免疫球蛋白轻链
病理
多发性骨髓瘤
淀粉样蛋白(真菌学)
形态学(生物学)
医学
淀粉样变性
肾病
生物
内科学
抗体
免疫学
内分泌学
遗传学
糖尿病
作者
Alok Sharma,Savita Bansal,Ramesh Jain
标识
DOI:10.4103/0377-4929.142712
摘要
Cast nephropathy is the most frequent pattern of renal involvement in multiple myeloma characterized by presence of tubular casts with characteristic morphology that are composed of monotypic (either kappa or lambda) light chains as seen by immunofluorescence microscopy. Rarely these casts may show evidence of amyloidogenesis and assume a unique morphology, which needs to be appreciated for arriving at accurate diagnosis. We present the case of an elderly male presenting with features of acute kidney injury and detected with extensive inspissation of intratubular casts with lambda light chain restriction and a unique morphology with spiculated congophilic periphery. Further investigations confirmed the presence of systemic myeloma. Presence of intratubular amyloid casts is a rare occurrence which needs to be recognized by the pathologist and forms a vital element in timely diagnosis of the systemic disease which often presents with renal involvement.
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