Maltese Cross appearance
Lab medicine—urinalysis ‘Maltese crosses’ are anisotropic or birefringent cholesterol-rich fat droplets, associated with finely granular renal casts, which have a cruciform appearance by polarised light and are found both within and outside of the cells in the urine sediment of patients with nephrotic syndrome, eclampsia, renal toxicity, fat embolism, after crush injury and in Fabry’s disease—due to aggregates of glycosphingolipids
Microbiology The tetrad form of Babesia spp, most typically seen in B equi, but also in B canis, B microti, and B bovis, has been termed ‘Maltese cross’ and is a rare but characteristic finding in infected red cells in a peripheral blood smear
Orthopaedics Maltese crosses occur in arthroscopic fluid following local trauma
Pathology—lung Maltese crosses measure 5-15 mm in diameter, appear as scintillating granules by polarised light microscopy and correspond to starch and talc granules, common in the lungs of IV drug abusers who ‘cut’ heroin with powder; the granules may be accompanied by foreign body-type giant cell reaction and appear in other tissues