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Lab Dept:
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Anatomic Pathology
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Test Name:
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BRONCHOALVEOLAR LAVAGE CELL COUNT AND DIFFERENTIAL
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General Information
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Lab Order Codes:
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Bronchoalveolar Lavage Cell Count
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Synonyms:
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BAL, cell count; Bronch washings, cell count; Bronchial brushing, cell count
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CPT Codes:
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89050 – Cell count
88108-26 – Smear and interpretation
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Test Includes:
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When ordered, nucleated cell count and manual differential, culture, special stains for microorganisms, other special stains.
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Logistics
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Test Indications:
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Useful for differential diagnosis and management of interstitial lung disease, sarcoid, histiocytosis, and hypersensitivity.
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Lab Testing Section:
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Anatomic Pathology and Hematology
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Phone Numbers:
Minneapolis:
Saint Paul:
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612-813-5875
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651-220-6550
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Test Availability:
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Monday - Friday
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Turnaround Time:
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1 - 3 days
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Special Instructions:
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N/A
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Specimen
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Specimen Type:
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Bronchoalveolar washings
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Container:
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Screw capped, sterile vial
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Draw Volume:
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40 - 70 mL of bronchoalveolar washings
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Processed Volume:
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Varies depending on orders.
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Collection:
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Maintain sterility and forward promptly at ambient temperature only.
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Special Processing:
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Specify need for counts and stains on the Bronchoalveolar Lavage Form (available from lab)
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Patient Preparation:
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Physician preference
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Sample Rejection:
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Insufficient specimen; mislabeled or unlabeled specimen
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Interpretive
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Reference Range:
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Differential Macrophages: 80 - 90%
Lymphocytes: 10%
Nucleated Cell Count: 10 - 15 x 10³/100 mL
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Critical Values:
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N/A
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Limitations:
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Wide variability in cell type and numbers are recovered. Standardized volumes and concentrations are not yet established.
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Methodology:
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Light microscopy
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Contraindications:
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Severe hypoxemia with impending respiratory failure.
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References:
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Rosai, Juan MD, Ackerman’s Surgical Pathology, 8th ed, vols 1 and 2, CV Mosby
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Sternberg, Steven (1997) Histology for Pathologists, 2nd ed, Lippincott/Raven
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