Cytology - Bladder Wash Only

WSLH Department: Cytology
WSLH Test Code: 93301 WASH
Availability: Monday-Friday
Turn-around Time: 2 business days
Recommended Uses: Evaluation of bladder washings for premalignant, malignant, inflammatory and infectious changes.
Contraindications: Delay in transport and processing may cause cells to degenerate.
Additional Tests Performed:
Patient Preparations: Dependent on collection method.
Specimen Requirements: MINIMAL SOURCE: Any amount, but prefer 20-50mL. LARGE SOURCE: Mix large amounts of fluid well. Aliquot 50-100mL of well-mixed solution. Add equal volume of 50% ethanol for mailing. Note the addition on the requisition form.
Specimen Handling & Transport: Place specimen container in a biohazard bag (one patient specimen per bag). Add one absorbent cloth per container. Place requisition form in biohazard bag sleeve. Place biohazard bag(s) and coolant (Kool Paks or rice) in styrofoam box and secure tightly so nothing can fall out. Label the styrofoam mailer with the following: Your laboratory/clinic's address, WSLH Cytology Department address, diagnostic specimen label. Send using courier or overnight service, with a tracking option strongly preferred.

NOTE: Unpreserved specimen NEEDS to remain cold and MUST be delivered within 24 hours to prevent degradation. Specimens preserved with an equal amount of 50% ethanol do not need to be shipped cold.
Collection Kit/Container: Washings Kit #12 and Mailers
Collection Instructions: Call lab for detailed collection instructions if needed. Washings: Per procedure, saline is washed into the area being sampled. The saline wash is recollected via aspiration and transferred into clean specimen container. The container is sealed and labeled with the patient's full legal name, DOB, DOS, specimen source, and name of clinician authorized to order the test. For all specimens: Place well-mixed specimen into one of the following: 50mL centrifuge container, urine container, Vacutainer, non-gynecologic (NGYN) ThinPrep vial. Add up to equal amounts of 50% ethanol to 50mL centrifuge container, urine container, Vacutainer. No additional ethanol required for NGYN ThinPrep vial. No need for more than three containers per specimen, or 150mL total. Close container lid tight and secure. Complete requisition form.
Unacceptable Conditions: Incomplete orders may cause a delay in preparation and evaluation. Leaky specimens may not be processible. Containers without names and unique ID will be rejected.
Requisition Form: WSLH Cytology Form 141-NGYN
Required Information: Laboratory regulations require the following minimum information to be provided on the requisition form for a specimen to be accepted for testing: Patient name or unique identifier; date and time of collection, patient date of birth and sex, specimen type/site of collection, test request(s), clinician name and UPIN, and address for reporting results. Please be certain that name/identifier on the form matches that on the specimen label.
Results Include: Negative for High-Grade Urothelial Carcinoma; Atypical Urothelial Cells; Suspicious for High-Grade Urothelial Carcinoma; High-Grade Urothelial Carcinoma; and unsatisfactory specimen. Results follow the Paris Reporting System. Results may also include inflammatory, bacterial, and viral findings.

Reference: Wojcik EM, Kurtycz DFI, Rosenthal DL, eds. The Paris System for Reporting Urinary Cytology. 2nd ed. Springer; 2022. Accessed August 9, 2022. http://link.springer.com/book/10.1007/978-3-030-88686-8
Limitations: Abnormal findings must be correlated with history and other test results. Certain fluids or washings require minimal amounts of local cells present to determine adequacy. Without an adequate number of locally expected cells, the specimen may be rendered unsatisfactory or non-diagnostic. Abnormal cells are documented as present regardless of the presence/absence of local cells. As with any laboratory test, both false negative and false positive results may occur.
Additional Tests Recommended:
Additional Comments: Immunohistochemistry may be ordered at the discretion of the pathologist to further confirm or rule out differential diagnoses (CPT 88342 and price $86.00).
Methodology: Cytologic evaluation of fluid from the bladder collected via saline wash.
Includes: Bladder washings
CPT Code: 88112
Price: $134.00
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