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Cell Count and Differential, body fluid

Item Value
Approval req'd? No
Available Stat? Yes
Test code CCDB
Test group Cell Count and Differential
Performed by Parnassus & Mission Bay Hematology
In House Availability Test available 24 hours per day 7 days per week
Method Hemocytometer for cell count, Wright stained cytospin preparation for differential
Collection Instructions Deliver samples IMMEDIATELY to the laboratory. Specimen label must contain the date and time the sample was collected and the legible name of the person who collected the sample.
Container type Lavender top or Dark Green top
Amount to Collect See preferred volume
Sample type Body Fluid
Preferred volume > 2 mL fluid
Min. Volume 1 mL fluid
UCSF Rejection Criteria Sample received in a syringe with needle attached.
Processing notes Deliver sample immediately to Hematology for testing.
Units x109/L (this is equivalent to x103/mm3 or x103/µL)
Normal range The reference range and other method performance specifications have not been established by the UCSF Clinical Laboratory for this body fluid. The test result must be integrated into the clinical context for interpretation.
Critical value Samples positive for microorganisms from normally sterile sites
Synonyms Body fluid cell count; pleural fluid cell count; peritoneal fluid cell count; synovial fluid cell count; Pericardial fluid cell count; joint fluid cell count
Stability Pleural, Pericardial, Peritoneal & Bronchoalveolar Lavage (BAL): Delay in analysis will cause cell lysis, cellular degeneration, and bacterial growth which can affect the test results. Samples received two (2) hours after collection are accepted but results modified as follows: "Sample stability period exceeded or collection time unknown. Cellular degeneration can begin within one hour of collection, interpret results accordingly. See Lab Manual for Moffitt-Long and Mt. Zion for more information".

Synovial: Delayed interpretation of synovial fluids may lead to false-negative findings. Studies have shown that WBC's disintegrate with time. Based on a small in-house study performed on refrigerated samples, WBC decreased by ~10% at 6 hours; although the proportion of cell loss may depend on the types of WBC's present. Studies have also shown that crystals such as CPPD dissolve with time. MSU crystals remained stable for several weeks.
Turn around times STAT 1 hour. Routine 4 hours
Additional information Cell counts and differentials on biliary fluid have not proven to be useful, due to the disruption of the cellular elements by bile acids, and are thus not offered for this specimen type. An assessment for the presence of WBC in biliary drainage fluid is included in the examination of biliary fluid for crystals. An examination for crystals is automatically ordered at an additional charge on Joint fluids.

Note: Cell differentials are performed on a concentrated sample. Therefore a differential can be reported even if the reported WBC is 0 x 109/L

If unusual findings are noted a pathologist review and interpretation may be performed and separately billed for
CPT coding 89051
LOINC code 34557-9
Last Updated 9/30/2015 3:15:54 PM
Entry Number 177
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