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- Urine, Bladder Washings/Lavage
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
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.
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.
Second morning specimen; voided or catheterized urine; intraoperative washings of urinary bladder, urethra, ureters, or renal pelvis
Not less than 20 mL
Sterile plastic urine container
Hydrate patient (give several glasses of water 30 minutes to one hour prior to collection).
Have patient drink one glass (6 oz) every 15 minutes for two to three hours. At the end of two 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 one 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.
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.
Causes for Rejection
Improper labeling; improper fixation; 24-hour collection; undue delay in transport; specimen submitted in vial that expired according to manufacturer's label; frozen specimen
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.
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|009068||Urine Cytology||191115||Specimen type:||22633-2|
|009068||Urine Cytology||191160||Clinician provided ICD9:||52797-8|
|009068||Urine Cytology||191174||Clinician provided ICD10:||52797-8|
|009068||Urine Cytology||191157||Pathologist provided ICD9:||52797-8|
|009068||Urine Cytology||191175||Pathologist provided ICD10:||52797-8|
|009068||Urine Cytology||191117||Clinical history:||22636-5|
|009068||Urine Cytology||191126||Amended report:||N/A|
|009068||Urine Cytology||191147||Diagnosis provided by:||N/A|
|009068||Urine Cytology||191119||Signed out by:||19139-5|
|009068||Urine Cytology||191120||Performed by:||N/A|
|009068||Urine Cytology||191116||Gross description:||22634-0|
|009068||Urine Cytology||191156||Microscopic description:||22635-7|
|009068||Urine Cytology||191141||Special procedure:||N/A|
|009068||Urine Cytology||191179||Previous history:||N/A|
|009068||Urine Cytology||191144||QA comment:||N/A|
|009068||Urine Cytology||000000||NonGyn CPT Code Automation||N/A|