Monoclonal Light Chain Deposits Within the Stomach Manifesting as Immunotactoid Gastropathy

Abstract

Immunotactoid deposits are defined by their ultrastructural appearance and are characterized by microtubular or cylindrical structures typically measuring greater than 30 nm in diameter. Although a rare entity, immunotactoid deposition most often manifests as immunotactoid glomerulopathy and is associated with underlying lymphoplasmacytic disorders. Corneal immunotactoid deposition known as immunotactoid keratopathy has also been reported in patients with paraproteinemia. Here, we describe the first reported case of immunotactoid deposition in the stomach. The deposits were composed solely of kappa immunoglobulin light chains without significant lambda light chain or immunoglobulin heavy chain components. The patient displayed no renal signs or symptoms, and additional thorough clinical examination failed to detect any evidence of a paraproteinemia or plasma cell dyscrasia. Thus, the gastric immunotactoid deposits in this case appear to be an isolated finding of light chain deposition, of which the significance and etiology are unclear.

• Deposition
• gastropathy
• glomerulopathy
• immunotactoid
• light chain
• microtubules

Acknowledgments

The authors would like to thank Dr. Tibor Nadasdy of The Ohio State University for performing and providing the images from immunoelectron microscopy studies.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.