Coexistence of AL and Aβ2M amyloid in tissues of a patient with myeloma on hemodialysis

A 61 year old male was diagnosed as having hypertensive nephropathy at age 50. Chronic renal failure at age 55 resulted in his beginning hemodialysis at age 57. A diagnosis of myeloma was also established at age 57 on the basis of Bence Jones proteinuria, increased bone marrow plasma cells and anemia. Amyloid deposits developed in nodules on the eyelids, in the carpal joints, cervical spine, shoulder synovial membrane, bone marrow and rectum. By immunostaining, the amyloid deposits reacted with anti-Ak and less abundantly with anti-4β2M.