PMC9437290_01
(A-L) Pathological findings of renal biopsy. (A-D) Light microscopy shows a MPGN pattern of glomerular lesion (A), HE; (B), PAS; (C), PASM; (D), MASSON, 400x). (E-L) Immunofluorescence depicts granular mesangial and wall deposits with IgG, C1q, kappa, lambda, IgG3, and IgG2 trace, while IgG1 and IgG4 are negative [(E-L), 400x].
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IgG (3+), IgA (2+), IgM (2+), C3c (2+), C1q (2+), kappa (3+), lambda (+~2+), IgG2 (+), and lgG3 (2+) in the glomerular mesangial area and along the capillary walls. IgG1 and IgG4 were negative ( Figure 1 ).
(A-F) Amyloid in renal biopsy. (A) Congo red staining was positive for amyloid deposits in cortical interstitium (200x). (B) Amyloid deposits showed apple-green birefringence under polarized light (200x). (C) EM showed randomly arranged fibrils with a diameter of 10 nm in the interstitium (8,000). (D) High magnification of selected area in panel (C) (35,000x). (E) Immunohistochemical staining for LECT2 was positive in amyloid deposits (200x). (F) Immune-electron microscopy showed specific labeling of LECT2 in amyloid fibrils (35,000x).
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The amyloid deposits were positive for LECT2 protein by immunohistochemical staining and immune-electron microscopy ( Figure 2 ).