Immunofluorescence Microscopy

When amyloid is due to monoclonal AL, immunofluorescence may show smudgy positivity in affected areas for the responsible light chain.

Figure 18.1. Amyloid with glomerulus and arteriole infiltrated by homogeneous acellular material replacing normal structures [periodic acid-Schiff (PAS) stain].

Lambda light chain more commonly gives rise to amyloid than does kappa. Other types of amyloid do not stain for light chains by immunofluores-cence, but may be detected by immunohistochemistry, with antibodies for specific amyloidogenic proteins such as AA.

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