Miscellaneous Cholesterol

Body fluid specimen, including but not limited to: Cerebrospinal Fluid, pleural fluid, pericardial fluid, peritoneal fluid, or synovial fluid. Note fluid type in order comments or on patient specimen label.

Collect body fluid in a body fluid collection bag or other sterile container and transport to lab. Refrigerate if transport will be delayed. Note fluid type in order comments or on patient specimen label.

This test is for cholesterol measurement on body fluids.  For cholesterol measurement on serum or plasma, order CHOL.

Body fluid collection bag or other sterile container

Daily upon receipt

This test is useful in distinguishing between chylous and nonchylous effusions and in identifying iatrogenic effusions.

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. 

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. 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.