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

A 77-year-old woman was diagnosed nephrotic syndrome with Waldenstrom’s macroglobulinemia (WM). Renal biopsy revealed MPGN-like lesions with extensive glomerular capillary thrombi which were positive for anti-IgM and anti-lambda-light chain immunofluorescence. The electron microscopy showed characteristic thrombi intra glomerular capillary walls 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 syndrome and her renal insufficiency were completely recovered. There were no previous reports of nephrotic syndrome and acute renal failure caused by oil-rich intracapillary thrombi in WM in the literature.