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Diagnose This (April 1, 2019)

L. Nich Cossey, MD
By L. Nich Cossey, MD

Apr 01, 2019

AL-type Amyloidosis, arkana laboratories, diagnose this, renal path, kidney path, nephropath, chronic kidney disease
Camera information: Calibration= 1.000 Pixels per pixel; Capture format= 1392 x 1040, Full Frame HQ; Gamma= 0.89; Gain= 1.0 x; Exposure= 7.19 ms; Auto exposure= On; Image type= Colour; Shading= (None); Sharpening= Off; Black clip= 10; White clip= 206; Microscope information:

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.

AL-type Amyloidosis stain

 

 

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