Inflammatory cells in sarcoid granulomas detected by monoclonal antibodies and an esterase technique.

Inflammatory cells in situ in Kveim reaction papules were identified in 15 patients with avidin-biotin-peroxidase complex and biotin-avidin-peroxidase methods for surface epitopes and with a simultaneously capturing azo dye method for cytoplasmic acid alpha-naphthyl acetate esterase (ANAE). The spatial relationship of cells in granulomas indicates a concentric arrangement. Endogenous peroxidase-negative, ANAE+, but OKIa-negative immunoincompetent epithelioid cells were in the center. T3+, ANAE+ T lymphocytes formed 60-80% of all cells in the lymphocyte mantle surrounding the epithelioid core. T4/T8 was 2:1. Equal proportions (5-15%) of Ia+ lymphocytes and M pattern ANAE+, endogenous peroxidase-positive mononuclear phagocytes on the one hand and T3+ and T pattern ANAE+ cells on the other in individual patients indicate that the proportion of activated T blasts in situ was less than 15%. The close contacts between different immunocompetent cells in the periphery indicates this as the site for cellular interactions.