Epithelial Cells in Renal Pathology
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Questions and Answers

What is another name for transitional epithelial cells?

  • Squamous epithelial cells
  • Epithelial lining cells
  • Urothelial cells (correct)
  • Renal tubular cells
  • What cell sizes are transitional epithelial cells typically classified as?

  • 10-15um
  • 5-10um
  • 20-30um (correct)
  • 30-40um
  • Which of the following conditions can lead to increased transitional epithelial cells?

  • Glomerulonephritis
  • Dehydration
  • Catheterization (correct)
  • Hematuria
  • What is a distinguishing feature of renal tubular epithelial cells compared to amorphous cells?

    <p>Motility</p> Signup and view all the answers

    Which type of cell is characterized by a rectangular, polyhedral, or cuboidal shape with an eccentric nucleus?

    <p>Renal tubular epithelial cells</p> Signup and view all the answers

    Which cells are classified as mononuclear cells?

    <p>Lymphocytes and monocytes</p> Signup and view all the answers

    What type of urine condition is associated with the presence of ghost cells?

    <p>Hypotonic urine</p> Signup and view all the answers

    What is a typical source of error when examining urine samples?

    <p>Oil droplets</p> Signup and view all the answers

    What remedy is suggested for reducing sources of error in urine analysis?

    <p>Add 2% acetic acid</p> Signup and view all the answers

    Which of the following is NOT a characteristic of red blood cells (RBCs)?

    <p>Nucleated structure</p> Signup and view all the answers

    What is the size range of squamous epithelial cells?

    <p>30-50 μm</p> Signup and view all the answers

    Which of the following conditions is associated with the presence of tubular injury?

    <p>Acute tubular necrosis</p> Signup and view all the answers

    What type of bodies are identified with lipid stains?

    <p>Renal tubular fat bodies</p> Signup and view all the answers

    How can bubble cells be characterized?

    <p>Presence of numerous lipid vacuoles</p> Signup and view all the answers

    Which microscopy technique is used to identify cholesterol in renal tubular fat?

    <p>Polarizing microscope</p> Signup and view all the answers

    Where are squamous epithelial cells primarily found?

    <p>Linings of the vagina and lower male urethra</p> Signup and view all the answers

    What structural form is observed in severe yeast infections?

    <p>Branched mycelial forms</p> Signup and view all the answers

    What defines the primary characteristic of RTE cells with non-lipid vacuoles?

    <p>Dilatation of the endoplasmic reticulum</p> Signup and view all the answers

    Which of the following pairs is correctly associated with renal tubular fat bodies?

    <p>Lipid stains - Nephrotic syndrome</p> Signup and view all the answers

    Which of the following is a known marker for urinary bladder cancer?

    <p>NMP (Nuclear Matrix Protein)</p> Signup and view all the answers

    What is the shape and movement characteristic of Trichomonas vaginalis?

    <p>Pear-shaped with jerky motility</p> Signup and view all the answers

    Which of the following parasites is not mentioned in association with urine?

    <p>Ascaris</p> Signup and view all the answers

    What description accurately matches the appearance of spermatozoa?

    <p>Oval, slightly tapered head with a long flagella-like tail</p> Signup and view all the answers

    When Trichomonas vaginalis is not moving, it may resemble which of the following?

    <p>White blood cells</p> Signup and view all the answers

    Which of the following conditions is associated with yeast infections?

    <p>Diabetes Mellitus</p> Signup and view all the answers

    What is identified by Hansel stain?

    <p>Urinary eosinophils</p> Signup and view all the answers

    What does 2% acetic acid primarily lyse in the context of distinguishing cells?

    <p>Red blood cells (RBCs)</p> Signup and view all the answers

    What is the motion type described for Trichomonas vaginalis?

    <p>Jerky motility</p> Signup and view all the answers

    What does the Gram stain differentiate?

    <p>Gram positive and Gram negative bacteria</p> Signup and view all the answers

    Which stain is used to identify free fat droplets and lipids in cells?

    <p>Lipid stains</p> Signup and view all the answers

    What does Prussian blue stain identify in cells?

    <p>Hemosiderin granules</p> Signup and view all the answers

    What is the significance of a carbocyanine stain?

    <p>It stains nuclear membranes, mitochondria, and cell membranes.</p> Signup and view all the answers

    What condition is indicated by a significant number of eosinophils in urine?

    <p>Inflammation</p> Signup and view all the answers

    Which of the following is predominantly stained by Phenathridine?

    <p>DNA</p> Signup and view all the answers

    Study Notes

    Squamous epithelial cells

    • RTE cells with abundant, irregular cytoplasm and prominent nucleus
    • Found in the lining of:
      • vagina
      • female urethra
      • lower male urethra
    • Associated with:
      • Tubular injury
      • Variations
      • OFB: Also known as renal tubular fat bodies
    • Lipid containing RTE cells
    • Seen in lipiduria (nephrotic syndrome)
    • Identified by:
      • Lipid stains: TAG & Neutral fats
      • Polarizing microscope: Cholesterol-MALTESE CROSS formation
    • Bubble cell:
    • RTE cell with non-lipid vacuoles
    • Injured cells with dilated endoplasmic reticulum
    • Seen in acute tubular necrosis

    Transitional epithelial cells

    • Also known as urothelial or bladder cells
    • Found in:
      • renal pelvis
      • calyces
      • ureters
      • urinary bladder
      • proximal urethra
    • Increased in:
      • Catheterization: singly, pairs, or clumps (syncytia)
    • Abnormal morphology
      • Malignancy or viral infection

    Renal tubular epithelial cells

    • Proximal tubular epithelial cells
    • Found in the lining of renal tubules
    • Rectangular, polyhedral, cuboidal, or columnar with eccentric nucleus
    • May be stained by:
      • bilirubin
      • hemosiderin
    • RTE cells from the DCT may be mistaken for WBCs

    White Blood Cells (WBCs)

    • NV = 0-5 or 0-8 / HPF
    • Increased numbers indicate:
      • presence of infection or inflammation
    • Neutrophils:
    • Most predominant
    • Granulated and multilobed
    • In hypotonic urine:
    • Swell
    • Granules undergo movement, producing a sparkling appearance (glitter cells)
    • When dying, form blebs and finger-like projections (myelin forms)
    • Eosinophils
      • NV = 4%
      • Significant= >4%
      • Associated with:
        • Allergic interstitial nephritis (AIN)
        • Drug-induced nephritis
        • Acute pyelonephritis (APN)
    • Mononuclear cells
      • Lymphocytes, monocytes, macrophages, histiocytes
      • Normally present in small numbers
      • Increased lymphocytes: Renal transplant rejection
      • Increased monocytes and histiocytes: Chronic inflammation and radiation therapy

    Red Blood Cells (RBCs)

    • NV = 0-2 or 0-3 / HPF
    • Smooth, non-nucleated, biconcave disks
    • Hypertonic urine: Shrink
    • Hypotonic urine: Swell (ghost cells)
    • Glomerular membrane damage: Dysmorphic with projections or fragmented
    • Source of error: Yeasts, oil droplets, air bubbles, Monohydrate calcium oxalate crystals
    • Remedy for source of error: Add 2% acetic acid (lyses RBCs but not others)

    2% Acetic Acid

    • Lyses RBCs and enhances nuclei of WBCs
    • Distinguishes RBCs from WBCs, yeast, oil droplets, and crystals

    Lipid stains

    • Stain TAG and neutral fats orange-red
    • Identify free fat droplets, lipid containing cells and casts

    Gram Stain

    • Differentiates Gram positive and negative bacteria
    • Identifies bacterial casts

    Hansel stain

    • Stains eosinophilic granules
    • Identifies urinary eosinophils

    Prussian blue

    • Rous test
    • Stains structures containing iron
    • Identifies hemosiderin granules

    Phenathridine

    • Stains DNA blue

    Carbocyanine

    • Stains nuclear membranes, mitochondria, and cell membranes

    Bacteria

    • True UTI: E. coli
    • Most common cause of UTI: E. coli
    • Can also be caused by:
      • Staphylococcus
      • Enterococcus
    • Motility differentiates them from amorphous urates & phosphates

    Yeasts

    • True yeast infection: Candida albicans
    • Small, refractile oval structure that may or may not bud
    • Branching, mycelial forms are seen in severe infections
    • Associated with:
      • Diabetes mellitus (DM)
      • Vaginal moniliasis

    Parasites

    • Trichomonas vaginalis:
      • Most frequently encountered parasite in urine.
      • Pear-shaped flagellate with jerky motility
      • Agent of ping-pong disease
      • Reporting: Rare, few, moderate, many /HPF
      • When not moving, may resemble WBC, TEC, or RTE
    • Other parasites seen:
      • Trichuris
      • Strongyloides
      • Giardia
      • Various amoeba
      • Various insects/bugs (lice, fleas, bedbugs, mites, ticks)

    Spermatozoa

    • Oval, slightly tapered head
    • Long, flagella-like tail
    • After sexual intercourse

    Urinary Bladder Cancer Markers

    • NMP - Nuclear Matrix Protein
    • BTA - Bladder Tumor Antigen

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    Description

    This quiz explores the characteristics and significance of various types of epithelial cells, including squamous and transitional epithelial cells in renal pathology. It covers their locations, associations with conditions like nephrotic syndrome, and identification methods. Ideal for students and professionals in medical and biological sciences.

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