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Case Reports
. 2016 May 3;7(5):2054270416640156.
doi: 10.1177/2054270416640156. eCollection 2016 May.

Rare and unusual clinicopathologic presentation of renal AL amyloidosis

Andrew Logan  1 , Craig Zuppan  1 , Alexander Pi  1 , Zhiwei Zhang  2 , Navin Jaipaul  2
Affiliations
Case Reports

Rare and unusual clinicopathologic presentation of renal AL amyloidosis

Andrew Logan et al. JRSM Open. .

Abstract

Rarely, renal light chain (AL) amyloidosis may present without significant proteinuria owing to glomerular sparing and amyloid deposition confined to the vasculature and tubulointerstitium.

Keywords: (AL) Amyloidosis; light chains; multiple myeloma; proteinuria; renal amyloidosis.

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Figures

Figure 1.
Figure 1.
(a–c) Light microscopy of kidney biopsy specimen shows widening of the interstitium and thickening of the tubular basement membranes by amorphous hyaline material (a), with prominent Congo Red staining of amyloid in the interstitium and (markedly thickened) small artery walls (b), but relative sparing of the glomeruli (c). (d) Immunofluorescence microscopy of kidney biopsy specimen shows a dominance of staining of the interstitial and vascular amyloid for kappa light chain. (e–f) Electron microscopy of kidney biopsy specimen shows finely fibrillar amyloid expanding the interstitium and surrounding interstitial capillaries and atrophic tubules (e) and high magnification (original 15,000×) of the typical randomly arrayed straight fibrils of amyloid, about 8–10 nm thick (f).
See this image and copyright information in PMC

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