Test ID: CHLBF
Cholesterol, BF
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Distinguishing between chylous and nonchylous effusions
Identifying iatrogenic effusions
Method Name A short description of the method used to perform the test
Colorimetry
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Cholesterol, Total, Body Fluids
Pseudochylous effusion
Chylothorax Analysis, Abnormal Body Fluid
Chylothorax Lipid Analysis, Abnormal Body Fluid
Fat, Body Fluids
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Sterile container
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge to remove any cellular material.
Additional Information: Indicate specimen source.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross OK |
| Lipemia | Mild OK; Gross OK |
| Icterus | Mild OK; Gross OK |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Body Fluid | Frozen (preferred) | 30 days |
| Refrigerated | 7 days | |
| Ambient | 24 hours |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Pleural Fluid:
Quantitation of cholesterol in body fluids is clinically important and relevant in particular to the diagnosis of a cholesterol effusion. Cholesterol effusions (also known as pseudochylothorax or chyliform effusion) are important to differentiate from chylothorax, as their etiologies and therapeutic management strategies differ. Pseudochylous or chyliform effusions accumulate gradually through the breakdown of cellular lipids in long-standing effusions such as rheumatoid pleuritis, tuberculosis, or myxedema and by definition the effluent contains high concentrations of cholesterol. The fluid may have a milky or opalescent appearance and be similar to that of a chylous effusion, which contains high concentrations of triglycerides in the form of chylomicrons. An elevated cholesterol >250 mg/dL defines a cholesterol effusion in pleural fluid.
Peritoneal Fluid:
Ascites is the pathologic accumulation of excess fluid in the peritoneal cavity. Cholesterol analysis in peritoneal fluid may be a useful index to separate malignant ascites (>45-48 mg/dL) from cirrhotic ascites. Using a cutoff value of 48 mg/dL, the sensitivity, specificity, positive and negative predictive value, and overall diagnostic accuracy for differentiating malignant from nonmalignant ascites were reported as 96.5%, 96.6%, 93.3%, 98.3%, and 96.6%, respectively.(1)
Synovial Fluid:
Normal synovial fluid contains extremely low concentrations of lipids. Abnormalities in synovial fluid lipids may be attributed to cholesterol-rich pseudochylous effusions which may be associated with chronic rheumatoid arthritis, lipid droplets due to traumatic injury and rarely due to severe chylous effusions associated with systemic lupus erythematosus, filariasis, pancreatitis, and trauma.(1) However, these diseases can usually be differentiated clinically and by gross and microscopic examination; quantification of lipids in synovial fluid only provides supporting information to the clinical picture.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Not applicable
Interpretation Provides information to assist in interpretation of the test results
Not applicable.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test cannot be performed on viscous fluids.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. McPherson RA, Matthew RP, Henry JB: Cerebrospinal, Synovial, and Serous Body Fluids. In Henry's Clinical Diagnosis and Management by Laboratory Methods. Philadelphia, Saunders Elsevier, 2007, pp 426-454
2. Valdes L, Pose A, Suarez J, et al: Cholesterol: a useful parameter for distinguishing between pleural exudates and transudates. Chest 1991;99:1097-1102
3. Tietz Textbook of Clinical Chemistry. Third edition. Edited by CA Burtis, ER Ashwood, WB Saunders, Philadelphia, 1999, pp 1130, 1767-1770
4. Ellefson RD, Elveback L, Weidman W: Plasma lipoproteins of children and youths in Rochester, MN. DHEW Publication No. (NIH) 1978;78-1472
Method Description Describes how the test is performed and provides a method-specific reference
Cholesterol is measured by an automated enzymatic method. The reagents include cholesterol ester hydrolase, cholesterol oxidase, and a coupled colorimetric end-point chemistry system. The method is referenced to the CDC standardized method performed in the Cardiovascular Risk Assessment Laboratory.(Package insert: Roche Cholesterol Reagent, Roche Diagnostics Corporation, Indianapolis)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
84311 Spectrophotometry, analyte not specified (Cholesterol)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| FLD25 | Fluid Type: | N/A |
| BFCHL | Cholesterol (BF) | N/A |
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