URINE SEDIMENT CONSTITUETNS

RBC (0-3/HPF)

• Smooth, non nucleated, biconcave disks

• about 6-8 um in diameter

• Concentrated or hypersthenuric urine

Ghost cells

Dilute or hyposthenuria urine-lysed colorless membranes

Crenated

Shrunken with spiky edges

Hematuria

Presence of increased RBCs in urine may indicate glomerular disease, urinary tract infection, trauma or renal calcul

WBCs (0-8/HPF)

• Larger than RBCs about 10-12 um, with visible granular cytoplasm and sometimes lobed nuclei (especially neutrophils)

• An increase number suggest infection of urinary tract

Neutrophils

Most predominant WBC

Brownian Movement

Producing a sparkling appearance as GLITTER CELLS

Mononuclear Cells 

Includes lymphocytes, monocytes, macrophages; Increased numbers suggest chronic inflammation, renal tubular injury, or viral infections.

Squamous epithelia cell

largest cells found in urine sediment, abundant, irregular cytoplasm and a centrally or eccentrically located prominent nucleus, from the lining of the distal urethra and vagina, usually considered contaminants in urine specimens, especially in females, due to their origin.

Clue cells

Squamous epithelial cells covered with GARDERELLLA VAGINALIS - presence is significant in the diagnosis of bacterial vaginosis

Transitional epithelial cells

appear spherical, polyhedral, or caudate (taillike projection), typically with a centrally located nucleus. Lining of the RENAL PELVIS, CALYCES, URETERS, AND BLADDER, UPPER PORTION OF MALE URETHRA. A few cells may normally be present in urine Increased numbers may indicate infection, inflammation, or catheterization.

Urothelial carcinoma

Large clusters of transitional cells

Renal Tubular Epithelial Cell

MOST CLINICALLY SIGNIFICANT epithelial cells, from nephrons, proximal and distal convoluted tubules and collecting ducts. Regular, polyhedral, cuboidal or columnar usually smaller than transitional cells. ECCENTRIC (offcenter) nucleus . Indicate RENAL TUBULAR INJURY OR NECROSIS

Oval Fat Bodies

When RTE cells absorb lipids they become ______ commonly seen in NEPHROTIC SYNDROME

Bubble cells

RTE cells with large, nonlipid vacuoles associated with acute tubular necrosis.

Bacteria

Tiny rods (bacilli) or cocci that may form chains or clusters, often moving due to Brownian motion (not true motility). Clinical significance: Can lead to cystitis, pyelonephritis, prostatitis, or sepsis

True UTI

Presence of Bacteria + WBC

Escherichia coli

most common cause; major pathogen in uncomplicated UTIs

Yeast

Associated conditions: Diabetes mellitus, prolonged antibiotic therapy, immunosuppression, pregnancy, and vaginal moniliasis. Small, oval, budding cells; may form PSEUDOHYPHAE, helping differentiate them from RBCs.

Trichomonas vaginalis

• Most frequently encountered parasite in urine.

• Motile, flagellated protozoan with a jerky, tumbling movement.

• Associated with sexually transmitted infection disease due to reinfection between partners).

Ping pong

Trichomoniasis is also called

Enterobius vermicularis

• Most common fecal contaminant in urine sediment

• Eggs or occasionally adult worms may appear.

• Indicates poor hygiene or contamination during specimen collection

Schistosoma haematobium

• Eggs with terminal spines may be seen in urine.

• Endemic in parts of Africa and the Middle East.

• Associated with urinary schistosomiasis, which can lead to hematuria, chronic cystitis, hydronephrosis, and bladder carcinoma.

Spermatozoa

• May be present after sexual intercourse, masturbation, or retrograde ejaculation.

• Oval heads with long, thin tails; may clump together.

• Generally not pathologic, but can be significant in fertility studies, forensic cases, and pediatric patients (possible sexual abuse concerns).

• In POST VASECTOMY , detection may indicate incomplete procedure or recanalization.

Mucus Threads

Appearance: Long, thin, thread-like, wavy, or ribbon-like strands with low refractive index, often overlooked unless stained. Primarily from the genitourinary tract epithelium. Increased amounts may be seen in UTIs, inflammation, or irritation of the urinary tract

Tamm-Horsfall Protein (uromodulin)

glycoprotein secreted by the thick ascending loop of Henle and distal convoluted tubules