LYMPHATIC SYSTEM

ALBERT CHRISTIAN C. BORBON, RMT, MD, DPSA

 LEARNING OBJECTIVES

• 1. Know the different lymphoid organs of the body and study the cells and
tissue components
• 2. Enumerate which organs are primary lymphoid organs and secondary
lymphoid organs
• 3. Recognize the different cells and their functions in lymphoid organs or in
immunity
 LYMPHOID ORGANS
• Primary Lymphoid organs
• Where lymphocytes are initially formed, the thymus and bone marrow
• Secondary lymphoid organs
• lymphocyte activation and proliferation occur
• the lymph nodes, the spleen, and diffuse lymphoid tissue found in the mucosa of the
digestive system - the tonsils, Peyer patches, and appendix
• MUCOSA ASSOCIATED LYMPHOID TISSUE (MALT)
• The immune cells located diffusely in the digestive, respiratory, or urogenital
mucosae
• Lymphoid Nodules – small spherical area where proliferation of B lymphocytes in
the secondary structures of MALT
 THYMUS
• a bilobed structure in the mediastinum.
• A main function induction of central tolerance, which along with regulatory
T cells prevents autoimmunity.
• The organ originates from the embryo’s third pair of pharyngeal pouches
(endoderm)
• Fully formed and functional at birth, the thymus remains large and very
active in T-cell production
• Puberty during which it normally undergoes involution, with decreasing
lymphoid tissue mass and cellularity and reduced T cell output
 THYMUS
• Capsule - vascularized connective
tissue that extends septa into the
parenchyma, dividing the organ into
many incompletely separated lobules
• Cortex - outer darkly basophilic part of
the lobule an extensive population of T
lymphoblasts/Thymocytes, located
among macrophages and thymic
epithelial cells (both epithelial and
reticular cells)
 THYMUS - CORTEX
• THYMUS EPITHELIAL CELLS OF THE CORTEX
• Squamous TECs - line the connective tissue of the capsule and septa and
surround the microvasculature, forms a blood-thymus barrier
• Stellate TECs, with processes containing keratin tonofilaments joined by
desmosomes, form a cytoreticulum to which macrophages attach; antigen
presenting cells – MHC Class II
• Other squamous cortical TECs - form a sheet-like structure a functional
corticomedullary barrier
 THYMUS - MEDULLA
• lightly stained, thymic medulla contains fewer and larger, more mature
lymphocytes
• Medullary TECs:
• A second layer of the boundary between cortex and medulla
• A cytoreticulum:
• supports T lymphocytes, dendritic cells, and macrophages (all less densely packed
than in the cortex)
• expresses many specialized proteins specific to cells of other organs
• Hassall corpuscles - Large aggregates of TECs, sometimes concentrically
arranged, secrete cytokines
 MUCOSA ASSOCIATED LYMPOID TISSUE
• Found in the mucosa of the GIT, Respiratory tract and the GUT to protect against
invaders because the lumen of these systems are open to the external
environment
• contains large and diffuse collections of lymphocytes, IgA-secreting plasma cells,
APCs, and lymphoid nodules
• others are found in aggregates forming large, conspicuous structures such as the
tonsils, the Peyer patches in the ileum, and the appendix
• Most of the lymphocytes here are B cells; among T cells, CD4+ helper T cells
predominate
 TONSILS

• large, irregular masses of lymphoid tissue in the mucosa of the posterior oral
cavity and nasopharynx
• Palatine tonsils - posteriorly on the soft palate, are covered by stratified
squamous epithelium.
• The surface area of each is enlarged with 10-20 deep invaginations or tonsillar
crypts in which the epithelial lining is densely infiltrated with lymphocytes and
other leukocytes.
• The lymphoid tissue is filled diffusely with lymphocytes, with many secondary
lymphoid nodules around the crypts; tissue is underlain by dense connective
tissue acting as a partial capsule
 TONSILS

• Lingual tonsils are situated along the base of the tongue, are also covered
by stratified squamous epithelium with crypts, and have many of the same
features as palatine tonsils but lack distinct capsules.
• The single pharyngeal tonsil (adenoids) is situated in the posterior wall of
the nasopharynx, is covered by pseudostratified ciliated columnar
epithelium, and has a thin underlying capsule.
• The mucosa with diffuse lymphoid tissue and lymphoid nodules is
invaginated with shallow infoldings but lacks crypts.
 PEYER’S PATCHES
• large aggregates of lymphoid nodules each containing dozens of nodules
with no underlying connective tissue capsule located in the mucosa and
submucosa of the ileum
• Covered by simple columnar epithelium
• M cells - scattered, large epithelial cells with apical microfolds rather than
the brush border with glycocalyx typical of the neighboring enterocytes.
• unique epithelial cell type specialized for uptake of particles and intact
microorganisms
 APPENDIX
• a short, small-diameter projection
from the cecum.
• Typically the mucosa of the
appendix is almost completely
filled with lymphoid tissue,
effacing the glands otherwise found
in the large intestine wall.
• The lumen contains the normal
bacterial flora of the large intestine
and may serve to retain some of
these beneficial bacteria there
during diarrheal illnesses.
 LYMPH NODES
• bean-shaped, encapsulated structures, embedded in CT, generally only 10 mm by
2.5 cm in size, distributed throughout the body along the lymphatic vessels
• A total of 400-450 lymph nodes are present in the axillae and groin, along the
major vessels of the neck, and in the thorax and abdomen, and especially in the
visceral mesenteries.
• a series of in-line filters of lymph that defend against the spread of
microorganisms and tumor cells and provide enclosed environments for antigen
presentation and development of plasma cells secreting non-IgA antibodies.
• Before merging with the bloodstream, all lymph is filtered and has antibodies
added by at least one lymph node
LYMPH NODES
• Afferent lymphatics – lymph vessels that enter
the convex side of the lymph node
• Hilum - a concave depression where an an artery,
vein, and nerve penetrate the organ
• Efferent lymphatic – lymph vessels that leave
the hilum
• A dense connective tissue capsule surrounds the
lymph node, extending trabeculae internally
through which the blood vessels branch.
• Valves in the lymphatics ensure unidirectional
lymph flow.
 LYMPH NODES -
CORTEX
• A subcapsular sinus immediately inside the capsule,
receives lymph from the afferent lymphatics.
• cortical sinuses/trabecular sinuses found in the
subscapular sinus branch internally among the
lymphoid nodules along trabeculae, are lined by a
very thin, discontinuous endothelium penetrated by
reticulin fibers and processes of dendritic cells,
lymph passes here
• Lymphoid nodules, with or without germinal
centers, consist largely of developing B
lymphocytes and occupy much of the cortex not
filled with helper T lymphocytes with
macrophages
 LYMPH NODES -
PARACORTEX
• The region between the cortex and
medulla does not have precise
boundaries
• lack of nodules unlike the superficial
cortex and contains lymphoid tissue
rich in T cells
• high endothelial venules (HEVs) –
specialized post capillary venules,
entry point for most (90%) circulating
lymphocytes into lymph nodes
LYMPH NODES -MEDULLA

• Medullary cords - branched cordlike masses of

lymphoid tissue extending from the paracortex and
contain T and B lymphocytes and many plasma cells.
• Medullary sinuses are dilated spaces lined by
discontinuous endothelium that separate the
medullary cords.
• the lumens of medullary sinuses include a meshwork
of processes from reticular cells, which represent a
final lymph filter and contain many macrophages and
sometimes neutrophils if the lymph node is draining
an infected region.
• They are continuous with the cortical sinuses and
converge at the hilum as the efferent lymphatic
vessel
 LYMPHATIC VASCULAR SYSTEM
• Lymph – excess interstitial fluid from the tissues that needs to be return back to
the blood and back to the heart, this comes from the plasma of blood and enters
the lymphatic capillaries
• Lymphatic capillaries - thin-walled channels of the lymphatic system that collects
lymph, present everywhere except BONE MARROW AND CNS;originate locally as
tubes of very thin endothelial cells which lack tight junctions with discontinuous
basal lamina
• Interstitial fluid  lymphatic capillaries  lymph  lymphatic vessels  lymph
nodes  lymphatic vessels  thoracic duct on Left side of the head neck and
chest, left upper extremities, abdomen, lower extremities and right lymphatic
duct on right side of the head, neck,chest and right upper extremity  HEART
• Contain VALVES- unidirectional flow of blood
 SPLEEN
• Located high in the left upper quadrant of the abdomen,
• the largest single accumulation of lymphoid tissue in the
body and is the only lymphoid organ involved in filtration
of blood – defense against blood-borne antigens.
• the main site of old erythrocyte destruction – graveyard
of RBCs
• surrounded by a capsule of dense connective tissue from
which emerge trabeculae to penetrate the parenchyma or
splenic pulp.
• Large trabeculae originate at the hilum, on the medial
surface of the spleen, and carry branches of the splenic
artery, vein, lymphatics, and nerves into the splenic pulp.
 SPLEEN – WHITE PULP
• 20% of the spleen’s pulp, consist of lymphoid nodules and the periarteriolar
lymphoid sheaths (PALS)
• Branching from the hilum, small trabecular arteries leave the trabecular connective
tissue and enter the parenchyma as arterioles enveloped by the PALS, which
consists primarily of T cells with some macrophages, Dendritic Cells, and plasma
cells
• Central arterioles – vessels surrounded by the PALS; B cells located within the PALS
may be activated by a trapped antigen
• Each central arteriole eventually leaves the white pulp and enters the red pulp, losing
its sheath of lymphocytes and branching as several short straight penicillar
arterioles that continue as capillaries
 SPLEEN – RED PULP
• splenic sinusoids and is the site where effete RBCs in blood are removed.
• The splenic cords/cords of Billroth contain a network of reticular cells and fibers
filled with T and B lymphocytes, macrophages, other leukocytes, and red blood
cells.
• Splenic sinusoids –separates the splenic cords; site where effete RBCs in blood
are removed.
• Stave Cells - unusual elongated endothelial cells that line these sinusoids,
oriented parallel to the blood flow and sparsely wrapped in reticular fibers and
highly discontinuous basal lamina
• FUNCTION: Removal of defective RBCs (after 120 days) and recycling of their iron;
Fe will be bound to transferrin or ferritin bound proteins
THANK YOU
FOR YOUR
ATTENTION!