSpecimen Type
Liver TissueSpecimen Minimum Volume
2 cm (22-gauge needle)
1 cm (18-gauge needle)
2 mm x 2 mm (punch) 0.3 mg by dry weight
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Liver Tissue | Refrigerated (preferred) | |
| Ambient | ||
| Frozen | ||
Clinical Information
Homeostatic regulation of copper metabolism is very complex. The liver is the key organ to facilitate copper storage and incorporation of copper into the transport protein ceruloplasmin. Intestinal absorption and biliary excretion also play major roles in the regulation of copper homeostasis.
Abnormal copper metabolism is associated with liver disease. Elevated serum copper concentrations are seen in portal cirrhosis, biliary tract disease, and hepatitis, probably because excess copper that would normally be excreted in the bile is retained in circulation. In primary biliary cirrhosis, ceruloplasmin is high, resulting in high serum copper. Lesser elevations of hepatic copper are found in chronic copper poisoning, obstructive jaundice, and certain cases of hepatic cirrhosis. Reduced serum copper concentration is typical of Wilson disease (hepatolenticular degeneration). Wilson disease is characterized by liver disease, neurologic abnormalities, and psychiatric disturbances. Kayser-Fleischer rings are normally present and urinary copper excretion is increased, while serum copper and ceruloplasmin are low.
Reference Values
<50 mcg/g dry weight
Cautions
Specimen handling should be minimized.
Elevated copper levels without supporting histology or other biochemical test results should instigate an investigation into whether the specimen has been contaminated.
A minimum tissue dry weight of 0.3 mg is required for analysis. This is the equivalent of a piece of tissue from a 22-gauge needle approximately 0.5 cm long, or approximately 0.3 cm in length when taken with an 18-gauge needle. Since the specimen must be manipulated during analysis, more than the minimal amount described in the previous sentence must be submitted for analysis.
Paraffin blocks that have been cut for slides may be contaminated if the microtome was previously used to cut specimens that had been fixed with a copper-containing solution. Many fixatives, such as Hollande's, contain high levels of copper. Any object that has been exposed to these fixatives (eg, cutting boards, towels, containers, utensils) and then comes into contact with the tissue can potentially contaminate the specimen. Rinsing and washing will not remove the copper contaminant. Therefore, submission of fresh-frozen, unfixed tissue is strongly recommended.
Day(s) Performed
Monday, Thursday
Report Available
3 to 6 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82525