An Exceptional Case of Light Chain Only Variant of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits Secondary to Chronic Lymphocytic Leukemia: A Case Report and Review of the Literature

Figure 1

Light microscopy shows a global increase of mesangial matrix, with focally mesangial hypercellularity (arrow). (a) Hyalinosis of the afferent arteriole was observed (asterisk) (H-E, 200x). (b) The glomerulus shows irregular capillary wall thickening and a cellular crescent (dashed crescent) (H-E, 200x). (c) Methanamine-silver stain (200x) shows a glomerulus with a cellular crescent (arrowhead). (d) Direct immunofluorescence showing bright granular staining of glomerular mesangium for lambda light chain (lambda++/kappa+, 200x). (e) Electron microscopy revealed large electron-dense nonorganized deposits in mesangial areas (arrow) (10000x). (f) Electron microscopy showing segmental subendothelial mesangial deposits (arrow-head) (10000x).

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