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Cell Counts (Cerebrospinal Fluid and Other Body Fluids)

CSF cell count w/ differential if indicated.
Body fluid cell count, diff if indicated (Southeast Michigan Only).

Test Codes

CSF: EPIC: LAB2111025  Body Fluids: EPIC: LAB1231439

Department

Hematology

Specimen Collection Criteria

• Cerebrospinal Fluid (CSF)
  • In a sterile container collect 1.0 mL Cerebrospinal Fluid (CSF). (Minimum: 1.0 mL)
    • No anticoagulant should be added to CSF.
  • In a Lumbar Puncture Kit (includes tubes embossed 1-4) collect 1 mL in tubes in numeric order.
    • The last tube collected should be submitted for the cell count (preferably tube 3 or 4). 
      
• Other Body Fluids
  • In a sterile container, collect 1.0 mL other body fluid (pleural, peritoneal, synovial, pericardial, etc.). (Minimum: 1.0 mL)

Any request that is received with less than 0.5 mL of sample is not guaranteed, but a cell count will be attempted.

Physician Office/Draw Specimen Preparation

Arrange for transportation to the Laboratory prior to specimen collection. Do not centrifuge. Cell counts are most accurate if performed within 1 hour of collection. Maintain specimen refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: 1.0 mL CSF or other body fluid, refrigerated (2-8°C or 36-46°F). (Minimum: 1.0 mL)

Rejection Criteria

• Clotted specimens.
• Specimens that have been centrifuged.
• Specimens received in bags, bottles, or syringes.
• Specimens received on ice.
• Specimens which are not from a sterile body cavity (e.g. drainage, abscess, pus, etc.).
• Specimens collected in e-swab collection media or other liquid media type. 

Inpatient Specimen Preparation

Transport specimen to the Laboratory immediately after collection.

In-Lab Processing

Do not centrifuge. Cell counts are most accurate if performed within one hour after being drawn. Fluids greater than 24 hours old should not be analyzed for cell counts due to deterioration and/or lysis of cells.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 1 hour
Refrigerated (2-8°C or 36-46°F): 1 hour 
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 30 days

Laboratory

Dearborn Hematology Laboratory
Farmington Hills Hematology/Coagulation Laboratory
Grosse Pointe Hematology/Urinalysis Laboratory
Royal Oak Hematology Laboratory
Taylor Hematology Laboratory
Trenton Hematology Laboratory
Troy Hematology/Coagulation Laboratory
Wayne Blood Bank

Performed

Sunday – Saturday, 24 hours a day.
STAT results available within 60 minutes if no further verification is necessary; 2 hours if verification is needed.
Routine results are available within 3 hours.

Reference Range

Pleural Fluid:	TNC: Less than or equal to 1000 cells/mcL	RBC: Less than 10,000 cells/mcL*
Spinal Fluid (CSF):	TNC: 0-5 cells/mcL	RBC: Absent
Synovial Fluid:	TNC: 0-200 cells/mcL	RBC: Absent*

*RBC counts for non-CSF fluids will be reported as "less than 2000 cells/mcL" when the RBC count is between 0-2000 cells/mcL.

*TNC (Total Nucleated Cells)

Test Methodology

Manual microscopy, automated instrumentation as applicable.

Interpretation

• Cerebrospinal fluid may be examined as an aid in the diagnosis of meningitis, subarachnoid hemorrhage, encephalitis, CNS syphilis, CNS leukemia, CNS tumor and multiple sclerosis.
• In general, CSF changes due to a viral etiology will exhibit increased lymphocytes and those changes due to a bacterial etiology will show increased neutrophils. Other body fluids may be examined to determine the etiology of effusions and can sometimes be of extreme usefulness in distinguishing an inflammatory from malignant etiology.

Clinical Utility

Normal body fluids are clear, colorless and hypocellular. A change in physical appearance, an increase in cell count and differentiation of TNC may indicate a variety of diseases.

CPT Codes

89050

LOINC:
Color CSF: 10335-8
Color BFL: 6824-7
Clarity CSF: 49736-2
Clarity BFL: 94127-8
Xanthochromia: 13532-7
TNC CSF: 58906-9
TNC BFL: 55793-4
RBC CSF: 792-2
RBC BFL: 26455-6

Contacts

Last Updated

7/26/2024