PMC5876448_01
Photomicrographs of kidney biopsy showing features of amyloidosis. (A) Hematoxylin and eosin stain at low power showing deposition of an eosinophilic amorphous substance in the mesangium and blood vessels (x100). (B) Jones' silver methenamine stain showing the amyloid to be negative for silver stain (x200). (C) Congo red stain under polarized light showing the amyloid to be birefringent (x200). (D) Immunofluorescence stain with AA amyloid stain showing the amyloid to be strongly positive (x200).
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F1
Renal biopsy suggested enlarged glomeruli with large mesangial matrix (Figure 1).
Hematoxylin and eosin stains of the duodenal biopsy. (A) Low-power view showing fusion and flattening of villous folds (x100). (B) High-power view showing focal increase in intraepithelial lymphocytes and increased chronic inflammatory cell infiltrate in the lamina propria (x200).
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F2
Subsequent esophagogastroduodenoscopy showed loss of duodenal fold on gross visualization, and biopsy revealed focal villous atrophy with numerous intraepithelial lymphocytes and chronic inflammatory cells in the lamina propria (Figure 2).