Case
178 With discussion |
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Versión
en Español |
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CASE 178 (December 2020)
Clinical information
A 17-year-old young man, with a history of renal transplantation from a cadaveric donor 15 months before, due to urethral valves, presented elevated serum cretinin: 1.9 mg/dL (previous, 2 months before, 0.9 mg/dL). High tracrolimus levels, with a history of poor adherence in several previous controls.
Urinary cytology is done among the initial studies. Look at the pictures.
Figure 1. H&E, X100. High cellularity.
Figure 2. H&E, X400.
Figure 3. H&E, X400.
Figure 4. H&E, X400.
Figure 5. H&E, X400. Comet cell.
Figure 6. H&E, X400.
Figure 7. H&E, X400. A cellular cast.
Figure 8. H&E, X400. Another cast.
Figure 9. H&E, X400. Another one cast, with cellular degeneration.
What is your diagnosis?
What are the characteristics of the casts in figures 7, 8, and 9?
Do these have any importance for the diagnosis?