Crystalloid podocytopathy with focal segmental glomerulosclerosis in PCM: a case report

Diagnostic Pathology

Sang Ho Lee¹  Sung-Jig Lim²  Myeong Hee Kim³  So Young Kang³  Yujin Choi³  Woo In Lee³  You La Jeon³ 

[1] Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University and Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea;Department of Pathology, School of Medicine, Kyung Hee University and Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea;Department of Laboratory Medicine, School of Medicine, Kyung Hee University and Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul 134-727, Republic of Korea

关键词: Bone marrow;    Tubulopathy;    Podocytopathy;    Focal and segmental glomerular sclerosis;    Crystalline deposition;    Plasma cell myeloma;   

Others  :  1235138
DOI  :  10.1186/s13000-015-0448-0

 received in 2015-07-29, accepted in 2015-11-28,  发布年份 2015

【 摘 要 】

Background

Crystalloid podocytopathy with focal segmental glomerulosclerosis in plasma cell myeloma (PCM) is rare.

Case Presentation

We present a case of crystalline deposition in the bone marrow (BM) and various renal cells with only proteinuria as a symptom. As workup for proteinuria, a renal biopsy sample was obtained. EM showed multiple crystalline depositions in renal tubular cells and podocytes. Focal segmental glomerulosclerosis with crystalloid podocytopathy was diagnosed. Because monoclonal gammopathy was detected in the serum and urine, a BM study was also performed. Plasma cells with needle-shaped inclusion bodies were observed. The crystalline deposits in the plasma cells and podocytes were positive for Masson’s trichrome and kappa light-chain staining. These findings indicated that the crystalline deposits originated from paraprotein. The case showed a rare process of focal segmental glomerulosclerosis via crystalline deposition in podocytes in plasma cell myeloma.

Conclusions

Crystalloid podocytopathy is a likely cause of renal damage such as FSGS in PCM, although it is an uncommon mechanism for myeloma kidney.

【 授权许可】

   
2015 Jeon et al.

【 图 表 】

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