Cerebrospinal Fluid Cytology

NAME OF PROCEDURE:

Cerebrospinal Fluid Cytology

TEST CODE:

NGYN

CPT CODE:

88108 – Cytopathology, concentration technique, smears and interpretation

SYNONYMS:

CSF, Spinal Fluid Cytology

APPLIES TO:

Hydrocele Fluid Cytology, Lumbar Tap Cytology, Ventricular Tap Cytology

SPECIAL INSTRUCTIONS:

• Information regarding type of specimen, admitting diagnosis, and pertinent clinical history (i.e., age, clinical impression, past diagnosis, radiographic findings, and history of radiation/chemotherapy or malignancy) is essential to interpretation and should be noted on the
• Infectious diseases suspected and special stains requested should be
• Clinical evidence of immunosuppression should be indicated.
• Special handling requirements (isolation) should be clearly noted on the requisition.
• If other studies are required, submit to appropriate laboratory separately.

SPECIMEN:

• Fresh Cerebrospinal FluidVolume: 3 – 5 mL                      Minimum Volume: 1 mL

  Cytologic examination of CSF is used to investigate patients with sign or symptoms of central nervous system disease.

CONTAINER:

• Sterile, clean, leak-proof container.
• Label container(s) with a minimum of two patient identifiers.

COLLECTION TECHNIQUE:

1. Complete the requisition entirely.
2. Pre-label collection container(s) with patient name and sample site.
3. Using standard CSF procedure, collect a minimum of 1 mL of CSF in labeled, leak proof container.
4. Seal container well to prevent leakage
5. Placed labeled container into a Biohazard specimen bag and include the requisition in the outside pocket of the bag.
6. Send the entire specimen to the laboratory, STAT.
7. Do not add anticoagulant or fixative.
8. REFRIGERATE fresh/unfixed specimen if immediate delivery to Lab/Cytology is not possible.
9. Transport with ice pack being careful not to freeze specimen.

**REFRIGERATE ALL CYTOLOGY SPECIMENS IF IMMEDIATE DELIVERY TO LAB/CYTOLOGY IS NOT POSSIBLE**

REQUEST FORM:

Anatomical Pathology Requisition

• Complete patient information section.
• Complete the Non-Gynecologic section thoroughly.

CAUSES FOR REJECTION:

• Incomplete requisition.
• Specimen container not labeled properly.
• Gross contamination due to spillage.
• Prolonged period (more than 8 hours) at room temperature.
• Delay in delivery for adequate processing.

LIMITATIONS:

• Cells may rapidly degenerate rendering morphologic evaluation less than optimal if adequate care is not taken.
• Generally, morphology of cells can be adequately maintained with prompt refrigeration for 24 hours.

METHODOLOGY:

• Cytocentrifuge preparations are examined microscopically using the Pap stain method and Wright-Giemsa stain method.

ADDITIONAL INFORMATION:

• Pneumoencephalography, myelography, radiation, or intrathecal therapy can produce striking cytologic changes.
• Meningeal carcinomatosis or lymphoma may shed few cells, intermittently.
• Malignant cells are shed into CSF only from tumors which extend to subarachnoid space or the ventricles.
• Metastatic tumors have a better detection rate than primary tumors.
• Material for Flow Cytometry should be collected in RPMI and submitted separately.

Information is also available on the SEPA website under Resources – Directory of Services.

Please call laboratory if you have questions.