Cytomorphologic and immunocytochemical characteristics of reactive renal tubular cells in renal glomerular disease.
OBJECTIVE
To investigate the morphologic characteristics and immunocytochemical reaction to vimentin of the reactive renal tubular cells (RRTCs) in renal glomerular disease.


METHODS
We prospectively evaluated the urine cytology of renal glomerular disease in 40 patients who underwent renal biopsy. The cytology and renal biopsy specimens were analyzed for vimentin immunostaining.


RESULTS
A total of 40 urine samples from the 40 patients were cytologically analyzed, and RRTCs were found in 25 samples (25 of 40, 62.5%). These RRTCs showed clear or vacuolated cytoplasm, intracytoplasmic pigmented granules (hemosiderin or lipofuscin) and large nuclei with round to irregular nuclear contours and prominent nucleoli. These cells were seen singly and in acinar clusters. Occasionally RRTCs were embedded in a cast (RRTC cast). Immunocytochemicalstudy revealed RRTCs to be positive for vimentin (25 of 25, 100%).


CONCLUSIONS
Frequently observed characteristic cytomorphologic features of RRTCs included RRTC cast, acinar cluster, vacuolated cytoplasm and intracytoplasmic pigmented granules. A diagnosis of RRTCs can be suggested based on these cytomorphologic features. However, a definitive diagnosis will require immunocytochemical confirmation for vimentin.
Laboratory of Pathology, Department of Medical Technology, Faculty of Health Sciences, Kagawa Prefectural College of Health Sciences, Kagawa, Japan. ohsaki@chs.pref.kagawa.jp
Hiroyuki
H
Ohsaki
Reiji
R
Haba
Toru
T
Matsunaga
Muneo
M
Nakamura
Hideyasu
H
Kiyomoto
Eiichiro
E
Hirakawa
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002467:Cell Nucleus / Q000473:pathology; D002648:Child; D005260:Female; D006485:Hemosiderin / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007674:Kidney Diseases / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D007684:Kidney Tubules / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008062:Lipofuscin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D014556:Urine / Q000166:cytology / Q000502:physiology; D014746:Vimentin / Q000378:metabolism
D008062:Lipofuscin; D014746:Vimentin; D006485:Hemosiderin