A case of IgD myeloma together with the existence of myelofibrosis is presented. More interesting is the concurrent presence of cast nephropathy, light chain deposition and amyloidosis in the kidney. Peculiar light-microscopic, immunohistochemical, immunofluorescence and ultrastructural findings were also noted. The possible mechanisms and implications for such findings were discussed. This case was analyzed together with a review of local pictures of renal involvement in multiple myeloma.