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26068 Cholesterol, Other

Cholesterol, Other
Test Code: CHOL-O
Synonyms/Keywords
​Body Fluid, Pleural Fluid, CHOL, Cholesterol, Pseudochylous effusion
Test Components
​Cholesterol
Useful For
​Providing supportive evidence to differentiate transudates and exudates.  Also used to distinguish between chylous and non-chylous effusions, and to identify iatrogenic effusions.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Body Fluid
​Sage Cup
Sterile Container
No additive Waste Tube
​2.0 mL ​0.5 mL
Collection Processing Instructions
​Body fluid without an anticoagulant are acceptable.
Specify specimen type at time of order.
Centrifuge prior to analysis.
Specimen should be refrigerated until analyzed.
Specimen Stability Information
Specimen Type Temperature Time
​Body Fluid ​ ​ ​Ambient ​24 hours
​Refrigerated ​7 days
​Frozen ​1 month
Rejection Criteria
Moderate and grossly icteric samples cannot be analyzed
​Specimens collected with EDTA, oxalate, or sodium fluoride
​Specimens too viscous to be aspirated by the instrument cannot be analyzed
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday through Sunday ​Less than 2 hours ​Enzymatic Endpoint Assay/Beckman AU
Reference Range Information
Performing Location Reference Range
​Marshfield ​ ​>250 mg/dL: Suggests cholesterol effusion in pleural fluid.
​>48 mg/dL:  Suggests malignant ascites in peritoneal fluid.
Interpretation
​Pleural Fluid:  Measurement of cholesterol in body fluids is clinically important and relevant in particular to the diagnosis of a cholesterol effusion.  Cholesterol effusions 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.  Generally, elevated cholesterol above 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)
 
1.  McPherson RA, Matthew RP, Hentry JB:  Cerebrospinal, Synovial, and Serous Body Fluids.  In Henry's Clinical Diagnosis and Management by Laboratory Methods.  Philadelphia, Saunders Elsevier, 2007, pp 426-454.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​82465 Cholesterol
Synonyms/Keywords
​Body Fluid, Pleural Fluid, CHOL, Cholesterol, Pseudochylous effusion
Test Components
​Cholesterol
Ordering Applications
Ordering Application Description
​COM ​Cholesterol, Other
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Body Fluid
​Sage Cup
Sterile Container
No additive Waste Tube
​2.0 mL ​0.5 mL
Collection Processing
​Body fluid without an anticoagulant are acceptable.
Specify specimen type at time of order.
Centrifuge prior to analysis.
Specimen should be refrigerated until analyzed.
Specimen Stability Information
Specimen Type Temperature Time
​Body Fluid ​ ​ ​Ambient ​24 hours
​Refrigerated ​7 days
​Frozen ​1 month
Rejection Criteria
Moderate and grossly icteric samples cannot be analyzed
​Specimens collected with EDTA, oxalate, or sodium fluoride
​Specimens too viscous to be aspirated by the instrument cannot be analyzed
Useful For
​Providing supportive evidence to differentiate transudates and exudates.  Also used to distinguish between chylous and non-chylous effusions, and to identify iatrogenic effusions.
Test Components
​Cholesterol
Reference Range Information
Performing Location Reference Range
​Marshfield ​ ​>250 mg/dL: Suggests cholesterol effusion in pleural fluid.
​>48 mg/dL:  Suggests malignant ascites in peritoneal fluid.
Interpretation
​Pleural Fluid:  Measurement of cholesterol in body fluids is clinically important and relevant in particular to the diagnosis of a cholesterol effusion.  Cholesterol effusions 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.  Generally, elevated cholesterol above 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)
 
1.  McPherson RA, Matthew RP, Hentry JB:  Cerebrospinal, Synovial, and Serous Body Fluids.  In Henry's Clinical Diagnosis and Management by Laboratory Methods.  Philadelphia, Saunders Elsevier, 2007, pp 426-454.
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Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday through Sunday ​Less than 2 hours ​Enzymatic Endpoint Assay/Beckman AU
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​82465 Cholesterol
For most current information refer to the Marshfield Laboratory online reference manual.