AN AUTOPSY CASE OF DIFFUSE MYELOMATOSIS ASSOCIATED WITH SYSTEMIC KAPPA LIGHT CHAIN DEPOSITION DISEASE (LCDD) A Patho-anatomical, Immunohistochemical and Immunobiochemical Study

A case of systemic light chain deposition disease in a 48-year-old man is presented. Clinically, the patient showed the signs of multiple organ (liver, heart and kidney) failure, but multiple myeloma was not diagnosed. Autopsy revealed generalized deposition of hyaline, a Congo red-negative substance, especially in the arterial walls of various organs. In the bone marrow, myelomatous proliferations of plasma cells positive for kappa light chain were recognized. The deposited substance was ultrastructurally different from amyloid fibrils, and was identified as kappa light chain by immunohistochemistry. A liver tissue extract was immunobiochemically examined and the deposited substance was confirmed to consist of kappa light chain, its molecular weight being approximately 14,000 to 17,000 Da.     

UNUSUAL RENAL PELVIC TUMOR CONTAINING TRANSITIONAL CELL CARCINOMA, ADENOCARCINOMA AND SARCOMATOID ELEMENTS (SO-CALLED SARCOMATOID CARCINOMA OF THE RENAL PELVIS)

A case of sarcomatoid carcinoma of the renal pelvis in a 66-year-old male is reported. The patient underwent left nephroureterectomy because of renal pelvic tumor and hydronephrosis. Left renal calcification and atrophy had been diagnosed in the patient about thirty years previously. The tumor showed a polypoid configuration and occupied the renal calyces. Histologically, not only solid nests of transitional cell carcinoma (TCC) and adenocar-clnomatous glands but also large spindle-shaped cells with bizarre nuclei simulating sarcoma were identified. Immunoreactlve keratin and epithelial-membranous antigen (EMA) were demonstrated in the sarcomatoid cells, indicating that they were of epithelial origin. So far, only 10 cases of so-called sarcomatoid carcinoma or carcinosarcoma of the renal pelvis have been reported in the world. In this report, we summarize the pathological findings of previously reported cases and discuss the histogenesis of this rare tumor.