Maltese Cross Sign Fatty Casts

Crystals in acid urine.
Maltese cross sign fatty casts. In the netherlands the maltese cross forms the basic form for the three highest royal orders. Fatty casts are an uncommon finding that is always abnormal. Fatty casts are characteristic of degenerative tubular disease and are frequently associated with heavy proteinuria. There also may be free globules of fat in the urine.
When lipiduria occurs epithelial cells or macrophages contain endogenous fats. Fatty casts containing cholesterol will produce classic maltese cross formations under polarized light. The maltese cross is a cross symbol consisting of four v or arrowhead shaped concave quadrilaterals converging at a central vertex at right angles two tips pointing outward symmetrically. Lipiduria or lipuria is the presence of lipids in the urine lipiduria is most frequently observed in nephrotic syndrome where it is passed as lipoproteins along with other proteins.
They are seen in nephrotic syndrome acute tubular necrosis and hepatorenal syndrome. Fatty casts oval fat bodies maltese cross pattern under polarized light. This is often referred to as a maltese cross sign because of the resemblance of the tetrad to the cross on peripheral blood smear. Although chiefly associated with the knights hospitaller order of st.
They may be confused with cellular. They are pathognomonic for high urinary protein nephrotic syndrome. It is a heraldic cross variant which developed from earlier forms of eight pointed crosses in the 16th century. They vary in length and width and are composed of irregular refractile droplets of fat which show a maltese cross polarization pattern bound by matrix.
Fatty degeneration of the tubular epithelium in degenerative tubular disease. If cholesterol or cholesterol esters are present they are associated with the maltese cross sign under polarized light. Uric acid many different shapes diamond rhombic prism or rosette. Maltese cross is within the scope of the heraldry and vexillology wikiproject a collaborative effort to improve wikipedia s coverage of heraldry and vexillology if you would like to participate you can visit the project page where you can join the project and see a list of open tasks.
Renal disease such as nephrotic syndrome produces a fatty cast composed of cholesterol that also has a maltese cross appearance on light microscopy. Start this article has been rated as start class on the project s quality scale. Choose from over a million free vectors clipart graphics vector art images design templates and illustrations created by artists worldwide. John now the.
This formation is indicated by the white arrow in the bottom image. Lipid droplets associated with gross proteinuria are round and translucent without internal structure whereas the particles in our patient were of roundish to polygonal shape colourless and had a nucleus like centre a pattern which. Formed by the breakdown of lipid rich epithelial cells these are hyaline casts with fat globule inclusions yellowish tan in color.