Cells Found In Urine
Cytology can be assessed in several ways including exfoliative cytology, Fine needle aspiration technique and using imprint biopsies in intraoperative leisions.
But in this article , going to see about the cells present in voided urine sedement which comes under Exfoliative cytology
Mainly there are 7 types of cells in urine sediment.
1. Epithelial cells
Usually , Epithelial cells are important to lines the surfaces of your body.They can be categorized in to
- Tubular epithelial cells
- Transitional epithelial cells &
- Squamous epithelial cells
Usually few number of epithelial cells can be seen in normal voided urine. However , a large amount may indicate an infection, kidney disease, or other serious medical condition.
Renal tubular cells are about 1/3 larger than WBCs. But the transitional cells appear as pear shape and they arise from renal pelvis or lower urinary tract. Squamous cells come from urethra and bladder. They are very large and having a flat prominant nucleus.
2. Red Blood Cells
Presence of >4 RBCs/ hpf is considered as abnormal. However, depend on the age of the patient this cut off point may vary. They contain No nuclei & , when viewed from side they have an hour glass appearance.
Presence of large number of RBCs in urine may suggest infection, trauma, renal calculi, tumors etc. However, presence of blood in the urine from menstrual contamination should not be considered as abnormal.
3. White Blood Cells – pus cells
Presence of >5 WBCs/ hpf is considered as abnormal.This also vary depend on the age.When we consider morphology , usually 1.5 – 2 x larger than a RBC , they are regularly round, colorless and have a grainy appearance.
However , The type of WBC cannot identify , but they are usually neutrophils.Anyway this clinical condition is called as pyuria and it may suggest infection, cystitis, pyelonephritis etc.
Bacteria found in urine include Gram-Negative bacillus and Gram positive cocci , most commonly Escherichia coli ,staphylococcus ,streptococcus , proteus etc,
It can not be confirmed simply according to the morphological characteristics , so the final result and its clinical significance must be based on bacterial culture results.
From the formation to the storage in the bladder of healthy people urine , there is no bacterial growth in the process.
Significant number of bacteria suggest urinary tract infection. Large number of bacteria can be found in old urine
samples which kept at room temperature, and due to skin contamination.
5. Yeast cells
- Yeast are oval , looking like RBCs , with strong refraction. Germs and pseudohyphae can be visible , commonly found in pregnant women urine , diabetes patients urine , or in alkaline urine.
They may occur in urine of immune deficient or immune suppressed patients. The most common species of yeast in urine in Candida albicans.
6. Trichomanas vaginalis
This is concerned as STD and it is a flagellate
Sometimes sperms can be seen in urine sediment. The clinical condition retrograde ejaculation results large number of spermatozoa in urine.