Examination of the urine; a manual for students and practitioners . anular cast; d, brown granular cast; e, granular castwith normal and abnormal blood adherent; /, granular cast with renalcells adherent; g, granular cast with fat and a fatty renal cell adherent(Ogden). granules probably come from the disintegration of renalepithelia, or partly from the destruction of pigmented granules, also called brown granules,probably derive their color from blood-pigment. Granu-lar casts may be stained yellow or brown by bile. These casts vary considerably in dimension, and areoften broke
Examination of the urine; a manual for students and practitioners . anular cast; d, brown granular cast; e, granular castwith normal and abnormal blood adherent; /, granular cast with renalcells adherent; g, granular cast with fat and a fatty renal cell adherent(Ogden). granules probably come from the disintegration of renalepithelia, or partly from the destruction of pigmented granules, also called brown granules,probably derive their color from blood-pigment. Granu-lar casts may be stained yellow or brown by bile. These casts vary considerably in dimension, and areoften broken, the end often being concave or zigag. Some- CASTS 305 times they show fragments of epithelial cells and transitionforms which prove that the granules are derived from theepithelia, and that granular casts are degenerated forms ofepithelial casts. They may be found in any inflammatorycondition of the kidney, and do not indicate any particulardisease of this organ. Their presence is about equallysignificant with that of renal epithelia as evidence of Fig. 64.—i, Epithelial cast; 2, blood-cast; 3, pus-cast; 4, fatty cast;5, fatty cast with a compound granule and fatty renal cell adherent(crystals of the fatty acids protruding) (Ogden). Epithelial Casts.—When a cast is entirely coveredwith renal epithelium, it is called an epithelial cast. Thebasis of this formation may be either hyaline or granular,and the cells may be imbedded or only adherent. Whenonly one or two cells adhere to a hyaline cast, the term hy-aline with adherent epithelium should be used. Theoutlines of the cells are not always distinguishable, buttheir nuclei usually stand out prominently. The cellsmay contain fat-globules, and leukocytes may adhere tothese casts along with the epithelium. Perfectly formed epithelial casts appear in urine undersuch conditions only as cause the separation of renal epi- 3°6 EXAMINATION OF THE URINE thelium in the entire circumference of a renal alway
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