Page 293 - Essential Haematology
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(a)                                    (b)


































                          (c)                                    (d)


                                Figure 21.7   The kidney in multiple myeloma.  (a)  Myeloma kidney: the renal tubules are distended with hyaline

                      protein (precipitated light chains or Bence - Jones protein). Giant cells are prominent in the surrounding cellular
                      reaction.  (b)  Amyloid deposition: both glomeruli and several of the small blood vessels contain an amorphous
                      pink - staining deposit characteristic of amyloid (Congo red stain).  (c)  Nephrocalcinosis: calcium deposition (dark
                        ‘ fractured ’  material) in the renal parenchyma.  (d)  Pyelonephritis: destruction of renal parenchyma and infi ltration
                      by acute infl ammatory cells.
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