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Test Update

Hematology

Hematology Testing Updates (Corewell Health West Michigan)

Effective Wednesday, July 30, 2025, changes to result reporting will be implemented across all Hematology Departments at Corewell Health Laboratories. These updates will help align all regions within Corewell Health Hematology Departments to provide a high-quality and standardize patient care experience.

The following are the most impactful changes for the Corewell Health West Michigan Region:

  • The Immature Platelet Fraction (IPF) will continue to be performed once every 24 hours if the platelet count is <100 x10^9/L, but the IPF results will now be located within the CBC.
  • The ‘immature cells’ component of the manual differential will be changed to ‘other cells’.
  • The Absolute Neutrophil Count (ANC) within a CBC w/Differential order will be EITHER an Automated ANC or a Manual ANC.
    • A CBC with Differential order with an automated differential will receive the automated ANC. A CBC with Differential order reflexing to a Manual Differential will receive a manual ANC.
  • The RBC Morphology will no longer include Anisocytosis, Microcytosis, or Macrocytosis components.
  • The RBC Morphology grading will change from “Moderate/Many” to “Present” for the following components:
    • Sickle Cells
    • Basophilic Stippling
    • Howell Jolly Bodies
    • Pappenheimer Bodies
    • Toxic Granulation
    • Dohle bodies
    • Vacuolated Neutrophils
    • Neutrophil Hypogranulation
    • Giant Platelets
  • The following RBC Morphology components will STILL be reported as Moderate/Many:
    • Hypochromia
    • Polychromasia
    • Schistocytes (Few, Moderate, Many)
    • Bite Cells
    • Spherocytes
    • Target Cells
    • Teardrop Cells
    • Acanthocytes
    • Blister Cells
    • Echinocytes
    • Macro Ovalocytes
  • Given the limited clinical utility and labor intensiveness of performing RBC counts, lower reportable limit for non-cerebrospinal fluid (non-CSF) body fluid red blood cell (RBC) counts will be updated to 2000 cells/uL. This means, if an RBC count on a non-CSF Body Fluid is <2000 cells/uL, Epic will report out the RBC count as <2000 cells/uL.
    • CSF will continue to report out all RBCs present within the cell count.

References:

  1. Kjeldsberg CR, Hussong, JW: Body Fluid Analysis. ASCP Press; 2015
  2. Collins, l. Examination of Body Fluids: Evaluating Gross Appearance; Performing Cell Counts. Clin Lab Sci 2009;22(1):46
July 18, 2025 by
General Information

Test Update: PD-L1

Effective July 30, 2025, PD-L1 testing will be performed at Corewell Health Reference Laboratory East and will no longer be a sendout to Neogenomics. Collection instructions and other information may have changed, please visit the lab catalog for more information.

For questions and inquiries, please use the “Contact Us” link above.

 

TEST INFORMATION

New test: PD-L1 [LAB3658]

Former test: PD-L1 to Neogenomics (LAB848)

July 18, 2025 by
Advanced Technology Laboratory, Cytology, General Information

Reflex HPV Testing Update

Effective April 2, 2025, the Reflex HPV algorithm will more closely align with ASCCP recommendations. HPV testing will no longer be performed for a normal Pap result in patients aged 30 years and older when a provider orders HPV Reflex.

Specimens will qualify for HPV Reflex with a cytologic diagnosis of:

  • ASCUS (Atypical Squamous Cells of Undetermined Significance) for patients aged 21 and older.
  • LSIL (Low Grade Squamous Intraepithelial Lesion) for patients aged 25 and older.

HPV testing will continue to be performed for all Paps, regardless of results, for patients aged 30 years or older when a provider orders Co-Testing.

If a provider wishes to request HPV testing on a normal pap for patients under 30, they must either place an electronic order at the time of the initial pap order or request an add-on test for:

  • HPV High Risk Screen with HPV Genotype Reflex – Cervical Source (LAB1231770)
  • HPV High Risk Screen with HPV Genotype Reflex – Vaginal Source (LAB1230722)

Updated Pap and HPV Testing Algorithm

Continue Reading

March 28, 2025 by
Chemistry, General Information

Collection Device Update: Chemistry β-hCG testing

Effective March 21, 2025, Corewell Health Laboratories will update the preferred specimen type for β-hCG testing from plasma to serum (mint green top, lithium heparin gel to gold top, serum separator-SST gel). The move to serum is mostly driven by the laboratory’s need to reduce assay performance problems that can occur sporadically with the use of plasma. Although serum is the preferred specimen type plasma will remain an acceptable container.
If you have questions regarding the preanalytical handling process and the optimum tube offering, contact the lab for support.
TEST INFORMATION
March 17, 2025 by
Immunochemistry, Test Spotlight

Update to Reporting for Urine Protein Electrophoresis Tests

On March 12th, 2025, the reporting for Protein Electrophoresis, 24 Hour Urine, do IFE if Indicated (LAB111444) and Protein Electrophoresis, Random Urine, do IFE if Indicated (LAB111445) will be updated to harmonize with Monoclonal Gammopathy Screen (LAB1230573) and Protein Electrophoresis, Serum, IFE if Indicated (LAB844).

The changes that will occur include the following.

  1. A single interpretive comment (Pathologist Interpretation Urine Protein Electrophoresis) that will encompass both the electrophoresis portion of the test and any immunotyping.
  2. Quantitation of monoclonal proteins will no longer be part of the interpretation but rather documented as discrete fields under Urine Protein Electrophoresis in result review. As a result, the interpretation will not include a comment about how the monoclonal protein has changed between studies.
  3. The quantitation of the monoclonal protein will only include mg/24-hour concentration and not the percentage.

TEST INFORMATION

  • Protein Electrophoresis, 24 Hour Urine, do IFE if Indicated (LAB111444)
  • Protein Electrophoresis, Random Urine, do IFE if Indicated (LAB111445)

Performing department: Immunochemistry (Corewell Health Reference Laboratory-West, Grand Rapids, MI)

March 9, 2025 by
Compliance & Safety

Anti-TPO Assay Falsely Elevated Recovery

A reagent bulletin from Roche has informed us that the recovery of the Anti-TPO assay has been falsely elevated for a reagent lot that was in use at Corewell Health Grand Rapids from September 2024 until March, 3, 2025. Based on the product evaluation, and in conjunction with a product and safety risk assessment, the remaining risk of false positive results with the Elecsys Anti-TPO assay is in the acceptable range.

We apologize for the inconvenience. Please reach out with any concerns or questions.

Best,

Dr. Alvarez
Yasel Alvarez, Ph.D.
Clinical Chemistry and Immunology
Corewell Health Reference Laboratory, West Michigan

Test Information

Thyroid Peroxidase Antibody, Blood Level [LAB516]

Clinical Implications

The risk of false positive results with the Elecsys anti-TPO assay is generally acceptable with respect to the given discrepancy.

Resources

Roche Customer Bulletin TP-02316

March 7, 2025 by