ATLAS OF RENAL PATHOLOGY

The Atlas of Renal Pathology presents a compilation of figures on a specific pathologic entity. You should read the Terms and Conditions of Use before using this site. If you agree to the terms, you may download the figures to create your own personal, noncommercial library of images or to create slides for teaching purposes.

To view a larger version of each figure, select View larger version below each figure. To make a slide, select download slide-quality image file. Download times may be somewhat lengthy. For tips on preparing slides from the files, please see Downloading Images for Slide Preparation.

Light Chain Deposition Disease

Pathology Editor: Agnes Fogo, MD
Medical Photographer: Brent Weedman
With Assistance From Kim Solez, MD, of the National Kidney Foundation's cyberNephrologyTM Team

 
View larger version
Download slide-quality image
Fig 1. The characteristic appearance of light chain deposition disease by light microscopy is that of a nodular glomerulosclerosis, which strongly resembles diabetic nephropathy, as in this case (periodic acid-Schiff stain; original magnification x400).
 
 
View larger version
Download slide-quality image
Fig 2. The typical nodular glomerulosclerosis appearance, which may be seen in light chain deposition disease, bears a striking resemblance to diabetic nephropathy, as in this case. Additional studies are necessary to differentiate between the two, although the minimal arteriolar hyalinization in this case in the presence of advanced nodular sclerosis suggests the possibility of a disease other than diabetes (Masson trichrome stain; original magnification x200).
 
 
View larger version
Download slide-quality image
Fig 3. Although nodular glomerulosclerosis is the typical appearance of light chain deposition, minor degrees of mesangial expansion may be the only manifestation as in this case. There is mesangial matrix and cellularity increase without distinct nodule formation (periodic acid-Schiff stain; original magnification x400).
 
 
View larger version
Download slide-quality image
Fig 4. Only minor degrees of mesangial increase are present in this case, although additional studies by immunofluorescence and electron microscopy confirm that the patient had light chain deposition disease involving tubules and glomeruli, in addition to the characteristic myeloma cast nephropathy (illustrated in the center of the field). The characteristic appearance of myeloma cast nephropathy is illustrated by the presence of fractured, hard, refractile casts with surrounding syncytial cell reaction. Coexistence of two manifestations of paraprotein-related disease occurs, with a combination of myeloma and light chain deposition disease perhaps being the most common (hematoxylin & eosin stain; original magnification x100).
 
 
View larger version
Download slide-quality image
Fig 5. Glomerular capillary loop, mesangial staining, and linear tubular staining are characteristic of light chain deposition disease. Either kappa or lambda light chain paraprotein may cause light chain deposition disease, although kappa more commonly is the culprit (antibody to kappa light chain, immunofluorescence; original magnification x200).
 
 
View larger version
Download slide-quality image
Fig 6. The granular, amorphous deposits typical of light chain deposition disease are seen as silt-like material on the endothelial aspects of the glomerular basement membrane in this case of light chain deposition disease (transmission electron microscopy; original magnification x11,250).
 
 
View larger version
Download slide-quality image
Fig 7. High-power view of the granular, amorphous deposits typical of light chain deposition disease, on the endothelial aspects of the glomerular basement membrane. These deposits have indistinct borders, are mottled, and occur both in the glomerular basement membranes and the mesangium and tubular basement membranes (transmission electron microscopy; original magnification x40,000). See other figures.
 
 
View larger version
Download slide-quality image
Fig 8. Tubular basement membrane with granular, amorphous deposits typical of light chain deposition disease (transmission electron microscopy; original magnification x14,000).
 

From the Department of Pathology, Vanderbilt University Medical Center, Nashville, TN.
Address author queries to Agnes Fogo, MD, Department of Pathology, Vanderbilt University Medical Center, MCN C-3310, Nashville, TN 37232. E-mail:Agnes.Fogo@vanderbilt.edu
Am J Kidney Dis 32(6):E1, 1998 (available www.ajkd.org)
 Copyright 1998 by the National Kidney Foundation, Inc.

Home | Help | Feedback | Subscription | Archive | Search | Atlas Home
Home Help Feedback Subscriptions Archive Search Atlas Home