Cell Characteristics Clinical

significance/Origin
Squamous  Folded cell may  Linings of vagina
epithelial cell resembles casts  Vulva
 Prominent nucleus  LOWER male
 Reporting: words/lpf urethra

Clue cell  Granular cytoplasm  Bacterial vaginosis

caused by
Gardnerella
vaginalis

Transitional/Uroth  Different shapes:  UPPER male

elial cell because of the ability urethra
to absorb water from  Seen in
the filtrate pairs/clumps:
 Central nucleus- MAIN Malignancy/Viral
IDENTIFICATION infection
 Reporting: words/hpf

Renal tubular  PCT- Eccentric nucleus  Tubular damage:

epithelial cell and coarsely >2/hpf
granulated cytoplasm  Renal fragments:
(Confused with casts) >3 sheets of RTE
 DCT-Smaller and round
and finely granulated
(Confused with WBC)
 CD- Polygonal and
finely
granulated/Never
round
 Reporting: ave # or
Words/hpf

Jellieh Galang
Oval fat bodies  Highly retractile RTE  LIPIDURUA
cell
 Maltese cross under
polarizing microscope
 Reporting: ave #/hpf

Red blood cells  Hypersthenuric-  Glomerulonephriti

Crenated/crinckled s- Dysmorphic RBC
border  Schistosomiasis
 Confused with: Yeast
cell, Oil droplets and
air bubbles
 Normal: 0-3/hpf
 Correlate with
bleeding
Bubble cell  Non-lipid vacuole  Acute tubular
 Injured RTE cell necrosis

White blood cell  Infection or  Cystitis

inflammation in the  Pyelonephritis
genitourinary tract  Pratatitis

Neutrophil  “Glitter cell”

 Sternheimer stain-
Light blue

A- Usual appearance
B- With acetic acid

Jellieh Galang
Yeast cells  Small refractile oval  Moniliasis/Candid
cells aiasis
 Accompanied with
WBC

Bacteria  Gram negative bacilli  With WBC=

 Correlate with LE upper/lower UTI
 ReportingL words/hpf

Mucus thread  Long, Narrow wavy 

shreds/ thread like
 LOW refractive index

Spermatozoa

Artifatcs  A. Hair
 B. Pollen grain
 C. Talcum powder
 D. Air bubble
 E. Fat droplets
 F. Cloth fiber

Glove powder

ACIDIC URINE
Jellieh Galang
Amorphous urates  Yellow brown granules  Dissolved by heat
 Brick dust- refrigerated and NaOH
 pH greater than 5.5

Uric acid  Rhombic (Common)  Soluble when

 pH lower than 5.5 heated with NaOH

Calcium oxalate  Soluble in HCl

Dihydrate/Whedellite
(Common form)

Monohydrate/Whewellite

Sodium urates  Needle shaped  GOUT

arranged in fan/sheaf
like structure

Calcium sulfates  Cigarette-butt looking

 Star like

ALKALINE URINE

Jellieh Galang
  Hydroxy apatite
Calcium  Bushite
 Dissolves in HAc
phosphate  Magnesium phosphate
crystals

 Struvite
 Ammonium
Triple
magnesium sulphate  Proteus mirabilis
phosphate
 COFFIN LIDS

 Dissolves in HAc
Calcium
 Dumb-bell shaped with evolution of
carbonate
GAS

 Heat + Gl. HAc =

Ammonium  Thorny apples crystals
will go back to
biurate  SEEN in old specimen
URIC ACID

ABNORMAL CRYSTALS IN URINE

 Hexagonal plates
 Cyanide-
 Sulfur odor
nitroprusside test
 Confused with: URIC
Cystine  Sulivan Test
ACID
 Soluble: Ammonia
 Use polarizing
and dilute HCl
microscope to confirm

 Seen in
conjunction with
 Seen in refrigerated
Cholesterol fatty casts and
urine
Crystal OFB
 Rectangular plates
 Soluble:
Chloroform

 Acidic urine
Radiographic  Soluble in 10%
 Specific gravity=
dye crystal NaOH
markedly elevated

CRYSTALS ASSOCIATED WITH LIVER DISEASE

Jellieh Galang
  Morner’s test and
Nitrosonaphtol
 Sheaths of very fine test – SCREENING
Tyrosine needles  Chromatography-
 Acid/Neutral urine CONFIRMATORY
 Soluble:
Alkali/Heat

 MSUD (Leucine,
 Oily looking spheres
Isoleucine, Valine)
 Scallop crystals
 Confirm:
 Confused with FAT
Leucine CHROMATOGRAP
GLOBULES
HY
 Stain with Sudan
 Soluble: Hot alkali
black/Oil red O
or alcohol

 Soluble in HAC, HCl,

Bilirubin NaOH,Ether,  Hepatic disorder
Chloroform

CRYSTALS ASSOCIATED WITH MEDICATIONS

 Lignin/Dextrin/Ol
d yellow
 Shocks of wheat
newspaper test-
 Confused: Calcium
Sulfonamides SCREENING
phosphate and Uric
 Diazo reaction-
acid
CONFRIM
 Soluble: ACETONE

 Wing like bundles

Indinavir
 Acidic, Neutral,
crystals
Alkaline

CASTS

 Most commonly
encountered cast
Hyaline
 Moot difficult to detect
casts
 MILDEST
 0-2/lpf - NORMAL

Jellieh Galang
  Most fragile
 Bleeding in the
RBC cast  Muddy brown cast-
UPPER URINARY
RBC start to hemolyze

 Kidney infection:
WBC cast +
Bacteria + Protein
 Glomerulonephrit
WBC cast  Mostly NEUTROPHILS is: WBC cast +
RBC cast
 Acute interstitial
nephritis: WBC
cast only

Epithelial  RTE is the only


cast epithelial cast

 Gram neg bacilli

Bacterial
 Consider if: WBC cast, 
cast
Free WBC, Bacteria

Mixed
cellular cast

Jellieh Galang
  Lipiduria
 Nephrotic syndrome=
Fatty cast
Lipiduria + heavy
proteinuria

 Seconf most common

Granular
cast seen
cast
 Prolonged stasis

 FINAL DISINTEGRATING
FORM
Waxy cast  Higly refractile,
homogenous
 1= SEVERE

 Renal failure cast

Broad cast  Error: Fecal debris
 Granular and waxy

Jellieh Galang
Jellieh Galang