PMC2782218_01
Immunofluorescent staining of the shoulder pad biopsy shows diffuse, strong deposits of kappa light chains (x200).
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F1
Immunofluorescent staining (IF) for kappa light chain was strongly positive (Fig. 1).
Pelvis MRI. Enhanced T1-weighted (A) and T2-weighted (B) images, demonstrating pseudohypertrophied iliopsoas muscles (arrow heads) compressing femoral nerves (arrows).
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F2
T1 and T2 weighted images with irregular gadolinium enhancement in T1 weighted images (Fig. 2). The neurovascular bundle containing the femoral nerve was medially adjacent to the iliopsoas muscle, which seemed to compress the bundle.
Endomysial and perimysial deposition of amyloid in the iliopsoas muscle. Congo red with light microscopy (A) and with polarizing microscopy (B) (x100).
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F3
In muscle specimens, deposits were primarily distributed in the perimysium, endomysium and perivascular space with scanty inflammatory cells (Fig. 3).