Vacuolated cast from the urinary sediment of a patient with diabetic nephropathy. The matrix of the cast is hyaline, and contains vacuolated cell-like bodies (degenerated tubular epithelial cells?). Sternheimer stain, X400.

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Vacuolated cast from the urinary sediment of another patient with diabetic nephropathy. The matrix of the cast is granular or waxy, and contains a vacuolated cell-like body stained blue (degenerated tubular epithelial cell?). The mechanism of vacuolated cast formation is unknown, but such casts can always be found in the urinary sediment of patients with severe nephrotic syndrome originating from primary renal disease, diabetes, systemic lupus erythematosus, and so on. Sternheimer stain, X400.