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Glomerular lesions in multiple myeloma.

T Tange, K Kurumado, M Nakazawa

    Acta Pathologica Japonica
    |March 1, 1978
    PubMed
    Summary
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    This autopsy case study reveals paraprotein deposition in kidney glomeruli of a multiple myeloma patient. These IgG lambda deposits caused glomerular changes, indicating myeloma kidney disease without amyloidosis.

    Area of Science:

    • Nephrology
    • Oncology
    • Pathology

    Background:

    • Multiple myeloma is a plasma cell malignancy.
    • Kidney involvement is common in multiple myeloma.
    • Glomerular filtration rate decline can indicate renal damage.

    Observation:

    • Autopsy of a patient with IgG lambda multiple myeloma and decreased glomerular filtration rate.
    • Histological examination showed increased mesangial matrix and thickened glomerular capillary walls.
    • Electron microscopy revealed subendothelial deposits and inclusions in visceral epithelial cells.

    Findings:

    • Histoimmunofluorescence confirmed IgG and lambda light chain deposition in glomerular capillary walls.
    • Deposits were intense focally and diffuse slightly.

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  • No other immunoglobulins were detected in the capillary walls.

    • Implications:

    • The findings demonstrate intraglomerular deposition of myeloma paraprotein.
    • This represents a form of myeloma kidney disease distinct from amyloidosis.
    • Understanding these deposits is crucial for diagnosing and managing myeloma-related kidney complications.