Answer
The image shows Maltese crosses. These Maltese crosses appear to reside mostly within oval fat bodies (OFBs). OFBs are cells with birefringent fat droplets
within their cytoplasm. Under low power magnification, oval fat bodies are
often seen as large brown spots (sometimes almost black). This coloration is
due to the yellowish brown pigmented fat making the droplets. These cells are
usually seen in a context of heavy proteinuria. True oval fat bodies show a
typical "maltese cross" interference pattern when viewed under
polarized light. This interference is a crystalline structure property, and is
due to the presence of esterified cholesterol in a liquid crystal state.
Naturally, cholesterol-free droplets are not birefringent.
Question
This is a urine evaluated under polarized light. What does the image show?
