Fatty Casts

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The page below is a sample from the LabCE course The Urine Microscopic: Microscopic Analysis of Urine Sediment. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about The Urine Microscopic: Microscopic Analysis of Urine Sediment (online CE course)
Fatty Casts

Fatty casts are highly refractile with the appearance of oil droplets on the cast matrix, as shown in the top image on the right. Fatty casts containing cholesterol will produce classic Maltese cross formations under polarized light. 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.