A renal biopsy from a 56 year old woman with progressive renal failure for the past 3 years shows glomerular and vascular deposition of pink amorphous material.It shows apple-green birefringence under polarized light after Congo red staining. These deposits are positive for lambda light chains. the person is most likely to suffer from ?

Ans. is 'd' i.e. Multiple myelomao Pink and amorphous material that shows apple green birefringence under polarized light confirms the diagnosis of Amyloidosis.o Now we have to look for a disease which can be complicated by amyloidosis (from the given options). Out of the given four, three diseases can be complicated by Amyloidosis. These areRheumatoid ahritisTuberculosis andc. Multiple myelomaBut there is one more clue i.e. the presence of Lambda light chains.o This easily leads us to the diagnosis, as lambda light chains are present in AL type of amyloid protein. AL type of amyloid is seen in multiple myeloma. Rheumatoid ahritis and T.B. are associated with AA type of amyloid protein.