Lymphadenopathy-

metastatic cancer

21-3
 Objectives

1. Discuss the functions of lymphatic

system
2. Identify the parts of lymphatic system and
its accessory organs
3. Trace the flow of the lymph in the system
4. Explain the role of the lymphatic system
in relation to cardiovascular system
21-6
 Components of the Lymphatic
System
• Lymph
• Lymphatic Vessels
– Lymphatic Capillaries
– Lymphatic Vessels
– Lymphatic Trunks
– Lymphatic Ducts
• Lymphatic Organs
– Thymus
– Lymph Nodes
– Spleen
24-7
Functions of Lymphatic System
• Fluid recovery
– absorbs plasma proteins and fluid (2 to 4 L/day) from
tissues and returns it to the bloodstream
• interference with lymphatic drainage leads to severe edema

21-8
Lymphatic and Immune Systems

• Maintain fluid balance

• Protect body from infection and disease
 Functions of Lymphatic System

• Immunity
– fluids from all capillary
beds are filtered
– immune cells stand ready
to respond to foreign cells
21-10
or chemicals encountered
Functions of Lymphatic System

• Lipid absorption
– Lacteals in
small intestine
absorb dietary
lipids

21-11
Components of the
Lymphatic System

24-12
Lymph and Lymphatic Capillaries
• Lymph
– clear,
colorless
fluid, similar
to plasma but
much less
protein

21-13
Lymphatic Capillary

21-14
Lymph and Lymphatic Capillaries
• Lymphatic capillaries
– endothelial cells loosely overlapped
• allow bacteria and cells entrance to lymphatic
capillary
• creates valve-like flaps that open when interstitial
fluid pressure is high, and close when it is low

21-15
Lymphatic Vessels

21-16
Valve in a Lymphatic Vessel

21-17
 Lymphatic Drainage of
Mammary and Axillary Regions

21-20
 How is fluid moved?
Contraction of skeletal
muscles against lymphatic
vessels
Smooth muscle contraction
Valves in lymphatic vessels
Breathing
Obstruction of system leads to
edema
LYMPHATIC CELLS

21-22
 Lymphatic Cells
• Natural killer (NK) cells
– responsible for immune surveillance

21-23
 Lymphatic Cells
• T lymphocytes
– mature in thymus
• B lymphocytes
– activation causes
proliferation and
differentiation into
plasma cells that
produce antibodies

21-24
 Lymphatic Cells
• Antigen
Presenting Cells
– macrophages
(from monocytes)
– dendritic cells (in
epidermis, mucous
membranes and
lymphatic organs)
– reticular cells (also
contribute to stroma
of lymph organs)

21-26
 Lymphatic Tissue
• Diffuse lymphatic tissue
– lymphocytes in mucous membranes and CT of
many organs
– Mucosa-Associated Lymphatic Tissue (MALT):
prevalent in passages open to exterior

21-27
Lymphatic Tissue

21-28
 Lymphatic Tissue
• Lymphatic nodules
– dense oval masses of lymphocytes,
congregate in response to pathogens
– Peyer patches: more permanent
congregation, clusters found at junction of
small to large intestine

21-29
21-30
 Lymphatic Organs
• At well defined sites; have CT capsules
• Primary lymphatic organs
– site where T and B cells become immunocompetent
– red bone marrow and thymus

• Secondary lymphatic organs

– immunocompetent cells populate these tissues
– lymph nodes, tonsils, and spleen

21-31
 Lymph Node
• Lymph nodes -
only organs
that filter
lymph

21-32
Lymph
nodes
Grouped together at
various parts of the
body

Filtration

“Immune
surveillance” immune
cells are concentrated
there (as is antigen)
 Lymphadenopathy
• Collective term for all
lymph node diseases
• Lymphadenitis
– swollen, painful
node responding
to foreign antigen

21-35
 Lymphadenopathy
• Collective term for all
lymph node diseases
• Lymph nodes are
common sites for
metastatic cancer
– swollen, firm and
usually painless

21-36
Lymphadenopathy- metastatic
cancer

21-37
Tonsil

21-38
 Location of Tonsils
• Palatine tonsils
– pair at posterior margin of
oral cavity
– most often infected
• Lingual tonsils
– pair at root of tongue
• Pharyngeal tonsil
(adenoid)
– single tonsil on wall of
pharynx

21-39
 Thymus

Very large in fetus; after age 14

begins involution
in elderly mostly fatty and fibrous
tissue 21-40
Histology of Thymus

21-41
 Thymus
• Capsule gives off trabeculae, divides
parenchyma into lobules of cortex and medulla
• Reticular epithelial cells
– form blood thymus barrier in cortex
• isolates developing T lymphocytes from foreign antigens
– secretes hormones (thymopoietin, thymulin and thymosins)
• to promote development and action of T lymphocytes

21-42
Spleen

21-43
 Spleen
• Parenchyma appears in fresh specimens as
– red pulp: sinuses filled with erythrocytes
– white pulp: lymphocytes, macrophages; surrounds
small branches of splenic artery

21-44
 Spleen
• Functions
– blood production in fetus
– blood reservoir
– RBC disposal
– immune reactions: filters blood,
quick to detect antigens

21-45
SHORT QUIZ ABOUT LYMPHATIC SYSTEM
 WRITE ONLY THE LETTER OF THE
CORRECT ANSWER

1) The lymphatic fluid ____________.

A) is a filtrate of the blood, as in the urine.
B) is completely separate from the circulatory
system for blood.
C) carries both red and white blood cells.
D) functions in adaptive immunity but not in
innate immunity.
E) carries a toxic gas that kills cancerous
cells.
 B. Essay
A. Trace the flow of lymph in the lymphatic system
from the lymphatic capillaries to subclavian vein
entering to circulatory system. (7pts)
B. Differentiate blood vessels from lymphatic
vessels (4 pts)
C. Explain this
diagram (4pts)
 Assignment:
1. Differentiate specific from nonspecific
defense mechanisms of the immune
system.
2. Explain the cell-mediated and antibody-
mediated immunities.
3. Trace the inflammatory response.
4. Provide script for the play – “immune
system”
grp 1 - nonspecific defense mechanisms
grp 2 – lymphatic system
grp 3 – cell-mediated immunity
grp 4 – antibody-mediated immunity
grp 5 – inflammatory response