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The biopsy is from a 65 year-old female who presented with acute renal failure and elevated creatinine up to 1.9 mg/dl. She has non-ischemic cardiomyopathy and protein electrophoresis is positive for lambda light chains. Serologies for ANA and rheumatoid factor are within normal limits. A biopsy was performed to rule out paraprotein associated disease and there was a specific concern for amyloidosis, due to cardiac changes. The biopsy consisted of a good sample, contained multiple cores of tissue and more than 20 glomeruli. The glomeruli were very unremarkable by light microscopy – loops were open, with regular contours, and no...