What are the features of LCDD on kidney biopsy?
LCDD, HCDD, and light and heavy chain deposition disease show the same morphologic features. The glomerular changes are heterogeneous and range from mild mesangiopathic changes to a mesangiocapillary (membranoproliferative) pattern with features similar to diabetic nodular glomerulosclerosis (Kimmelstiel-Wilson type) but do not stain strongly positive with Silver stains. They are Congo red negative, and immunofluorescence microscopy shows monoclonal LC deposits in the glomerular basement membrane, the Bowman capsule, and the cortical and medullary tubular basement membranes ( Fig. 39.4 ). Electron microscopy shows a band of dense granules usually in the inner position of the lamina densa of the glomerular basement membrane and the outer aspect of the tubular basement membrane.
