University of Arkansas for Medical Sciences, USA
Title: Dysproteinemias and the kidney: Spectrum of diseases with morphologic heterogeneity
Neriman Gokden has completed her anatomic and clinical pathology residency and surgical pathology fellowship training at Washington University in Saint Louis. She is the Associate Professor of Pathology and Director of Surgical Pathology at
Medical Sciences. She has published more than 40 papers in reputed journals on kidney diseases. One of her research interests is multiple myeloma and the kidney involvement. She is heavily involved in resident and medical student education and quality control/management of the laboratory.
The kidney is affected in a variety of dysproteinemias, the pathogenesis, and the morphology, which varies depending on the etiology. Th e common morphological presentation of the affected kidney includes myeloma cast nephropathy, monoclonal immunoglobulin deposition disease, and amyloidosis. These diseases may occur concomitantly in the same patient. Other entity which is less frequently reported is light chain proximal tubulopathy. The published case series have shown that there is a great deal of morphologic heterogeneity in the light microscopic, immunofluorescence and electron microscopic findings in monoclonal immunoglobulin deposition disease. This heterogeneity can be present in pure form of monoclonal immunoglobulin deposition disease and also can be seen when it is combined with myeloma cast nephropathy. Similarly, light chain proximal tubulopathy has shown heterogeneity with light and electron microscopic findings. Therefore, it is crucial to have a full work-up in these kidney biopsies for defi nitive diagnoses.