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Currently filtering by tag: Waldenstrom macroglobulinemia

Type 1 Cryoglobulinemic Glomerulonephritis

Type 1 Cryoglobulinemic Glomerulonephritis, arkana laboratories
The patient is a 75 year-old female who presents with proteinuria, a necrotic skin lesion on her lower extremity, and a creatinine of 5.5 mg/dL. Her serum complement levels (C3/C4) are low.  Serologies for ANA, dsDNA, rheumatoid factor, c-ANCA, p-ANCA, anti-GBM, and ASO are negative. Her cryoglobulins are positive. Image 1 shows hyaline thrombi and image 2 shows mild interstitial fibrosis. Images 3, 4, 5, and 6 are IgG, IgM, kappa, and lambda, respectively. This is a case of Type 1 cryoglobulinemia. Type 1 cryoglobulins are composed of a single monoclonal immunoglobulin that reversibly participates at low temperature (<37C).  Type...

Waldenström’s Macroglobulinemia

Waldenström's Macroglobulinemia, arkana laboratories, teaching points for renal pathology, kidney biopsy
A 57-year-old white male presents with fatigue, mild proteinuria, and a creatinine of 1.5 mg/dL. He was diagnosed with lymphoplasmacytic lymphoma 6 months ago, but refused treatment. Figures 1 & 2 show prominent pseudothrombi and a membranoproliferative pattern of glomerular injury. Image 3 shows moderate interstitial fibrosis. Image 4, 5, 6, & 7 show IgG, IgM, kappa, and lambda, respectively. This is a case of cryoglobulinemic glomerulonephritis secondary to lymphoplasmacytic lymphoma (Waldenström's macroglobulinemia). Waldenström's macroglobulinemia is a rare B-cell lymphoma characterized by lymphoplasmacytic cell infiltration in the bone marrow and other organs and the presence of a monoclonal immunoglobulin M...

Waldenstrom Macroglobulinemia

In this image of a combined silver-trichrome stain, the arrow points to the abnormal material within the arteriole lumen. This material was positive for IgM and showed kappa light chain restriction by immunofluorescence, supporting the diagnosis of paraprotein. Interestingly, this kidney biopsy was taken from an 81-year-old man with acute renal failure who had been diagnosed with Waldenström macroglobulinemia (his bone marrow biopsy showed involvement by lymphoplasmacytic lymphoma and he had a circulating IgM-kappa paraprotein). A key point to remember is that monoclonal IgM paraproteins are associated with a wide spectrum of kidney diseases, including AL-type amyloidosis, cryoglobulinemic glomerulonephritis, and...