Maltese Cross Sign Fatty Casts

Formed by the breakdown of lipid rich epithelial cells these are hyaline casts with fat globule inclusions yellowish tan in color.

Maltese cross sign fatty casts. Fatty casts oval fat bodies maltese cross pattern under polarized light. Fatty casts can appear under two types. Start this article has been rated as start class on the project s quality scale. 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.

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. Uric acid many different shapes diamond rhombic prism or rosette. Fatty degeneration of the tubular epithelium in degenerative tubular disease. 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.

John now the. This is often referred to as a maltese cross sign because of the resemblance of the tetrad to the cross on peripheral blood smear. This type should be reported as a hyaline fatty cast. In the first type the embedded fat droplets are parsed in the hyaline matrix.

It has also been reported as a sign following fat embolism. Because of the maltese cross interference pattern when viewed under polarized light the fatty casts are easy to identify. This formation is indicated by the white arrow in the bottom image. Fatty casts are characteristic of degenerative tubular disease and are frequently associated with heavy proteinuria.

Renal disease such as nephrotic syndrome produces a fatty cast composed of cholesterol that also has a maltese cross appearance on light microscopy. They are pathognomonic for high urinary protein nephrotic syndrome. When lipiduria occurs epithelial cells or macrophages contain endogenous fats. The fatty casts are casts that contain lipid droplets sequestrated in a hyaline matrix.

It is a heraldic cross variant which developed from earlier forms of eight pointed crosses in the 16th century. Although chiefly associated with the knights hospitaller order of st. In the netherlands the maltese cross forms the basic form for the three highest royal orders. 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.

If cholesterol or cholesterol esters are present they are associated with the maltese cross sign under polarized light. Fatty casts containing cholesterol will produce classic maltese cross formations under polarized light.