Multiple Myeloma
Section Editor: Dharam M. Ramnani, MD
Virginia Urology, Richmond, VA, USA
Image Description
Myeloma Kidney: Renal damage in multiple myeloma develops gradually over several years. Excretion of free light chains in urine (Bence-Jones proteins) occurs in about 70% of multiple myelomas. The free light chains precipitate and get deposited as casts in distal and collecting tubules - a condition referred to by a variety of names, including myeloma kidney, light chain cast nephropathy or Bence-Jones cast nephropathy. The resulting tubulo-interstitial inflammation causes progressive decline in renal function.
The image shows myeloma kidney in the center and on the left. A normal kidney is shown on the right for comparison. The myeloma kidney appears pale and scarred due to a combination of deposition of casts in the tubules, inflammation and fibrosis. Image copyright: pathorama.ch. A more detailed discussion of renal pathology in multiple myeloma is here.
The image shows myeloma kidney in the center and on the left. A normal kidney is shown on the right for comparison. The myeloma kidney appears pale and scarred due to a combination of deposition of casts in the tubules, inflammation and fibrosis. Image copyright: pathorama.ch. A more detailed discussion of renal pathology in multiple myeloma is here.