Abstract : Objective: In clinical cytology the presence of reactive renal tubular cells (RRTCs) in voided urin
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Abstract : Objective: In clinical cytology the presence of reactive renal tubular cells (RRTCs) in voided urine can be a diagnostic pitfall since such cells can mimic cancer cells. The purpose of this study was to investigate the morphologic characteristics and immunocytochemical reaction to vimentin of the RRTCs in renal glomerular disease. Study Design: 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 (25/40, 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). Immunocytochemical study revealed RRTCs to be positive for vimentin (25/25, 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. - Slides
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