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There is a histopathologic spectrum to the casts that can be seen in light chain cast nephropathy. A portion of this spectrum is shown in these photomicrographs of renal biopsies stained with PAS. All three of these cases had casts with light chain restriction by immunofluorescence. Photomicrograph A shows the classic PAS-negative cast with a cellular reaction. The casts in Photomicrograph B have an elongated crystalline appearance. The casts in Photomicrograph C stain weak by PAS and have more of a granular appearance. It is important for the renal pathologist to be aware of this histopathologic spectrum though there is...