Tange T, Kurumado K, Nakazawa M, Imamura Y, Kosaka K, Kawaoi A
Acta Pathol Jpn. 1978 Mar;28(2):325-33. doi: 10.1111/j.1440-1827.1978.tb00545.x.
An autopsy case of multiple myeloma (IgG, lambda type), clinically characterized by decreased glomerular filtration rate, is reported with particular emphasis on changes in the glomeruli of kidneys. Histologically, the glomeruli revealed slight increase in mesangial matrix and focal thickening of tuft capillary wall. Electron-microscopically, deposits were observed in a subendothelial location in the glomerular capillary walls, and inclusions were noted in the cytoplasm of the visceral epithelial cells. Histoimmunofluorescent study of the kidney demonstrated intense focal and slight diffuse positivity against labelled antisera of anti-IgG and anti-lambda type of light chain on the capillary wall of the glomerular tufts. Other immunoglobulins were not demonstrable in capillary walls. These findings represent the intraglomerular deposition of paraprotein of multiple myeloma without amyloidosis.
报告一例多发性骨髓瘤（IgG，λ型）尸检病例，其临床特征为肾小球滤过率降低，特别强调肾脏肾小球的变化。组织学上，肾小球显示系膜基质轻度增加和毛细血管襻壁局灶性增厚。电子显微镜下，在肾小球毛细血管壁的内皮下位置观察到沉积物，在内脏上皮细胞的细胞质中发现包涵体。肾脏的组织免疫荧光研究表明，在肾小球襻的毛细血管壁上，针对抗IgG和抗λ型轻链标记抗血清呈现强烈的局灶性和轻微的弥漫性阳性。在毛细血管壁中未检测到其他免疫球蛋白。这些发现代表了无淀粉样变性的多发性骨髓瘤副蛋白的肾小球内沉积。
