Cholesterol crystals may be seen in renal tubular disease. These crystals look like plates of glass, sometimes with a notch out of one corner (top image). Under polarized light, they exhibit a stained glass effect (bottom image). These crystals are rarely seen unless the specimen has been refrigerated because the lipids remain in droplet form. Large amounts of protein, lipid droplets, fatty casts, or oval fat bodies should be found along with cholesterol crystals. Cholesterol crystals are found in acid or neutral urine.
