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Microscopic Sediment – White Blood Cells. Significance and source Few are normal - < 5 /hpf (Unlike RBCs, WBCs are capable of entering the urinary system - at will. They diapedise- move around in tissues, etc. by amoeboid movement.

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microscopic sediment white blood cells
Microscopic Sediment – White Blood Cells
  • Significance and source
    • Few are normal - < 5 /hpf (Unlike RBCs, WBCs are capable of entering the urinary system - at will. They diapedise- move around in tissues, etc. by amoeboid movement.
    • Larger amounts indicate inflammation/infection or seen in trauma, malignancy
    • Usually increased # of WBC is Associated with increased # of bacteria
microscopic sediment white blood cells2
Microscopic Sediment – White Blood Cells
  • Condition of increased WBC in the urine called pyuria / leukocyturia
    • usually are neutrophils can also be eosinophils or mononuclear - lymphs, monocytes, macrophages, etc.
    • Addressed on page 79
  • May be found in clumps - significant finding, should note on report.
microscopic sediment white blood cells3
Microscopic Sediment – White Blood Cells
  • Detection
    • High power
    • Fine adjustment
  • Description
    • Greyish-blue sheen
    • @ 10-12 microns in diameter
    • Fine cytoplasmic granulation, rough surface, may have irregular edges. Nuclei may be mono or poly, but often hard to see detail.
microscopic sediment white blood cells4
Microscopic Sediment – White Blood Cells
  • rough surface, may have irregular edges. Nuclei may be mono or poly, but often hard to see detail.
  • WBC can be confused with RBCs that are swollen, or renal epithelial cells.
microscopic sediment white blood cells5
Microscopic Sediment – White Blood Cells
  • WBC / leukocytes
  • Higher level of magnification than normally used in routine examination.
microscopic sediment white blood cells6
Microscopic Sediment – White Blood Cells
  • WBC
  • Leukocytes (unstained and Toluidine blue, hpf) 
microscopic sediment white blood cells9
Microscopic Sediment – White Blood Cells
  • Pus (degenerated neutrophils) – clumps / aggregates of neutrophils
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Microscopic Sediment – White Blood Cells
  • Eosinophils
    • Hansel stain preferred over Wrights to demonstrate presence of eosinophils in urine.
      • Increases seen in variety of conditions, most notably allergic reactions such as acute graft rejection, schistosomiasis, & acute allergic interstitial nephritis
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Microscopic Sediment – White Blood Cells
  • Lymphocytes
    • Occasionally seen in normal sediment
    • Increased numbers reported in acute allergic interstitial nephritis, graft rejection, etc.
    • Requires special staining to verify identity
  • Monocytes
    • Also can be found in above conditions
    • Also requires special staining to verify identity
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Microscopic Sediment – White Blood Cells
  • Macrophages
    • Usually of normal size with inclusions in cytoplasm.
    • Occasionally enlarged with one or more smaller cells engulfed.
    • Seen in acute inflammatory processes
    • When filled with fat droplets would be called oval fat bodies.
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Microscopic Sediment – White Blood Cells
  • WBCs, RBCs, cell debris, bacteria