Abstract:
CONTEXT:Lesions associated with monoclonal light and heavy chains display a variety of glomerular, tubular interstitial, and vascular manifestations. While some of the entities are well recognized, including light and heavy chain deposition diseases, AL (light chain) and AH (heavy chain) amyloidosis, and light chain ("myeloma") cast nephropathy, other lesions centered on proximal tubules are much less accurately identified, properly diagnosed, and adequately understood in terms of pathogenesis and molecular mechanisms involved. These proximal tubule-centered lesions are typically associated with monoclonal light chains and have not been reported in patients with circulating monoclonal heavy chains. OBJECTIVE:To determine the incidence of proximal tubulopathies in a series of patients with monoclonal light chain-related renal lesions and characterize them with an emphasis on clinical correlations and elucidation of molecular mechanisms involved in their pathogenesis. DESIGN:A study of 5410 renal biopsies with careful evaluation of light microscopic, immunofluorescence, and electron microscopic findings was conducted to identify these monoclonal light/heavy chain-related lesions. In selected cases, ultrastructural immunolabeling was performed to better illustrate and understand molecular mechanisms involved or to resolve specific diagnostic difficulties. RESULTS:In all, 2.5% of the biopsies were diagnosed as demonstrating renal pathology associated with monoclonal light or heavy chains. Of these, approximately 46% were classified as proximal tubule-centered lesions, also referred to as monoclonal light chain-associated proximal tubulopathies. These proximal tubulopathies were divided into 4 groups defined by characteristic immunomorphologic manifestations associated with specific clinical settings. CONCLUSIONS:These are important lesions whose recognition in the different clinical settings is extremely important for patients' clinical management, therapeutic purposes, and prognosis. These entities have been segregated into 4 distinct variants, conceptualized morphologically and clinically. Specific mechanisms involved in their pathogenesis are proposed.
journal_name
Arch Pathol Lab Medjournal_title
Archives of pathology & laboratory medicineauthors
Herrera GAdoi
10.5858/arpa.2013-0493-OAsubject
Has Abstractpub_date
2014-10-01 00:00:00pages
1365-80issue
10eissn
0003-9985issn
1543-2165journal_volume
138pub_type
杂志文章,多中心研究abstract::A case of cystic cerebellar hemangioblastoma with previously unreported light and electron microscopic features is reported. Deposits of intranuclear, osmiophilic, lipid-like material produced unusual stromal cells, with distended clear nuclei similar to empty cysts at the light-microscopic level. This description exp...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1981-06-01 00:00:00
abstract::Three fatal cases of heat stroke were encountered in the central New York area over a two-month period. Although in each instance one or more predisposing factors were identified, exertion clearly played a role in its development in only one case. In addition to laboratory and postmortem findings indicative of dysfunc...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1980-07-01 00:00:00
abstract:CONTEXT:Accurate categorization of uterine smooth muscle neoplasms by light microscopic examination is difficult. Multiple classification schemes have been proposed based on mitotic rate, nuclear atypia, and the presence or absence of necrosis. None of these classification systems has been entirely successful. Multiple...
journal_title:Archives of pathology & laboratory medicine
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abstract::Mammary carcinoma arising in ectopic breast tissue is an uncommon occurrence. Most reported cases have involved ductal carcinoma, but other types, such as medullary, papillary, and lobular carcinomas, have been described. For pathologists, the diagnosis of mammary carcinoma arising in ectopic breast tissue can be diff...
journal_title:Archives of pathology & laboratory medicine
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abstract::A case of nongestational, extragonadal choriocarcinoma in a middle-aged man is described. Autopsy examination confirmed that the tumor originated in the lung. The trophoblastic origin of the tumor was documented by immunoperoxidase staining for human chorionic gonadotropin. ...
journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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更新日期:1981-01-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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更新日期:1988-11-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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更新日期:1981-04-01 00:00:00
abstract::Yeast forms of Blastomyces dermatitidis typically range from 8 to 20 microm in largest diameter. We report a rare case of primary pulmonary blastomycosis with an unusual morphology, in which we found significant numbers of large yeast forms ranging from 30 to 35 microm in diameter. To our knowledge, this is only the s...
journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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pub_type: 杂志文章
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更新日期:1988-07-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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更新日期:1986-10-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 传,历史文章,杂志文章
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