PMC3927191_01
Bone marrow biopsy (H and E, x100) showing plenty of atypical plasma cells; with bone marrow aspirate (H and E, x400) showing plasmablasts (insets a and b)
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F1
BM biopsy done showed 79% of plasma cells with plasmablastic morphology [Figure 1], which were CD138 positive with kappa restriction.
Renal biopsy (H and E, x100) showing interstitial infiltrates with mononuclear cells and extensive tubular pale eosinophilic fractured casts (arrows), which were kappa restricted on immunoflurosence
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F2
Renal function deteriorated rapidly; he underwent a renal biopsy, which showed pale eosinophilic, Schiff poor fractured casts in the renal tubules [Figure 2], which were kappa restricted.