Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Department of Neuropathology

Our Services

Neurosurgical specimens

We perform diagnostic histopathology on a wide variety of RPA neurosurgical specimens in partnership with RPA Tissue Pathology and Diagnostic Oncology.

A second opinion service for neurosurgical specimens outside of RPA is freely available. Please contact us for further details.


Molecular Neuropathology

The Molecular Neuropathology Laboratory offers molecular testing for brain tumour specimens. Please note that some tests are not currently NATA-accredited. The tests offered are:


  • MGMT promoter methylation
    MGMT promoter methylation analysis has prognostic and predictive implications for high grade gliomas. We perform pyrosequencing using a commercial assay to assess MGMT promoter methylation on fresh or formalin fixed paraffin embedded brain tumour specimens.

  • IDH1/IDH2 pyrosequencing
    The majority of low grade diffuse gliomas and secondary glioblastomas have mutations in Isocitrate Dehydrogenase-1 or -2 (IDH-1/2). IDH mutations have been found to carry prognostic significance in both low and high-grade gliomas. We perform pyrosequencing to assess IDH1 and IDH2 mutations on fresh or formalin fixed tumour samples.

Fluorescent In-Situ Hybridization (FISH)
FISH testing is performed in partnership with RPA Tissue Pathology and Diagnostic Oncology.

  • 1p/19q deletion testing (oligodendrogliomas).
  • EGFR amplification testing (glioblastomas)

 Immunohistochemistry for IDH1 (R132H) or BRAF (V600E) mutations
This is performed in conjunction with RPA Tissue Pathology and Diagnostic Oncology.

Please click here to download the molecular request form (updated 02/03/2017)


Creutzfeldt-Jakob Disease Laboratory

The RPA Neuropathology Department is the NSW state referral centre for all suspected clinical cases of Transmissible Spongiform Encephalopathies (TSE’s) that included Creutzfeldt-Jakob disease (CJD), Fatal Familial Insomnia (FFI), Gerstmann–Sträussler–Scheinker (GSS) and variant CJD.

We work closely with Forensic Medicine Sydney, the NSW Ministry of Health and the Australian National CJD registry at the University of Melbourne.

Please note the turn around time for diagnosis of suspected CJD cases is around 3-4 months.

Information Sheet for clinicians referring potential CJD cases (updated 20/08/2019)

Please click here to download the Non-Coronial Post Mortem Consent & Authorisation form (updated 20/08/2019)


Forensic Neuropathology

We provide Neuropathology expertise to all three NSW forensic hubs (Glebe, Newcastle, Wollongong). We also offer diagnostic services for neurological autopsy material from hospitals across NSW. Please contact us for further details.

Please click here to download the request form (updated 17/05/2016)

Please click here to download the Information for sending the specimen for examination (updated 13/03/2017)


Muscle Pathology

We work closely with RPA Neurologists and the RPA Nerve and Muscle laboratory to provide diagnostic expertise in muscle biopsy interpretation.