PMC6381920_01
a: A mass is visible in the right lower lung field. b: A mass of 5 cm in diameter is visible in right S8.
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F1
On the other hand, in the imaging tests at the time of admission, a mass was observed in the right lower lung field (Fig. 1a, b).
a: Masson trichrome staining. Mild thickening of the glomerular walls is visible. b: PAM staining. Spikes of the glomerular basement membrane protruding towards the epithelium are visible (arrowheads).
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F2
Then, histopathological findings of the renal biopsy included mild thickening of the glomerular walls in HE-stained specimens (Fig. 2a) and spikes of the glomerular basement membrane protruding towards the epithelium in PAM-stained specimens (Fig. 2b).
a: Immunofluorescence staining. Granular deposition of IgG on the glomerular walls is visible. b: Immunofluorescence staining. IgG4 deposits are predominantly visible.
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F3
IgG on the glomerular walls (Fig. 3a). IgG subclass analysis showed predominant deposits of IgG4 (Fig. 3b), which is consistent with the staining patterns in primary membranous nephropathy.