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Test Code LAB4276 DIFFERENTIAL, BAL

Important Note

Sample must be walked to the laboratory. Do not use tube system.

Specimen Type

Bronchoalveolar lavage
Preferred Specimen: Lithium Heparin Tube
Alternative Specimen: Sterile Container

Specimen Volume

5 mL. It is acceptable for the provider to pool multiple aliquots to obtain the 5 mL.

Turnaround Time

STAT: 1 hour
Routine: 4 hours

Test Schedule

Daily

Sample Stability

Room Temperature: 30 minutes
On Ice: 1 hour

Specimen Processing

Fresh specimen is ideal for testing and can remain at room temperature for up to 30 minutes. If delivery time is over 30 minutes but less than 60 minutes, the specimen should be transported on ice at 4°C.

Method

Microscopic

Reference Ranges

Cell differential in normal, healthy (non-smoking) adults are as follows:

Cell Type Reference Range
Macrophages > 85%
Lymphocytes 10-15%
Neutrophils ≤ 3%
Eosinophils ≤ 1%
Epithelial cells
(squamous and columnar) ≤ 5%

Note: If a large amount of ciliated bronchial lining cells is present, no further testing should be done. This is a sign of poor BAL collection techniques

Synonyms

Bronchoalveolar Differential

Test Components

Neutrophils, %; Lymphocytes, %; Variant Lymphocytes, %; Macrophages/Monocytes, %; Eosinophils, %; Basophils, %; Squamous Epithelial Cells, %; Columnar Epithelial Cells, %; Others; Fungus; Bacteria; BAL Note.

CPT Codes

89051

Rejection Criteria

Grossly bloody specimens or those more than ¾ mucous. Clotted Specimens. Frozen specimens or specimens transported with dry ice.