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Diagnosis: Amyloidosis.

The amorphus material seen in glomeruli suggests an extracellular protein, and the most frequent is amyloid. Then, congo red should be done. It was positive (see the next images).

The positivity is evidenced as apple green birefringence (in these images appear almost yellow, perhaps due to a bad photography, but was green on direct microscopic examination).

In some cases glomerular amyloid deposits are localized in the capillary walls, and they can be seen as perpendicular proyections: spikes, that simulate membranous glomerulonephritis.

To read more about amyloidosis see the chapter Amyloidosis... of our Tutorial.

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Bibliography

• Qu Z, Zheng X, Wang SX, Ao J, Zhou FD, Chen M, Liu G. Clinical and pathological features of renal amyloidosis: an analysis of 32 patients in a single Chinese centre. Nephrology (Carlton). 2010;15(1):102-7. [PubMed link]
• Sen S, Sarsik B. A proposed histopathologic classification, scoring, and grading system for renal amyloidosis: standardization of renal amyloid biopsy report. Arch Pathol Lab Med. 2010;134(4):532-44. [PubMed link]
• Homes RO, Baethge BA. Amyloidosis, overview. In e-Medicine. Visited June 24th: http://emedicine.medscape.com/article/335414-overview
• Sasatomi Y, Sato H, Chiba Y, Abe Y, Takeda S, Ogahara S, Murata T, Kaneoka H, Takebayashi S, Iwasaki H, Saito T. Prognostic factors for renal amyloidosis: a clinicopathological study using cluster analysis. Intern Med. 2007;46(5):213-9. [PubMed link]

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