Abstract: 64-year-old male patient presented as nephrotic syndrome without hypertension and renal function impairment. Blood immunofixation electrophoresis showed λ IgA monoclonal immunoglobulin bands, and blood free light chain examination showed a decreased free κ/λ ratio. Bone marrow flow cytometry showed 4.52％ monoclonal plasma cells. He was diagnosed with AL type renal amyloidosis by renal biopsy. The patient achieved clinical VGPR after chemotherapy and repeat renal biopsy showed renal AL amyloidosis with prominent multinuclear giant cell formation.

Key words: light chain amyloidosis, multinucleated giant cells, renal biopsy