TY - JOUR T1 - Nephrotic syndrome in a 60-year-old man JF - Journal of Clinical Pathology JO - J Clin Pathol SP - e3 LP - e3 DO - 10.1136/jclinpath-2019-206298 VL - 73 IS - 10 AU - Miguel Garcia Pardo AU - Inmaculada Aparicio AU - Marta Arregui AU - Rosa Melero AU - Francisco Díaz AU - Rosa Álvarez AU - Antonio Calles AU - Miguel Martin Y1 - 2020/10/01 UR - http://jcp.bmj.com/content/73/10/e3.abstract N2 - A man in his 60s presented with increased oedema in the lower limbs and dyspnoea. Chest X-ray showed right pleural effusion and a body CT scan revealed a severe right pleural effusion as well as presence of solid nodules and pleural plaques. It was decided then to obtain a CT-guided pleural biopsy. Pathology of this biopsy showed an epithelioid mesothelioma. Blood test showed hypoproteinaemia (4.2 g/dL) with hypoalbuminaemia (2.2 g/dL), proteinuria of 1.4 g /24 hours and non-oliguric acute renal failure with serum creatinine of 3.28 mg/dL. A renal biopsy was performed (online supplementary appendix 1).Supplementary data [jclinpath-2019-206298supp001.pdf] Review the high quality, interactive digital Aperio slides at http://virtualacp.com/JCPCases/jclinpath-2019-206298/001/, http://virtualacp.com/JCPCases/jclinpath-2019-206298/002/, and http://virtualacp.com/JCPCases/jclinpath-2019-206298/003/, and consider your diagnosis.A (secondary) amyloidosisCollapsing variant of focal segmental glomerulosclerosisDiabetic nephropathyMembranous nephropathyMinimal change disease.The correct answer is after the Discussion.A clinical suspicion of secondary membranous nephropathy (MN) was made due to the increase … ER -