section epub:type=”chapter” id=”c0007un” role=”doc-chapter”> Urine Sediment Image Gallery Outline Outline Artifacts/Contaminants, 195 Blood Cells, 197 Red Blood Cells, 197 White Blood Cells, 197 Casts, 198 Cellular Casts, 198 Granular Casts, 200 Hyaline Casts, 201 Waxy Casts, 202 Crystals, 203 Ammonium Biurate Crystals, 203 Bilirubin Crystals, 203 Calcium Carbonate Crystals, 203 Calcium Oxalate Crystals, 204 Cholesterol Crystals, 205 Cystine Crystals, 205 Drug Crystals, 205 Phosphate Crystals, 206 Urate Crystals, 207 Uric Acid Crystals, 208 Epithelial Cells, 208 Fat Droplets and Oval Fat Bodies, 210 Microorganisms, 211 Bacteria, 211 Trichomonads, 212 Yeast, 212 Miscellaneous Formed Elements, 213 Hemosiderin, 213 Mucus, 213 Sperm, 214 Artifacts/contaminants Fig. 1 Three air bubbles trapped beneath a coverslip observed using low-power (100 ×) magnification. Numerous white blood cells (WBCs) are also present. Appearance varies with condenser and aperture positions of microscope. Brightfield. Fig. 2 Three air bubbles trapped beneath the coverslip. Compare with Fig.1; adjustment of the microscope’s condenser and aperture can change the appearance of air bubbles. Brightfield. Fig. 3 When plastic commercial standardized slides are used, fragments of plastic (red arrows) can be present in the sediment. Red blood cells, yeasts, and pseudohyphae are also present. Fig. 4 Three starch granules, all highly refractile, with slightly differing appearances, yet each has a centrally located dimple. Fragments of plastic (red arrows) are also present. Fig. 5 A starch granule (black arrow) demonstrating a characteristic dimple. When glass slides and coverslips are used, glass fragments (red arrows) can be present. Numerous white blood cells are also present. Fig. 6 Talc fragments (arrows)—note layering, refractility, and irregular edges. Also a single fiber—its refractility and shape helps distinguish it from a cast. Brightfield. Fig. 7 An absorbent fiber (diaper or hygiene product). Note its flat appearance with perforations and its strong refractility. Brightfield. Fig. 8 A clothing fiber. Its strong refractility, frayed ends, and flatness aid in its proper identification. Brightfield. Blood Cells Red Blood Cells Fig. 9 Numerous intact and ghost red blood cells (RBCs) (arrows). Intact RBCs have a characteristic appearance caused by the hemoglobin within them. In contrast, ghost RBCs have lost their hemoglobin but retain an intact cell membrane. This urine was hypotonic (dilute; low specific gravity). Many of the RBCs appear swollen and rounded because of the diffusion of fluid into the cells. Fig. 10 Red blood cells (RBCs) in hypertonic urine (concentrated; high specific gravity). Many of the cells in this field of view have lost their typical biconcave shape and become echinocytes (i.e., crenated). This happens when fluid moves out of the cell in an attempt to achieve balance with the tonicity of the environment. Consequently, the cell membrane shrinks, forming folds or projections, a process that is reversible. Near the center is a single schizocyte form—fragmented RBCs with three pointed extremities. Brightfield. White Blood Cells Fig. 11 White blood cells and a single squamous epithelial cell. Note the size similarity between the squamous cell nucleus and the diameter of the white blood cells. Brightfield. Fig. 12 Five white blood cells. Note that the lobed nuclei in several of these neutrophils are readily apparent; whereas in degenerating cells, the nucleus has become mononuclear. Brightfield. Fig. 13 (A) Three white blood cells, a single red blood cell, and a squamous epithelial cell. Note the size similarity between the squamous cell nucleus and the diameter of the white blood cells. Brightfield. (B) Numerous white blood cells and two red blood cells (just left of center). Many of the white blood cells show evidence of degeneration. Brightfield. Fig. 14 Many macrophages as well as other white blood cells in urine sediment. Cytospin preparation, Wright stained, Brightfield. Casts Cellular Casts Fig. 15 A mixed cellular cast. Brightfield. Fig. 16 Renal tubular epithelial cell cast with one end broken or incompletely formed. Fig. 17 Renal tubular epithelial cell cast. Note the cuboidal shape of the entrapped cells. Also, the nuclei become more apparent when adjusting the fine focus up and down during the microscopic examination. Fig. 18 A renal tubular cell cast and several free-floating renal tubular cells in a Sternheimer-Malbin stained sediment. A highly refractile glass fragment is present in the center of this field of view. Fig. 19 A cast with oval fat bodies (i.e., renal tubular cells that contain fat). In this Sternheimer-Malbin stained sediment, the fat droplets take on a yellow or greenish appearance. Fig. 20 A white blood cell cast. Note the spherical or round shape of entrapped cells. Fig. 21 A mixed cell cast. This cast contains both white blood cells and red blood cells (arrow). Fig. 22 A mixed cell cast, predominantly red blood cells. Fig. 23 A red blood cell cast. Red blood cells are dispersed in the hyaline matrix of this cast. Fig. 24 A red blood cell cast packed with red blood cells. Fig. 25 A fatty cast with fat droplets of varying size within the cast matrix; a fat droplet the size of a red blood cell is most notable mid-cast. Note the deteriorating renal epithelial cell within the cast at its end (lower right). (A) Brightfield. (B) Polarizing microscopy with first-order red compensator. Note that the fat droplet mid-cast demonstrates a Maltese-like cross pattern indicating that it is a cholesterol droplet. Fig. 26 Oval fat bodies in a hyaline matrix (i.e., a fatty cast). (A) Using Sudan III stain, the fat in the oval fat bodies has taken on the characteristic terra-cotta or red-orange color, identifying it as neutral fat (triglycerides). Brightfield. (B) Using phase contrast microscopy, the hyaline matrix of the cast is easy to see. Granular Casts Fig. 27 Granular cast with several disintegrating renal tubular cells embedded. One cell now appears as a large “coarse” granule that is colored by methemoglobin. Brightfield. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Urine Specimen Types, Collection, and Preservation Quality Assessment and Safety Routine Urinalysis—the Physical Examination The Kidney Stay updated, free articles. 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section epub:type=”chapter” id=”c0007un” role=”doc-chapter”> Urine Sediment Image Gallery Outline Outline Artifacts/Contaminants, 195 Blood Cells, 197 Red Blood Cells, 197 White Blood Cells, 197 Casts, 198 Cellular Casts, 198 Granular Casts, 200 Hyaline Casts, 201 Waxy Casts, 202 Crystals, 203 Ammonium Biurate Crystals, 203 Bilirubin Crystals, 203 Calcium Carbonate Crystals, 203 Calcium Oxalate Crystals, 204 Cholesterol Crystals, 205 Cystine Crystals, 205 Drug Crystals, 205 Phosphate Crystals, 206 Urate Crystals, 207 Uric Acid Crystals, 208 Epithelial Cells, 208 Fat Droplets and Oval Fat Bodies, 210 Microorganisms, 211 Bacteria, 211 Trichomonads, 212 Yeast, 212 Miscellaneous Formed Elements, 213 Hemosiderin, 213 Mucus, 213 Sperm, 214 Artifacts/contaminants Fig. 1 Three air bubbles trapped beneath a coverslip observed using low-power (100 ×) magnification. Numerous white blood cells (WBCs) are also present. Appearance varies with condenser and aperture positions of microscope. Brightfield. Fig. 2 Three air bubbles trapped beneath the coverslip. Compare with Fig.1; adjustment of the microscope’s condenser and aperture can change the appearance of air bubbles. Brightfield. Fig. 3 When plastic commercial standardized slides are used, fragments of plastic (red arrows) can be present in the sediment. Red blood cells, yeasts, and pseudohyphae are also present. Fig. 4 Three starch granules, all highly refractile, with slightly differing appearances, yet each has a centrally located dimple. Fragments of plastic (red arrows) are also present. Fig. 5 A starch granule (black arrow) demonstrating a characteristic dimple. When glass slides and coverslips are used, glass fragments (red arrows) can be present. Numerous white blood cells are also present. Fig. 6 Talc fragments (arrows)—note layering, refractility, and irregular edges. Also a single fiber—its refractility and shape helps distinguish it from a cast. Brightfield. Fig. 7 An absorbent fiber (diaper or hygiene product). Note its flat appearance with perforations and its strong refractility. Brightfield. Fig. 8 A clothing fiber. Its strong refractility, frayed ends, and flatness aid in its proper identification. Brightfield. Blood Cells Red Blood Cells Fig. 9 Numerous intact and ghost red blood cells (RBCs) (arrows). Intact RBCs have a characteristic appearance caused by the hemoglobin within them. In contrast, ghost RBCs have lost their hemoglobin but retain an intact cell membrane. This urine was hypotonic (dilute; low specific gravity). Many of the RBCs appear swollen and rounded because of the diffusion of fluid into the cells. Fig. 10 Red blood cells (RBCs) in hypertonic urine (concentrated; high specific gravity). Many of the cells in this field of view have lost their typical biconcave shape and become echinocytes (i.e., crenated). This happens when fluid moves out of the cell in an attempt to achieve balance with the tonicity of the environment. Consequently, the cell membrane shrinks, forming folds or projections, a process that is reversible. Near the center is a single schizocyte form—fragmented RBCs with three pointed extremities. Brightfield. White Blood Cells Fig. 11 White blood cells and a single squamous epithelial cell. Note the size similarity between the squamous cell nucleus and the diameter of the white blood cells. Brightfield. Fig. 12 Five white blood cells. Note that the lobed nuclei in several of these neutrophils are readily apparent; whereas in degenerating cells, the nucleus has become mononuclear. Brightfield. Fig. 13 (A) Three white blood cells, a single red blood cell, and a squamous epithelial cell. Note the size similarity between the squamous cell nucleus and the diameter of the white blood cells. Brightfield. (B) Numerous white blood cells and two red blood cells (just left of center). Many of the white blood cells show evidence of degeneration. Brightfield. Fig. 14 Many macrophages as well as other white blood cells in urine sediment. Cytospin preparation, Wright stained, Brightfield. Casts Cellular Casts Fig. 15 A mixed cellular cast. Brightfield. Fig. 16 Renal tubular epithelial cell cast with one end broken or incompletely formed. Fig. 17 Renal tubular epithelial cell cast. Note the cuboidal shape of the entrapped cells. Also, the nuclei become more apparent when adjusting the fine focus up and down during the microscopic examination. Fig. 18 A renal tubular cell cast and several free-floating renal tubular cells in a Sternheimer-Malbin stained sediment. A highly refractile glass fragment is present in the center of this field of view. Fig. 19 A cast with oval fat bodies (i.e., renal tubular cells that contain fat). In this Sternheimer-Malbin stained sediment, the fat droplets take on a yellow or greenish appearance. Fig. 20 A white blood cell cast. Note the spherical or round shape of entrapped cells. Fig. 21 A mixed cell cast. This cast contains both white blood cells and red blood cells (arrow). Fig. 22 A mixed cell cast, predominantly red blood cells. Fig. 23 A red blood cell cast. Red blood cells are dispersed in the hyaline matrix of this cast. Fig. 24 A red blood cell cast packed with red blood cells. Fig. 25 A fatty cast with fat droplets of varying size within the cast matrix; a fat droplet the size of a red blood cell is most notable mid-cast. Note the deteriorating renal epithelial cell within the cast at its end (lower right). (A) Brightfield. (B) Polarizing microscopy with first-order red compensator. Note that the fat droplet mid-cast demonstrates a Maltese-like cross pattern indicating that it is a cholesterol droplet. Fig. 26 Oval fat bodies in a hyaline matrix (i.e., a fatty cast). (A) Using Sudan III stain, the fat in the oval fat bodies has taken on the characteristic terra-cotta or red-orange color, identifying it as neutral fat (triglycerides). Brightfield. (B) Using phase contrast microscopy, the hyaline matrix of the cast is easy to see. Granular Casts Fig. 27 Granular cast with several disintegrating renal tubular cells embedded. One cell now appears as a large “coarse” granule that is colored by methemoglobin. Brightfield. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Urine Specimen Types, Collection, and Preservation Quality Assessment and Safety Routine Urinalysis—the Physical Examination The Kidney Stay updated, free articles. Join our Telegram channel Join
