Multiple myeloma, nephrotic syndrome and crystalloid inclusions in podocytes  S.H. Nasr, D.C. Preddie, G.S. Markowitz, G.B. Appel, V.D. D'Agati  Kidney International  Volume 69, Issue 3, Pages 616-620 (February 2006) DOI: 10.1038/sj.ki.5000144 Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 1 (a) There is global collapse of the glomerular capillary walls with marked hypertrophy and hyperplasia of overlying podocytes (Jones methenamine silver with methyl green counterstain, original magnification × 400). (b) The swollen podocytes contain abundant trichrome-red intracytoplasmic inclusions (original magnification × 400). (c) The tubules contain numerous brightly eosinophilic angular geometric casts with adherent monocytes (hematoxylin and eosin, original magnification × 400). (d) Immunofluorescence staining for κ shows 3+ positivity in the angular tubular casts, with negativity for λ (not shown) (original magnification × 400). (e) Immunohistochemical staining for κ light chain performed on paraffin sections highlights the podocyte inclusions. Staining for λ was negative (not shown) (original magnification × 400). Kidney International 2006 69, 616-620DOI: (10.1038/sj.ki.5000144) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 2 (a) The swollen podocytes are engorged with numerous electron-dense intracytoplasmic crystalline inclusions. There is complete effacement of foot processes and wrinkling and retraction of the glomerular basement membrane (original magnification × 2000). (b) Tubules contain crystalline fractured casts with sharp edges. Crystalline intracytoplasmic inclusions are also seen within the adjacent tubular epithelial cells (arrow) (original magnification × 2000). Kidney International 2006 69, 616-620DOI: (10.1038/sj.ki.5000144) Copyright © 2006 International Society of Nephrology Terms and Conditions