Sarcoid reactions have been described in association with lymphomas and rarely with other solid tumors. We describe a patient with renal papillary adenocarcinoma and prominent sarcoid-like granulomatous infiltration of the ipsilateral and most likely the contralateral kidney. There was no evidence of extrarenal granulomas. This is the first description of impairment in renal function in a patient with renal carcinoma and with sarcoid reaction to this tumor isolated in the kidney.

j chain expression in lymphoid cells has been detected by a variety of immunochemical techniques (for reviews see 1-4). Studies of mouse plasmacytomas initially suggested that J chain was synthesized only in cell lines that produced polymeric immunoglobulins (5, 6). This result supported the idea of J chain involvement in the process ofimmunoglobulin polymerization (2,7,8). However, subsequent studies have revealed that J chain may also be present in cells that contain monomeric immunoglobulins, heavy chains, light chains, or no immunoglobulin chains (3, 4, 9-15). The latter finding is particularly intriguing because it suggests that J chain expression may occur independently of immunoglobulin synthesis.With Materials and MethodsCells. Cells from peripheral blood (PB) I and bone marrow (BM) of normal individuals, patients with acute lymphocytic leukemia (ALL), two patients with Sezary syndrome, and a patient with acute myelofibrosis, and two pre-B cell lines (Nos. 207 and 697) were examined. Lymphoid cells from PB were separated by centrifugation on Ficoil-Hypaque gradients. Immunologic characterization of the leukemic cells was performed by immunofluorescence to detect surface and cytoplasmic immunoglobulin, HLA-DR, B cell, common ALL, and a myelomonocytic antigen.

The monoclonal antibody OKT9 (a known transferrin receptor antibody) and a monoclonal antibody to transferrin (ATfn) were used to localize the transferrin receptor and transferrin on marrow cells. After incubation of cell suspensions with the antibody, the cells were reacted with an affinity purified Fab fragment of goat anti-mouse IgG conjugated to horseradish peroxidase (GAM-HRP), which was in turn visualized by reaction with 3,3'-diaminobenzidine (DAB). Erythroblast cell surfaces stained intensely with OKT9-GAM-HRP-DAB, weaker staining was observed on reticulocyte surfaces, whereas erythrocyte surfaces lacked staining. Staining was present on surface caveolae, which often contained endogenous ferritin particles. Moderate to strong OKT9 staining was observed on less than 10% of presumed lymphoid cells. Monocytes, macrophages, promyelocytes, granulocytes, megakaryocytes and platelets consistently lacked OKT9 staining. ATfn-GAM-HRP-DAB staining of erythroid cells was similar to that observed with OKT9 staining; however, in contrast to the latter staining, ATfn stained the surfaces of megakaryocytes, platelets, monocytes and most lymphocytes. Promyelocytes stained weakly, whereas late granulocytes lacked staining. These results indicate that the T9 transferrin receptor (1) is largely confined to erythroid cells in marrow, (2) is diffusely distributed on the surface of early erythroid cells, (3) decreases with cell maturation, and (4) is lost when haemoglobin synthesis is completed. Transferrin appears in a similar distribution on erythroid cell surfaces but also appears to bind to some cell surfaces lacking the T9 receptor.

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The concentration of gamma globulins is greatly increased in the cerebrospinal fluid (CSF) during inflammatory and degenerative disorders of the central nervous system (CNS). The mechanism by which immunoglobulins enter the CSF under normal conditions is unknown. The extent of participation of the blood-brain barrier in protein delivery to the CSF is unclear, although the choroid plexus is known to have primary responsibility for the formation and movement of certain proteins into the CSF. To investigate the role of the choroid plexus in immunoglobulin delivery to the CSF, the authors evaluated rat brain tissue by light and electron microscopic immunohistochemical technique using the peroxidase technique of immunoglobulin (Ig)G and IgA detection. Peanut agglutinin was used to identify macrophages, cells known to have important immune functions and which have been reported as a normal component of the choroid plexus. Antisera to IgG' and IgA demonstrated diffuse surface staining of the choroidal epithelial cells with light and electron microscopy; the cytoplasm and nuclei did not contain immunoglobulins. Macrophages were not present in the choroid plexus, in contrast to previous reports. The results demonstrate that immunoglobulins do not enter the CSF via the choroid plexus, unlike other proteins in similar concentrations in the CSF. In addition, macrophages are shown to be an insignificant component of the plexus, thereby further diminishing the likelihood of participation-of the choroid plexus in the regulation of immunoglobulin entry into the CNS under normal conditions.