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Test Code CC CSF Cell Count Cerebral Spinal Fluid

Additional Codes

Cerner

NextGen

Cell Count Cerebral Spinal Fluid

Cell Count Cerebral Spinal Fluid

Useful For

Cell counts on spinal fluids provide important diagnostic information in the detection and diagnosis of meningitis, subarachnoid hemorrhage, encephalitis, central nervous system syphilis, spinal cord tumor, or multiple sclerosis. Most body fluids exist in small quantities in healthy individuals and serve as lubricant to prevent friction between the organ and the sac that contains it. When disease processes occur, fluid accumulation can occur in quantities sufficient to aspirate for analysis. CSF is the only fluid that exists in large enough quantities that it can be aspirated in a healthy or a disease state.

Methodology

Two methods are available for cell counts: An automated CBC instrument (XN) utilizing flow cytometry, and a manual Hemacytometer. The automated method is preferred, reserving the manual method for low counts that fall below the automated linearity limits. Manual differentials are performed on slides prepared by cytocentrifuge and stained with Modified Wrights Giemsa stain.

Patient Preparation

None

Collection Instructions

  • The tube submitted for cell counts must not be a previously centrifuged specimen.
  • Do not use mechanical rockers to mix specimens.
  • CSF Tube Distribution:

Tube#1

Chemistry

Tube#2

Microbiology

Tube#3

Hematology

Tube#4

Virology/Special/Hematology
  • Cell count is normally performed on tube # 3. If a cell count is ordered on any other tube, the provider will be contacted to confirm the order priority
  • Performing the count on tube #3 reduces errors caused by the possible contamination of the fluid with tissue fluids and peripheral blood from the puncture during spinal tap.
  • Cell count on tube # 1 and tube # 3/ tube#4 may be ordered to differentiate spinal tap contamination from disease process.

Specimen Requirements

Preferred Volume

2 mL or more

Minimum Volume

Due to the nature of CSF specimens, no volume is rejected, but if specimen volume is inadequate, not all testing may be completed. The provider and/or pathologist will be contacted to discuss test priority if specimen volume is inadequate.

  • Sysmex open mode: 300 µL
  • Sysmex closed mode: 1 mL
  • Hemacytometer Manual: 500 µL

Container

CSF specific tubes without additive

Stability
  • 1 hour at room temperature
  • 2 hours at 2-8⁰C.        

Rejection Criteria
  • Clotted Specimens:
    • The provider will be notified.
    • If a cell count and differential are still required, a comment under specimen result "Specimen clotted; results may be inaccurate.”  The requesting provider’s name will also be added in the comment documented with the result.

Result Reporting and Reference Values

Reference Range

Parameter (units)

Range

Total Volume CSF mL

Not Defined

Color CSF

Colorless

Charact CSF

Clear

Tube Num CSF

N/A

WBC CSF /mm³

0-5

RBC CSF /mm³

0

PMN # CSF /mm³

0-3

Lymph # CSF /mm³

0-5

Mono # CSF /mm³

0-1

Eos # CSF /mm³

0-1

Others Cells # CSF /mm³

N/A

Body Fluids Performed by

Lists method(s) used

 

Critical Ranges

None

Reflex Testing

Pathology Fluid Cell Review will be reflexed if “Other” cells were identified in the differential.

Limitations

  • WBC interferences:  NRBCs, giant platelets, precipitated elevated proteins, fragmented cells, unlysed particles > 35 fL in size, crystals and other elements.
  • RBC interferences:  Include highly elevated WBC, high concentration of very large platelets, auto agglutination, etc.
  • Crystals in fluids may be counted in error by automated instruments.

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