A Case of Castleman’s Disease during the Long-Term Course of Membranous Nephropathy

Figure 3

Renal biopsy findings. Periodic acid schiff (PAS) staining shows no obvious mesangial proliferation, crescent, or focal adhesions (a). Periodic acid methenamine silver (PAM) staining shows spikes and bubbling in the basement membranes (b). Electron microscopy reveals subepithelial and intramembrane deposits of homogenous sizes and stages and mild subendothelial enlargement (c). Immunofluorescent findings show marked granular deposit of IgG, IgA, and IgM, but no staining for complement (d). We examined depositions of IgG subclasses (e) and several MN-associated antigens as follows: phospholipase A2 receptor (PLA2R), thrombospondin type-1domain-containing 7A (THSD7A), neural epidermal growth factor-like 1 (NELL-1), and exostosin-1 (EXT-1) (f).

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