Lipid-rich Glomerular Capillary Thrombi, of a Patient with WaldenstromâÂÂsMacroglobulinemia

A 77-year-old woman was diagnosed nephrotic syndromewith Waldenstrom’s macroglobulinemia(WM). Renal biopsyrevealed MPGN-like lesions with extensive glomerular capillarythrombi which were positive for anti-IgM and anti-lambda-light chain immunofluorescence. The electron microscopy showed characteristic thrombi intra glomerular capillarywalls which were occupied with a lot of vacuoles. These structures were similar with them of lipoprotein glomerulopathy. The patient was started to treat with R-CHOP, and then nephrotic syndromeand her renal insufficiency were completely recovered. There were no previous reports of nephrotic syndromeand acute renal failure causedby oil-rich intracapillary thrombi in WM in the literature.