CELLS DESCRIPTION CLINICAL SIGNIFICANCE

REDBLOOD CELLS - Nonnucleated biconcave - Elevated RBC’s are seen in the urinary tract infection, Trauma to the
- 6-8 micrometer kidneys, or menstrual contamination.
• Hypotonic urine – RBC’s appears colorless with membrane intact and - Dysmorphic RBC’s are associated with glomerular damge
regular, often lose their hemoglobin.
• Hypertonic urine - RBC’s loses their biconcave shape, the membrane
becomes irregular
• Dysmorphic – RBC’s vary in size and shape, often fragmented

WHITE BLOOD CELLS • Colorless, 12 micrometers in size • Neutrophils – Bacterial infection

• Neutrophils are granular and multinucleated • Eosinophils – drug induced interstitial nephritis or parasitic infection
• Lymphocytes and monocytes are granular • Lymphocytes – Renal transplant
• Hypotonic urine : sparkling cytoplasm in the neutrophils • Monocytes – Chronic inflammation

EPITHELIAL CELLS • 60 – 100 micrometers in size • Clue cells are pathological and indicative of vaginal infection caused
• Nucleus is in the center and is the size of rbc by GARDNERELLA VAGINALIS
• CLUE CELL: squamous epithelial cells covered with Gardnerella
coccobacillus gives the cell a granular apperance

TRANSITIONAL EPITHELIAL CELLS • Smaller than squamous epithelial cells • Infection, inflammation , renal stones, bladder cancer and
• Can be spherical, pear-shaped, polyhedral, or caudate shaped w/ a catheterization
centrally located nucleus
• Cells contain a moderate amount of cytoplasm
RENAL TUBULAR EPITHELIAL CELLS (RTE) • Collecting duct cells are polygonal or cuboidal with a large nucleus • Necrosis of the renal tubule
• Proximal tubular cells are large in size rod in shape • Renal tubular damage
• Distal tubular cell are smaller and more round to oval • Exposure to heavy metals

OVAL FAT BODIES • Renal tubular cells laden with fat • Nephrotic Syndrome
• Polarizing microscopy demonstrate a MALTESE CROSS FORMATION • Glomerular dysfunction
• Renal tubular necrosis

BACTERIA • Small spherical cocci and rod shaped (bacilli) structures • Urinary Tract infection
• Can appear single or in pairs or chains • Bacteria should be seen w/ increased WBC, positive in leukocyte
esterase and nitrite

YEAST • Colorless, small, retractile round to oval structure • Candida Albicans – yeast MOST OFTEN INDICATES VAGINAL
• SINGLE/BUDDING SECRETION CONTAMINATION OR VAGINAL INFECTION
• Seen with Immunocompromised and diabetic patient
Ex. HIV patients

TRICHOMONADS • Trophozoite- pear shapes flagellate with an underlying membrane cause • Trichomonas vaginalis
rapid flitting motion
PINWORM • Football shape with one flattened side and one round side • Found as a result of FECAL CONTAMINATION
• Eggs are transparent • School aged children

D-shaped egg

SCHISTOSOMA HAEMATOBIUM • Football shaped with a terminal spine • Eggs be found in urine and are ENDEMIC TO AFRICA AND MIDDLE
• Cell wall looks thick EAST

SPERM • SPERMATOZOA – tapered oval head w/ long delicate flagella like tails • After sexual intercourse, masturbation and nocturnal emission
• Ex. Prostate Cancer

MUCUS • Single or clumped ribbon-like or thread-like structures • No clinical significance

• Subdued light is required when using bright field microscopy • Indication of UTI

HYALINE CASTS • Colorless, Homogenous Matrix • Glomerulonephritis

• Composed of uromodulin • Pyelonephritis
• Low refractive index to bright field microscopy • Chronic renal disease
• Congestive heart failure
• Stress and exercise
RBC CASTS • Orange-red color, cast matrix containing RBC’s • Glomerulonephritis
• RBC’s dispensed in the protein matrix • Strenuous exercise

WBC CASTS • Cast matrix containing WBC’s • Pyelonephritis

• Prominent nuclei found in a cylindrical matrix with parallel side and • AIN
rounded

BACTERIAL CASTS • Bacilli bound to protein in matrix • Pyelonephritis

• Urinary Tract Infection

EPITHELIAL CELL CASTS • RTE cells attached to protein matrix • Renal tubular damage
• They have a high refractive index • Glomerulonephritis

GRANULAR CASTS • Coarse and fine granules in a cast matrix • Glomerulonephritis

• Coarse granules in Dark in color • Pyelonephritis
• Stress and exercise

same as with hyaline cast

WAXY CASTS • Highly refractile cast with jagged ends and notches • Stasis of urine flow
• Colorless - gray • Chronic renal failure
FATTY WAX CASTS • Fat droplet and oval fat bodies attached to protein matrix • Nephrotic syndrome
• Highly refractile • Toxic tubular necrosis
• Diabetes mellitus
• Crush injuries

BROAD CASTS • Wider than normal cast matrix • Extreme urine stasis
• Formed due to distention of the collecting tubules where they are formed • Renal failure

URIC ACID CRYSTAL • Yellow-brown, rosettes and wedges • Urinary stones

• Gout
• High purine metabolism
• Acute febrile conditions
• Leukemia patient

AMORPHOUS URATES CRYSTAL • Appear as yellow to reddish granules • No clinical significance

• Brick dust • SPOMAC (sodium, potassium, magnesium, calcium)

SODIUM URATES • Colorless or yellowish • No clinical significance

• Slender needles w/ blunt ends
CALCIUM OXALATE CRYSTAL • Colorless • Frequently can be found in normal urine after ingesting oxalate rich
• Envelopes , oval, dumbbell food such as tomatoes spinach, orange, fruit juice, vitamin C and
chocolate
• Pathological condition include ethylene glycol poisoning, liver
disease and renal calculi

AMORPHOUS PHOSPHATE CRYSTAL • White -colorless • No clinical Significance

TRIPLE PHOSPHATE CRYSTAL • Colorless Prism • Associated with UTI

• “Coffin lids” • No clinical significance

CALCIUM PHOSPHATE CRYSTAL • Colorless – grayish white • Renal Stones

• “Thin Needles” • Normal in Urine

AMMONIUM BIURATE CRYSTAL • Yellow-brown • Urine that is nor properly stores

• “Thorny apples” • Ammonia produced by urea splitting bacteria
CALCIUM CARBONATE CRYSTAL • Colorless, Small • No Clinical significance
• “Dumbbell Shape”