Table 1.
Clinical characteristics at biopsy.
Table 2.
Laboratory and radiological features.
Table 3.
Laboratory and radiological features.
Table 4.
Kidney biopsy pathology.
Table 5.
Kidney biopsy pathology.
Fig 1.
(a) Masson trichrome staining. (b) Specific immunostaining to human CD3. (c) Specific immunostaining to human CD5. (d) Specific immunostaining to human CD20. Light microscopy, original magnification, X 40.
Fig 2.
Representative cases of interstitial granulomas.
(a) Case 4. Masson trichrome. Interstitial epithelioid and gigantocellular non-necrotizing granuloma, surrounded by lymphocytes. Original magnification, X 20. (b) Case 6. Hematoxylin and eosin staining. Granuloma associated with severe diffuse CLL/SLL monomorphic infiltrate. Original magnification, X 40.
Fig 3.
(a) Case 10. Light microscopy, Masson trichrome staining. Cryoglobulin-related MPGN. Endocapillary proliferation, fibrinoid necrosis and pseudo-thrombi. Original magnification, X 20. (b) Case 11. Light microscopy, Masson trichrome. Endo- and extracapillary proliferation. Note the severe CLL/SLL monomorphic infiltrate. Original magnification, X 40. (c) Case 11 (IgG kappa type I cryoglobulin). Immunofluorescence microscopy. Endomembranous deposits of IgG1, kappa, C3, C1q. Original magnification, X 20. (d) Case 11. Electron microscopy. Subendothelial granular and fibrillar deposits. Bar = 1200 nm.
Fig 4.
GOMMID (case 15) (a) Light microscopy.
Masson trichrome. Mesangial sclerosis with focal mesangial proliferation. Note mild monomorphic focal CLL/SLL infiltrate. Original magnification, X 10. (b) Light microscopy. Masson trichrome. Mesangial sclerosis and proliferation, capillary deposits. Original magnification, X 40. (c) Immunofluorescence microscopy. Monotypic Ig lambda deposits. The same fluorescence patern was obtained with an anti-C3 antibody (data not shown). (d) Electron microscopy. Subendothelial organized microtubular deposits, 30-nm external diameter. Bar = 1200 nm.
Fig 5.
AHL amyloidosis (case 14) (a) Light microscopy.
Masson trichrome staining. Massive amorphous deposits in the mesangium and extending to the subendothelial space of glomerular capillaries, Bowman’s capsule, the interstitium, the tubular basement membrane and the arterioles. Original magnification, X 20. (b) Apple green birefringence detected under polarized light. Original magnification, X 20. (c) Immunofluorescence microscopy. Monotypic Ig lambda deposits. Equally intense staining for heavy and light chains. (d) Electron microscopy. Non oriented, randomly arranged, 10-nm diameter fibrils. Bar = 1250 nm.
Table 6.
Post-biopsy follow-up and clinical course.
Table 7.
Post-biopsy follow-up and clinical course.
Table 8.
Previously reported series.