Anatomic Pathology: Vascular Pathology

63) This electron photomicrograph from a glomerulus demonstrates classic fibrillar deposits measuring 9 nm in diameter. Similar deposits may also be found in:

• Fibrillary deposits of amyloid are randomly arranged, are nonbranching, and measure 9 to 12 nm in diameter (see inset of image).

• Identical fibrillary deposits are found in all affected organs with the major sites of systemic amyloid deposition being the kidneys, heart, GI tract, subcutaneous adipose tissues, and liver.

• In the glomeruli, larger fibrils can be found measuring approximately 20 nm in diameter. These large fibrils do not stain in Congo red incubations. The disease entity characterized by the deposition of such large Congo red–negative fibrils in glomeruli is named fibrillary glomerulopathy and should clearly be distinguished from amyloidosis).

Herrera GA, Joseph L, Gu X, et al: Renal pathologic spectrum in an autopsy series of patients with plasma cell dyscrasia. Arch Pathol Lab Med 2004;128(8):875-879.

Iskandar SS, Herrera GA: Glomerulopathies with organized deposits. Semin Diagn Pathol 2002;19(3):116-132.

Markowitz GS: Dysproteinemia and the kidney. Adv Anat Pathol 2004;11(1):49-63.

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