Rastlinske celice v urinu pri bolnikih z Brickerjevim mehurjem Plant cells in urine of patients with bricker ileal conduit

Abstract

V citoloških vzorcih občasno opazimo različne kontaminante, kot so smukec, kristali in nitke bombažne vate. Pri rutinskem pregledovanju citoloških vzorcev urina za malignost smo občasno opazili kontaminacijo preparatov z rastlinskimi celicami. Ugotovili smo, da so bile prisotne samo pri bolnikih, ki so imeli narejen obvod urina po Brickerju. Preparate urina za rutinsko citopatološko preiskavo smo pripravili z membransko filtracijo, jih fiksirali v Delaunayu in jih pobarvali po Papanicolaouu. Pregledali smo jih s svetlobnim mikroskopom. Pripravili smo tudi preparate iz kožnih podlog podjetij Coloplast in ConvaTec, ki jih stomisti uporabljajo za pritrditev vrečke na urostomo. Samo v Coloplastovih kožnih podlogah smo našli rastlinske celice, ki so bile morfološko enake rastlinskim celicam v urinu bolnikov z Brickerjevim mehurjem. Pripravili smo tudi preparate iz različnih snovi, ki so sestavni del kožnih podlog. Rastlinske celice so bile prisotne samo v preparatih guar gumija, ki ga pridobivajo iz semen rastline Cyamopsis tetragonoloba. Rastlinske celice so se po velikosti, obliki in barvi močno razlikovale od epitelijskih črevesnih celic, ki so prisotne v urinu bolnikov z Brickerjevim mehurjem, zato bi jih tudi neizkušen presejalec težko zamenjal z displastičnimi človeškimi celicami. Pomembno pa je, da vse elemente, ki jih najdemo v celičnih vzorcih, prepoznamo in da pri neobičajnih najdbah, kot so rastlinske celice, tudi razložimo, kako je prišlo do kontaminacije vzorca.

Abstract (Eng)

Cytology samples occasionally reveal different contaminants, such as talc, crystals and cotton wool strings. The routine examination of cytology urine samples to confirm malignancy occasionally showed contamination with plant cell. We have established that they were present only in patients with a Bricker ileal conduit. Urine preparations for the routine cytopathological examination were prepared with membrane filtration, fixed in Delaunay solution and stained according to Papanicolaou. They were examined using the light microscope. We also prepared adhesives preparations made by the companies Coloplast and ConvaTec, which are used by the ostomist to attach the bag on the urostomy. Plant cells were found only in the Coloplast adhesives. Morphologically, they were equal to the plant cells found in the urine of patients with a Bricker ileal conduit. To continue, we also provided preparations from different substances, namely adhesives components. Plant cells were present only in the preparations of guar gum, which is produced from Cyamopsis Tetragonoloba seeds. The size, shape and colour of plant cells differed from those of epithelial intestinal cells. The latter are present in the urine of patients with a Bricker ileal conduit, thus even an inexperienced cytotechnologist would have difficulty confusing them with dysplastic human cells. Nevertheless, it is important to take knowledge of all elements found in cell samples and to provide an explanation for sample contamination in the event of unusual findings, such as plant cells.