Systemic kappa light-chain deposition. An ultrastructural and immunohistochemical study

Am J Surg Pathol. 1983 Jan;7(1):85-93. doi: 10.1097/00000478-198301000-00009.

Abstract

This report describes the pathology of kappa light-chain deposition in a 55-year-old patient who presented with respiratory insufficiency and hepatomegaly. Biopsies of lung and liver showed PAS-positive deposits which did not stain with congo red, crystal violet, or thioflavin-T. By indirect immunoperoxidase techniques, the deposits were composed of kappa light-chain immunoglobin. Electron microscopy revealed granular and fibrillar electron-dense material which lacked the characteristics of amyloid. Subsequent clinical studies showed this patient had a plasma cell dyscrasia. These data show that kappa light-chain deposition is not limited to the kidney, and that the first manifestation of a plasma cell dyscrasia may be systemic deposits of light chain. These deposits can be distinguished from amyloid by their immunochemical, tinctorial, and ultrastructural appearance.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Amyloidosis / pathology
  • Biopsy
  • Diagnosis, Differential
  • Hepatomegaly
  • Humans
  • Immunoenzyme Techniques
  • Immunoglobulin Light Chains / analysis*
  • Immunoglobulin kappa-Chains / analysis*
  • Liver / pathology*
  • Liver / ultrastructure
  • Lung / pathology*
  • Lung / ultrastructure
  • Microscopy, Electron
  • Middle Aged
  • Respiratory Insufficiency / pathology*

Substances

  • Immunoglobulin Light Chains
  • Immunoglobulin kappa-Chains