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Cerebrospinal Fluid

Test indication: Detection and characterization of malignant cells in the central nervous system. In cytology, cerebrospinal fluid is most commonly evaluated to detect and characterize malignancy which may have gained access to the central nervous system. While in most individuals CSF specimens are relatively easy to obtain, in some individuals, collection may require radiographic guidance. In addition, due to lack of nutrients in this fluid, cells may rapidly degenerate rendering morphologic evaluation less than optimal if adequate care is not taken.

Methodology: Routine cytopathologic evaluation.
Performed: Monday-Friday.
TAT: 1 day.

Specimen required: Minimum of 3 mL cerebrospinal fluid (CSF). 10 ml CSF (minimum) of required for immunologic marker studies.

Supplies: Standard cerebrospinal fluid collection equipment. Clean, clear 10 mL collection container for CSF. Fixative: 50% ethanol or CytoRich Red™ cytology preservative.

Collection procedure: Using standard CSF procedure collect 3 mL of CSF. In general, morphology of cells within the CSF can be adequately maintained with prompt refrigeration for 24 hours.

Fixation: Although a fresh specimen is preferred, if a longer time period between collection and processing is anticipated, the specimen may be preserved by adding an equal volume of 50% ethanol or CytoRich Red™ cytology preservative to the specimen. Label the container with the patient’s first and last name, date of birth, specimen type and collection date. Submit the specimen to the Cytopathology Laboratory along with the completed Cytology test request form.

Note: Do not add fixative. Specimens submitted for immunocytochemical testing must be submitted fresh.

Transport: Each specimen should be placed in a clearly labeled container that is leak proof. Place specimen in a biohazard transport bag. The paper requisition(s) that accompanies the specimen should be placed in the outside pocket of the biohazard bag to avoid exposure to any leakage.

Causes for rejection: Incomplete patient requisitions, unlabeled/incorrectly labeled specimen, frozen specimen, incorrect test ordered for specimen, specimen submitted in incorrect or expired fixative, specimen from unauthorized person .

Stability: Refrigerated: 24 hours.

Reference interval: By report.

CPT code(s): 88108 Concentration and interpretation or 88112 selective cellular enhancement with interpretation. Additional CPT codes may apply if special studies are required.

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