Urine Cytology
| Urine Cytology | | | |
| Number | | 009068 |
| CPT | | 88112 |
| Synonyms | | Urine, Bladder Washings/Lavage |
| Special Instructions | | Include patient's name, date of birth, sex, Social Security number, previous malignancy, drug therapy, radiation therapy, and all other pertinent clinical information, including history of alcohol abuse, on the request form. A first morning voided specimen is not suitable. Collection method must be identified. For CMV Study, indicate chemotherapy or immunosuppression. |
| Specimen | | Second morning specimen; voided or catheterized urine; intraoperative washings of urinary bladder, urethra, ureters, or renal pelvis |
| Volume | | Not less than 50 mL |
| Container | | Sterile plastic urine container |
| Collection | | Have patient drink one glass (6 oz) every 15 minutes for 2-3 hours. At the end of 2 hours, have the patient void or catheterize. Discard specimen. Technique I (routine): One hour after collection of discarded specimen, have patient void and save the specimen. Send labeled specimen to the laboratory immediately. Technique II (when residual bladder urine is present): Thirty minutes to 1 hour after collection of discarded specimen, catheterize bladder. Send labeled specimen to the laboratory immediately. Technique III (for detection of upper urinary tract lesions): Catheterize ureters to pelvis for suspected renal or pelvic lesions. Repeat procedure using either ureter for control. For ureteral lesion, catheterize ureter to a point just below the level of the suspected lesion. Catheterize other ureter for control. Collect urine for 30 minutes. Label appropriately, right and left ureteral or pelvic specimen. Ship specimen immediately to the laboratory. |
| Storage Instructions | | If collected after hours, add equal amount of 50% ethyl alcohol or Saccomanno fixative and place in the laboratory refrigerator. (Note: Specimens prepared with fixatives that contain 50% ethyl alcohol, eg, Saccomanno fixative, are not acceptable for microbiology testing.) Specify source of specimen. |
| Patient Preparation | | Hydrate patient (give several glasses of water 30 minutes to 1 hour prior to collection). |
Causes for Rejection | | Improper labeling; improper fixation; 24-hour collection;
undue delay in transport; specimen was submitted in a vial
that expired according to the manufacturer's label |
| Use | | Establish the presence of primary or metastatic neoplasms; aid in the diagnosis of infections with herpesvirus, cytomegalovirus, Blastomyces, and Schistosoma; evaluate malacoplakia; establish the presence of cytomegalic inclusion disease |
| Limitations | | Low-grade papillary transitional cell or urothelial carcinomas may not be diagnosed by cytologic examination. Calculi or recent instrumentation may produce atypical changes in urothelial cells simulating malignancy. Chemotherapy and radiation may also produce changes stimulating neoplasia. Viral culture is the method of choice for the diagnosis of CMV but cytology can provide faster results. |
| Methodology | | The fluid will be centrifuged, supernatant poured off, and diagnostic cells aspirated from the remaining material. Filters, monolayers, and/or cytospins will be made along with a cell block, if applicable. Microscopic examination is performed. |
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