Overview: Cell Count and Differential, Body Fluid (2023)

Useful For

Suggests clinical disorders or settings where the test may be helpful

Aids in the diagnosis of joint disease, systemic disease, inflammation, malignancy, infection, and trauma, using body fluid specimens

Profile Information

A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
CCBF_ Cell Count and Differential, BF No Yes
CRSF Morphologic Review, BF No Yes

Reflex Tests

Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
LCMS Leukemia/Lymphoma, Phenotype Yes No
CYTNG Cytology Non-GYN Yes No

Testing Algorithm

Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When abnormal cytologic features are present, the laboratory may reflex to a miscellaneous cytology test. Fee codes for that test vary depending on review process.

Method Name

A short description of the method used to perform the test

Automated or Manual Cell Count/Cytocentrifugation followed by Manual Differential and Morphology Review

Stain slide with Wright-Giemsa stain.

NY State Available

Indicates the status of NY State approval and if the test is orderable for NY State clients.

No

Reporting Name

Lists a shorter or abbreviated version of the Published Name for a test

Cell Count and Differential, BF

Testing Algorithm

Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When abnormal cytologic features are present, the laboratory may reflex to a miscellaneous cytology test. Fee codes for that test vary depending on review process.

(Video) Hematologic Analysis of Body Fluids

Specimen Type

Describes the specimen type validated for testing

Body Fluid

Ordering Guidance

For spinal fluid specimens, order CCCF / Cell Count and Differential, Spinal Fluid.

For bronchoalveolar lavage specimens, order LAV / Cell Count and Differential, Bronchoalveolar Lavage.

Shipping Instructions

Specimen must arrive within 24 hours of collection.

Necessary Information

Indicate specimen source.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
FLD2 Fluid Type

Specimen Required

Defines the optimal specimen required to perform the test and the preferred volume to complete testing

For Local Accounts Only

Sources: Synovial, pleural, peritoneal, pericardial

Container/Tube:

Preferred: Body fluid container

Acceptable: EDTA or heparin

Specimen Volume: 1 mL

Specimen Minimum Volume

Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.7 mL

Reject Due To

Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Clotted Nasal fluid, sputum, amniotic fluid Reject

Specimen Stability Information

Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Body Fluid Ambient (preferred) 24 hours
Refrigerated 24 hours

Useful For

Suggests clinical disorders or settings where the test may be helpful

(Video) Differential Count with Atypical cells seen - Pleural Fluid Analysis

Aids in the diagnosis of joint disease, systemic disease, inflammation, malignancy, infection, and trauma, using body fluid specimens

Testing Algorithm

Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When abnormal cytologic features are present, the laboratory may reflex to a miscellaneous cytology test. Fee codes for that test vary depending on review process.

Clinical Information

Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Body fluids, other than the commonly analyzed urine and blood, include synovial, pleural, peritoneal, and pericardial fluids. These fluids may be present in increased volumes and may contain increased numbers of normal and abnormal cells in a variety of disease states.

Reference Values

Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

TOTAL NUCLEATED CELLS

Synovial fluid: <150/mcL

Peritoneal/pleural/pericardial fluid: <500/mcL

NEUTROPHILS

Synovial Fluid: <25%

Peritoneal/pleural/pericardial fluid: <25%

LYMPHOCYTES

Synovial fluid: <75%

MONOCYTES/MACROPHAGES

Synovial fluid: < or =70%

Interpretation

Provides information to assist in interpretation of the test results

Trauma and hemorrhage may result in increased red and white blood cells; RBCs predominate. WBCs are increased in inflammatory and infectious processes:

-Neutrophils predominate in bacterial infections

-Lymphocytes predominate in viral infections

-Macrophages may be increased in inflammatory and infectious processes

-Eosinophils may be increased in parasitic or fungal infections

Cautions

Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference

Recommendations for in-depth reading of a clinical nature

(Video) Counting Cells with a hemocytometer (Neubauer) for a count WBS & RBC in the cerebrospinal fluid CSF

1. Kjeldsberg C, Knight J: Body Fluids: Laboratory examination of cerebrospinal, seminal, serous and synovial fluids. American Society of Clinical Pathologists, 1993

2. Dyken PR, Shirley S, Trefz J, El Gammel T: Comparison of cyto-centrifugation and sedimentation techniques for CSF cyto-morphology. Acta Cytologica 1980;20:137-170

3. Sheth KV: Cerebrospinal and body fluid cell morphology through a hematologist's microscope, workshop presented at the ASCP-CAP Joint Spring Meeting, San Diego, March 1981

4. Schumacher AH, Reginato A: Atlas of Synovial Fluid Analysis and Crystal Identification. Lea and Febiger, 1991

5. Hussong JW, Kjeldsberg CR: Kjeldsberg's Body Fluid Analysis. First edition. ASCP Press 2015

Method Description

Describes how the test is performed and provides a method-specific reference

The cells are applied to a glass slide by cytocentrifugation. Wright-Giemsa stained slides are examined by light microscopy and a differential is performed. Total nucleated cell count is determined using an automated hematology analyzer or a microscopic counting chamber. (Instruction manual: Automated Hematology Analyzer XN series [XN-1000]. Code No. CJ410539. North American Edition. November 2015)

PDF Report

Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed

Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available

The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Specimen Retention Time

Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

1 week

Rochester

Fees

Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

(Video) Differential Leucocyte Count DLC Practical Lab

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification

Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

89051-Cell count with differential count

88184 if applicable

88185 if applicable

88187 if applicable

88188 if applicable

88189 if applicable

88104 if applicable

88108 if applicable

88112 if applicable

88161 if applicable

88162 if applicable

88305 if applicable

LOINC® Information

Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CCBF Cell Count and Differential, BF 34557-9
Result Id Test Result Name Result LOINC Value

Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.

FLD2 Fluid Type 14725-6
APP2 Gross Appearance 9335-1
TOT12 Total Nucleated Cells 74689-1
RBC1 Erythrocytes 26455-6
CMT37 Comment 48767-8
NE_BF Neutrophils 26513-2
LY_BF Lymphocytes 11031-2
MM_BF Monocytes/Macrophages 30437-8
EO_BF Eosinophils 26452-3
BA_BF Basophils 28543-7
OTH1 Other Cells 75353-3
CMT3 Diff Comments 59466-3
DCCBF Download CCBF No LOINC Needed
OTH11 Other Cells Are: 75353-3
CMT81 Comment 48767-8
REV81 Reviewed by: 18771-6

Test Setup Resources

Setup Files

Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports

Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports

International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

(Video) Cytology of Body Fluid by Dr. Ankur Gupta

SI Normal Reports | SI Abnormal Reports

FAQs

What is a body fluid cell count? ›

A body fluid cell count enumerates the RBCs and WBCs. The WBCs are further classified into neutrophils and mononuclears (lymphocytes, monocytes-macrophages). Abnormal cells, such as malignant cells or mesothelial cells can be detected, but may require cytopathologic analysis for further description.

How do you calculate CSF cell count? ›

If cells are counted in the four corner squares and the center square on both sides of the hemocytometer, the number of cells counted equals the number of cells/mm3 which is the equivalent of cells/µL.

What are nucleated cells in body fluid? ›

Nucleated cells are defined as any cell with a nucleus; the types of nucleated cells present depend on the specimen source.

What is normal body fluid WBC? ›

Normal Results

The normal number of WBCs in the blood is 4,500 to 11,000 WBCs per microliter (4.5 to 11.0 × 109/L). Normal value ranges may vary slightly among different labs.

What are the 4 major body fluids? ›

Body fluids are considered to be the interstitial fluids, saliva, tears, and gastric juices. They moisten the tissues, muscles, body organs and skin. In Chinese medicine, the production of these fluids is influenced by proper gastrointestinal function by the spleen and stomach qi.

What is body fluid analysis? ›

Body fluid cellular analysis is used by physicians to get substantial information regarding a patient's medical conditions, including inflammatory diseases, infection, hemorrhage and malignancy.

What is normal cell count in CSF? ›

Cell Count

Normal CSF may contain up to 5 WBCs per mm3 in adults and 20 WBCs per mm3 in newborns. Eighty-seven percent of patients with bacterial meningitis will have a WBC count higher than 1,000 per mm,3 while 99 percent will have more than 100 per mm3.

What is the normal value of CSF? ›

Normal Results

CSF total protein: 15 to 60 mg/100 mL. Gamma globulin: 3% to 12% of the total protein. CSF glucose: 50 to 80 mg/100 mL (or greater than two thirds of blood sugar level) CSF cell count: 0 to 5 white blood cells (all mononuclear), and no red blood cells.

What is normal RBC in CSF? ›

Normally, there are no RBCs in the cerebrospinal fluid, and there should be no more than five WBCs per cubic millimeter of CSF. If your fluid contains RBCs, this may indicate bleeding.

What is body fluid cell count test for? ›

Body fluid cell counting provides valuable information for the diagnosis and treatment of a variety of conditions. Chamber cell count and cellularity analysis by optical microscopy are considered the gold-standard method for cell counting.

What is a normal nucleated cell count? ›

A normal result is 0 NRBCs/100 WBCs or a complete absence of NRBCs in the blood. Possible causes of NRBCs in the blood include anemia, low oxygen, spleen dysfunction, and bone marrow damage and disorders. You can reduce NRBCs by addressing the underlying cause.

What does a high nucleated cell count mean? ›

A positive nucleated red blood cell (NRBC) count may indicate that the individual has leukemia.

What happens if WBC count is high? ›

Produced in your bone marrow, they defend your body against infections and disease. But, when there are too many white blood cells, it usually means you have infection or inflammation in your body. Less commonly, a high white blood cell count could indicate certain blood cancers or bone marrow disorders.

What causes high white blood cell count? ›

A high white blood cell count usually indicates: An increased production of white blood cells to fight an infection. A reaction to a drug that increases white blood cell production. A disease of bone marrow, causing abnormally high production of white blood cells.

What happens if WBC count is low? ›

A low white blood cell count in adults is less than 4,000 cells per microliter of blood. A low white blood cell count can be an indicator of certain conditions, including lupus, rheumatoid arthritis, vitamin deficiencies, or a side effect of cancer treatment.

What are the 3 principle body fluids? ›

There are three major fluid compartments; intravascular, interstitial, and intracellular.

What is cell fluid called? ›

The fluid inside the cell is called intracellular fluid (ICF). All the fluid outside of the cell is called extracellular fluid (ECF) and is separated from the intracellular fluid by a semipermeable membrane that surrounds the cell.

What are the 2 types of body fluids? ›

Blood and lymph are the two main body fluids in the human body.

What are examples of body fluids? ›

Biological fluids include blood, urine, semen (seminal fluid), vaginal secretions, cerebrospinal fluid (CSF), synovial fluid, pleural fluid (pleural lavage), pericardial fluid, peritoneal fluid, amniotic fluid, saliva, nasal fluid, otic fluid, gastric fluid, breast milk, as well as cell culture supernatants.

What is body fluid sample? ›

Samples are usually obtained through collection of the fluid in a container (e.g., urine, semen) or by inserting a needle into the body cavity and aspirating with a syringe a portion of the fluid (e.g., CSF, pericardial fluid).

How do you collect body fluids? ›

Blood and Body Fluid Collection
  1. Wet absorption. A sterile swab, gauze pad or threads slightly moistened with distilled water. ...
  2. Scraping method. The sample is scraped with a clean razor blade or scalpel, into a clean piece of paper that can be folded and packaged in a paper envelope.

What is body fluid cell count test for? ›

Body fluid cell counting provides valuable information for the diagnosis and treatment of a variety of conditions. Chamber cell count and cellularity analysis by optical microscopy are considered the gold-standard method for cell counting.

What does a high nucleated cell count mean? ›

A positive nucleated red blood cell (NRBC) count may indicate that the individual has leukemia.

What happens if you have a high red blood cell count? ›

Red blood cells play a big role in carrying life-giving oxygen throughout your body. But when your body makes too many, it can cause your blood to thicken and slow, making you more vulnerable to blood clots. Too many red blood cells can also indicate certain health conditions and disorders.

What is normal nucleated cell count? ›

A normal result is 0 NRBCs/100 WBCs or a complete absence of NRBCs in the blood. Possible causes of NRBCs in the blood include anemia, low oxygen, spleen dysfunction, and bone marrow damage and disorders.

Videos

1. Cerebrospinal Fluid Examination (CSF)
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2. Performing a Manual Differential
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3. Body Fluids
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4. Analyzing the cell count and protein concentration in ascites
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5. Fluid Examination Specific
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6. Manual Blood Cell counts
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