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April 1, 2019

Diagnose This (April 1, 2019)

What is your diagnosis?

 

 

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This photomicrograph (PAS stain) shows a glomerulus with mesangial expansion by an acellular, PAS-pale, homogenous material consistent with amyloid. Further confirmation staining by Congo red (see below) shows positive staining within areas of amyloid deposition and apple-green birefringence on polarization. By immunofluorescence the amyloid deposits showed lambda light chain restriction making this an AL-type amyloidosis.