lymph node, 

any of the small, bean-shaped masses of lymphoid tissue enclosed by a capsule of connective tissue that
occur in association with the lymphatic vessels. As part of the lymphatic system, lymph nodes serve as filters for the
blood, providing specialized tissues where foreign antigens can be trapped and exposed to cells of the immune system
for destruction. They are typically found concentrated near junctions of the major lymphatic vessels, most prominently
in the neck, groin, and armpits.

Each lymph node is divided into two general regions, the capsule and the cortex. The capsule is an
outer layer of

lymphatic system

lymphatic system,  a subsystem of the circulatory system in the vertebrate body that consists of a complex network of
vessels, tissues, and organs. The lymphatic system helps maintain fluid balance in the body by collecting excess fluid
and particulate matter from tissues and depositing them in the bloodstream. It also helps defend the body against
infection by supplying disease-fighting cells called lymphocytes. This article focuses on the human lymphatic system.

Lymphatic circulation

The lymphatic system can be thought of as a drainage system needed because, as blood circulates through the body,
blood, plasma leaks into tissues through the thin walls of the capillaries. The portion of blood plasma that escapes is
called interstitial or extracellular fluid, and it contains oxygen, glucose, amino acids, and other nutrients needed by
tissue cells. Although most of this fluid seeps immediately back into the bloodstream, a percentage of it, along with
the particulate matter, is left behind. The lymphatic system removes this fluid and these materials from tissues,
returning them via the to the bloodstream, and thus prevents a fluid imbalance that would result in the organism’s
death.

Role in immunity
In addition to serving as a drainage network, the lymphatic system helps protect the body against infection by
producing white blood cells called lymphocytes, which help rid the body of disease-causing microorganisms. The
organs and tissues of the lymphatic system are the major sites of production, differentiation, and proliferation of two
types of lymphocytes—the T lymphocytes and B lymphocytes, also called T cell and B cells. Although lymphocytes
are distributed throughout the body, it is within the lymphatic system that they are most likely to encounter foreign
microorganisms.

Lymphoid organs
The lymphatic system is commonly divided into the primary lymphoid organs, which are the sites of B and T cell
maturation, and the secondary lymphoid organs, in which further differentiation of lymphocytes occurs. Primary
lymphoid organs include the thymus, bone marrow, fetal liver, and, in birds, a structure called the bursa of Fabricius.
In humans the thymus and bone marrow are the key players in immune function. All lymphocytes derive from stem
cells in the bone marrow. Stem cells destined to become B lymphocytes remain in the bone marrow as they mature,
while prospective T cells migrate to the thymus to undergo further growth. Mature B and T lymphocytes exit the
primary lymphoid organs and are transported via the bloodstream to the secondary lymphoid organs, where they
become activated by contact with foreign materials, such as particulate matter and infectious agents, called antigens in
this context.

Thymus

The thymus is located just behind the sternum in the upper part of the chest. It is a bilobed organ that consists of an
outer, lymphocyte-rich cortex and an inner medulla. The differentiation of T cells occurs in the cortex of the thymus.
In humans the thymus appears early in fetal development and continues to grow until puberty, after which it begins to
shrink. The decline of the thymus is believed to be the reason T-cell production decreases with age.

In the cortex of the thymus, developing T cells, called thymocytes, come to distinguish between the body’s own
components, referred to as “self,” and those substances foreign to the body, called “nonself.” This occurs when the
thymocytes undergo a process called positive selection, in which they are exposed to self molecules that belong to the
(MHC). Those cells capable of recognizing the body’s MHC molecules are preserved, while those that cannot bind
these molecules are destroyed. The thymocytes then move to the medulla of the thymus, where further differentiation
occurs. There thymocytes that have the ability to attack the body’s own tissues are destroyed in a process called
negative selection. Positive and negative selection destroy a great number of thymocytes; only about 5 to 10 percent
survive to exit the thymus. Those that survive leave the thymus through specialized passages called efferent
(outgoing) lymphatics, which drain to the blood and secondary lymphoid organs. The thymus has no afferent
(incoming) lymphatics, which supports the idea that the thymus is a T-cell factory rather than a rest stop for
circulating lymphocytes.

Bone marrow

In birds B cells mature in the bvursa of fabricus. (The process of B-cell maturation was elucidated in birds—hence B
for bursa.) In mammals the primary organ for B-lymphocyte development is the bone marrow, although the prenatal
site of B-cell differentiation is the fetal liver. Unlike the thymus, the bone marrow does not atrophy at puberty, and
therefore there is no concomitant decrease in the production of B lymphocytes with age.

Secondary lymphoid organs

Secondary lymphoid organs include the lymph nodes, spleen, and small masses of lymph tissue such as Peyer’s
patches, the appendix, tonsils, and selected regions of the body’s mucosal surfaces (areas of the body lined with
mucous membranes). The secondary lymphoid organs serve two basic functions: they are a site of further lymphocyte
maturation, and they efficiently trap antigens for exposure to T and B cells.
Lymph nodes

The lymph nodes, or lymph glands, are small, encapsulated bean-shaped structures composed of lymphatic tissue.
Thousands of lymph nodes are found throughout the body along the lymphatic routes, and they are especially
prevalent in areas around the armpits (axillary nodes), groin (inguinal nodes), neck (cervical nodes), and knees
(popliteal nodes). The nodes contain lymphocytes, which enter from the bloodstream via specialized vessels called the
high endothelial venules. T cells congregate in the inner cortex (paracortex), and B cells are organized in germinal
centres in the outer cortex. Lymph, along with antigens, drains into the node through afferent (incoming) lymphatic
vessels and percolates through the lymph node, where it comes in contact with and activates lymphocytes. Activated
lymphocytes, carried in the lymph, exit the node through the efferent (outgoing) vessels and eventually enter the
bloodstream, which distributes them throughout the body.

spleen

The spleen is found in the abdominal cavity behind the stomach. Although structurally similar to a lymph node, the
spleen filters blood rather than lymph. One of its main functions is to bring blood into contact with lymphocytes. The
functional tissue of the spleen is made up of two types of cells: the red pulp, which contains cells called macrophages
that remove bacteria, old blood cells, and debris from the circulation; and surrounding regions of white pulp, which
contain great numbers of lymphocytes. The splenic artery enters the red pulp through a web of small blood vessels,
and blood-borne microorganisms are trapped in this loose collection of cells until they are gradually washed out
through the . The white pulp contains both B and T lymphocytes. T cells congregate around the tiny arterioles that
enter the spleen, while B cells are located in regions called germinal centres, where the lymphocytes are exposed to
antigens and induced to differentiate into antibody-secreting .

Mucosa-associated tissues

Another group of important secondary lymphoid structures is the mucosa-associated lymphoid tissues. These tissues
are associated with mucosal surfaces of almost any organ, but especially those of the digestive, genitourinary, and
respiratory tracts, which are constantly exposed to a wide variety of potentially harmful microorganisms and therefore
require their own system of antigen capture and presentation to lymphocytes. For example,peyer’s patches, which are
mucosa-associated lymphoid tissues of the small intestine, sample passing antigens and expose them to underlying B
and T cells. Other, less-organized regions of the gut also play a role as secondary lymphoid tissue.

Diseases of the lymphatic system

The host of secondary lymphoid organs provides a system of redundancy for antigen sampling by the cells of the
immune system. Removal of the spleen, selected lymph nodes, tonsils, or appendix does not generally result in an
excessive increase in disease caused by pathogenic microorganisms. However, the importance of the primary
lymphoid organs is clear. For example, two autoimmune diseases, DiGeorge syndrome and Nezelof’s disease, result in
the failure of the thymus to develop and in the subsequent reduction in T-cell numbers, and removal of the bursa from
chickens results in a decrease in B-cell counts. The destruction of bone marrow also has devastating effects on the
immune system, not only because of its role as the site of B-cell development but also because it is the source of the
stem cells that are the precursors for lymphocyte differentiation.

Aspects of the topic lymphatic system are discussed in the following places at Britannica.

diseases and disorders

 cancer  (in lymphoma)
 Epstein-Barr virus  (in Epstein-barr virus (EBV) (pathology))
 filariasis  (in filariasus (disorder))
 fluid accumulation during pregnancy  (in pregnancy: Cardiovascular & lymphatic system)
 lymphogranuloma venereum  (in lymphogranuloma venerum (pathology))

Each lymph node is also an important part of your immune system. Your lymph node filters fluids, catching viruses,
bacteria, and other unknown materials. Then your unique white blood cells destroy the unwanted materials.

A lymph node may be found alone or in a group through out your body. The main groups can be felt in the following
areas:
  Neck
 underarm
 Groin

Normally, a healthy lymph node is not sensitive or sore to touch.

Children between the ages of 10 to 12 years old usually have larger lymph nodes, which can be twice the normal size,
compared to adults .

Neck Lymph Node

These are found on either side of the neck, behind your ears, or under your chin.

Painful lymph node

Placing a heating pad (on low) or a warm towel on your painful lymph node may reduce the soreness. It may have
negative effects so use with caution.

THE LYMPHATIC SYSTEM AND IMMUNITY

INTRODUCTION

1. The lymphatic system includes a network of lymphatic vessels that carry lymph , a fluid similar in composition to
interstitial fluid.A series of lymph organs are associated with the vessels of the system.

2. The lymphatic system returns interstitial fluid to the general circulation, prevents local variations in the composition
of tissue fluids, and provides specialized defenses against infection.

3. Lymphocytes are the cells of the lymphatic system.

ANATOMY OF THE LYMPHATIC SYSTEM

[Link] flows along a network oflymphatics that originate in theterminal lymphatics of lymph capillaries.

2. The lymphatic vessels from areas below the diaphragm and from the left half of the upper body are connected to the
large thoracic duct that empties into the venous system at the left subclavian vein near the junction of the left internal
jugular.

3. The lymphatics servicing the right half of the body above the diaphragm are connected to the smallerright
lymphatic duct that empties into the venous system in the same region on the right side.

The Lymphocytes

1. There are three distinct populations of lymphocytes, T cells, B cells, and NK cells.

2. There are several different populations of T [Link] T cells include helper and suppressor T cells that
regulate the immune response. Cytotoxic (killer) T cells attack invading, infected, or abnormal [Link] T cells are
responsible for cellular immunity.

3. B cells are concerned with the production of antibodies, special proteins that can either cause or facilitate the
destruction of specific antigens. These proteins are dissolved in body fluids, and they provide what is known as
humoral immunity.

4. NK cells detect the presence of abnormal antigens on cell membranes; they are responsible for immunological
surveillance and the removal of cancer cells from normal tissues.
The Life Span and Circulation of Lymphocytes

1. Lymphocytes are found in the blood, bone marrow, spleen, thymus, and peripheral lymphatic tissues. The ratio of B
cells to T cells varies from one site to another.

2. Lymphocytes are continually migrating in and out of the blood and through the lymphatic tissues and organs.

[Link] are relatively long-lived, and some survive for decades.

Lymphopoiesis

1. Lymphocytic stem cells are produced in the bone marrow. B cells and NK cells are primarily produced in the bone
marrow. T cells are produced by stem cells that have migrated to the thymus.

2. The thymus produces the hormone thymosin. Thymosin stimulates the mitosis of stem cells in the thymus. Mature
T cells leave the thymus and reside in other tissues, including the bone marrow.

Lymphatic tissues

1. Lymphatic tissues are connective tissues dominated by lymphocytes. A lymphatic tissue has no clearcut boundaries,
for the lymphocytes are not surrounded by a fibrous capsule.

2. A lymphatic nodule consists of a dense aggregation of lymphocytes in an area of loose connective tissue, usually
beneath an epithelium.

3. Lymphatic nodules often have a pale central area, the germinal center, where mitosis occurs.

4. The pharyngeal(adenoid), palatine , and lingual tonsils are large lymphatic nodules embedded in the walls of the
pharynx.

[Link]'s patches are lymphatic nodules beneath the epithelium of the small intestine.

6. Large lymphatic nodules are also found beneath the epithelium of theappendix and large intestine.

Lymphatic Organs

1. Lymphatic organs have a clear internal organization, and they are surrounded by a dense fibrous capsule.
Lymphatic organs include the thymus, lymph nodes, and the spleen.

The Thymus:

1. The thymus lies within the mediastinum behind the sternum. It reaches its maximum size during puberty, and
slowlyinvolutes thereafter.

2. There are two thymic lobes, partitioned by septae into lobules. Each lobule has an outer cortex and an inner
medulla. Epithelial cells scattered among the lymphocytes produce the thymic hormones.

Lymph Nodes:

1. Lymph nodes are encapsulated masses of lymphatic tissue up to 25 mm in diameter. Blood vessels, nerves, and
lymphatics are connected to each node. The cortical zone contains T cells, and the medullary cords are dominated by
B cells.

2. Lymph arrives at a lymph node via lymphatics that penetrate the capsule opposite the hilus. The lymph flows
through a network of cortical sinuses.

3. The lymphocytes and macrophages of lymph nodes monitor the contents of the lymph as it proceeds towards the
lymphatic ducts and the venous system.
4. Lymph nodes are largest and most abundant where the peripheral lymphatics connect with the trunk. At these sites
the nodes are often called lymph glands, and their swelling usually indicates peripheral inflammation or infection.

The spleen:

1. The adult spleen contains the largest mass of lymphatic tissue in the body. Its shape is primarily determined by its
relationship with adjacent structures.

NOTE: Many sources list "blood reservoir" as a splenic function, and include splenic contraction as an event that
occurs under sympathetic stimulation. Such statements are valid for members of the Order Carnivora (dogs, cats,
bears, and so forth), whose large spleens have layers of smooth muscle in the capsule. The human spleen does not
contain smooth muscle and cannot contract; in addition, the volume of blood enclosed (150 ml) represents a relatively
insignificant fraction of the venous reserve.

[Link] splenic artery, splenic vein, and lymphatics are connected at the hilus of the spleen.

[Link] cellular components constitute the pulp of the spleen. Red pulp contains large numbers of red blood cells, and
areas of white pulp resemble lymphatic nodules.

Integration with the Immune System

1. The lymphatic system is one component of the immune system

defends the body and maintains tissue homeostasis.

2. The immune system includes nonspecific defenses and it provides specific immunity.

3. Nonspecific defenses do not discriminate between one threat and another. Such defenses include physical barriers,
phagocytic cells, immunological surveillance, complement, and inflammation.

4. Nonspecific defenses are fully operational at birth, and they contribute to the natural immunity of the individual.

5. Specific immunity develops after birth as the result ofexposure to specific antigens.

NONSPECIFIC DEFENSES

1. Nonspecific defenses either prevent approach, deny access, or

imit the spread of threats to homeostasis.

Physical Barriers

1. Physical barriers include hair, epithelia, and various secretions of the integumentary and digestive systems.

Phagocytic cells

1. There are two classes of phagocytic cells, microphages (neutrophils and eosinophils) and macrophages (cells of the
monocyte-phagocyte system).

2. Fixed macrophages are found in many peripheral tissues. Free and fixed macrophages are derivatives of circulating
monocytes.

Orientation and Phagocytosis:

1. Phagocytes move between cells through diapedesis, and they show chemotaxis, sensitivity and orientation to
chemical stimuli.

2. Phagocytized materials are destroyed by lysosomal enzymes and the residue ejected via exocytosis.
3. Phagocytic cells often have short life-expectancies, and populations must be continually replenished.

Immunological Surveillance

1. NK cells are sensitive to the presence of abnormal antigens on the surfaces of otherwise normal cells.

2. Cancer cells with tumor-specific antigens on their surfaces are killed; after immunological escape cancer cells may
be treated like normal cells, and ignored by the immune system.

Complement

1. There are at least 11 different types of complement proteins. Complement binding may disintegrate the cell wall of
a bacterium, inactivate a virus, stimulate inflammation, or attract lymphocytes and phagocytes.

2. The primary method of complement activation is binding to antibodies. Activation may also occur following
exposure to certain bacteria; this response is sustained and enhanced by properdin.

Inflammation

1. Inflammation represents a coordinated nonspecific response to tissue injury.

2. The inflammatory response begins with the release of histamine and other chemicals by stimulated mast cells.
Important events then include an increase in capillary blood flow and permeability, increased local phagocytic
activities, elevated local temperature, complement entry and activation, clotting, scar tissue formation, and the
activation of specific defenses.

SPECIFIC IMMUNITY

1. Specific immunity results from the activities of lymphocytes.

2. Humoral immunity results from the presence of antibodies within body fluids. Antibodies are produced by plasma
cells that differentiate from activated B cells.

3. Cellular, or cell-mediated, immunity requires intimate contact between an activated T cell and its specific target.
Humoral Immunity:

B cells and Antibody Production

1. Antigens are molecules that trigger the production of antibodies. Acomplete antigen has two antigenic determinant
sites, and it can react with its specific antibody to form an antigen-antibody complex .

2. Molecules with a single antigenic determinant site are called partial antigens, or [Link] may bind to
another compound to form a complex that acts like a complete antigen.

3. An activated B cell undergoes repeated mitoses. Some of the daughter cells develop into plasma cells and begin
producing antibodies. Others remain as memory B cells that will respond following subsequent exposure to the same
antigen.

4. The production of antibodies in response to the initial exposure constitutes the primary response . The maximum
antibody titer appears during the secondary , or anamnestic response that follows subsequent exposures.

Antibody Structure and Function:

1. An antibody changes shape when it binds to its antigen. Effects that appear subsequent to binding include
complement activation, opsonization, phagocyte attraction, stimulation of inflammation, and prevention of bacterial
adhesion.

Antibody Diversity:
1. Five different classes of immunoglobulins have been identified.

2. IgG is the largest group, providing specific immunity against many viruses, bacteria, and bacterial toxins.

3. IgA antibodies are primarily found in glandular secretions that attack potential pathogens before they enter the
body.

4. IgM appears shortly after exposure to an antigen, but its production declines as IgG titers rise. Plasma agglutinins
are IgM antibodies.

5. IgE antibodies bind to the exposed surfaces of basophils and mast cells. If the specific antigens appear these cells
break down and cause an immediate and pronounced inflammation.

[Link] resides on the surfaces of B cells, where it may help to bind specific antigen molecules to the cell membranes.

Cellular Immunity

1. T cells responsible for cellular immunity undergo mitoses to produce memory T cells and cytotoxic (killer) T cells .
Cytotoxic T cells migrate to the site of invasion or infection and attack bacteria, fungi, foreign tissues, infected cells,
and some cancer cells. Their targets are destroyed by direct contact or by the production of lymphotoxins.

The Regulation of the Immune Response

1. T cells and B cells are particularly sensitive to foreign or abnormal antigens bound to otherwise normal cell
membranes.

2 Molecules are found on the surfaces of almost every cell in the body. Class II molecules are restricted to the
membranes of macrophages and lymphocytes. Each of the proteins in this complex has a distinctive shape, and binds
specific antigens.

3. Lymphocytes are sensitive to antigens bound to normal HLA proteins, abnormal HLA molecules, and the HLA
proteins of foreign cells.

4. Active macrophages accumulate antigenic materials on their surfaces, bound to Class I and Class II molecules. T
cells sensitive to antigens bound to HLA Class I receptors differentiate into cytotoxic T cells, memory T cells, and
suppressor T cells. Those sensitive to antigens carried by HLA Class II molecules differentiate into helper T cells.

5. Regulatory cells modify the sensitivities and immune responses of T cells and B cells.

6. In many cases B cells only become activated after antigen presentation by helper T cells. Suppressor T cells inhibit
B cell maturation and antibody production; ordinarily helpers outnumber suppressors by a factor of 3 to 1.

Chemical Communication and Coordination:

1. Chemicals released by macrophages and lymphocytes adjust the timing and intensity of the immune response.
Monokines are produced by macrophages and lymphokines are secreted by lymphocytes.

2. Important monokines and lymphokines include the interleukins, interferons, BCGF, BCDF, and factors attracting
and keeping phagocytes in the affected area.

PATTERNS OF IMMUNE RESPONSE

Immunological competence

1. Immunological competence is the ability to respond to the presence of an antigen by the production of antibodies
and cytotoxic T cells.

2. Cellular immunity can be demonstrated after the third month of embryonic development.
3. The developing fetus receives passive immunity from the maternal blood [Link] delivery the infant begins
developing acquired immunity as the result of exposure to environmental antigens.

Tolerance:

1. Tolerance, the acceptance of an antigen as "normal" by the immune system, usually continues only as long as the
individual is exposed to the antigen on a regular basis.

Stress and the Immune Response

1. Interleukin-1 released by active macrophages triggers the release of ACTH by the anterior pituitary.
Glucocorticoids produced by the adrenal cortex moderate the immune response.

2. Chronic stress reduces resistance to disease by depressing both specific and nonspecific defenses. Effects
attributable to glucocorticoid activities include inhibition of the immune response, depression of phagocytic activity,
and reduction in interleukin secretion.

Lymph node
Lymph node

Lymph node, showing (1) capsule, (2) subcapsular sinus, (3)

germinal centers, (4) lymphoid nodule, (5) trabeculae.

A lymph node is a small ball-shaped organ of the immune system, distributed widely throughout the body including
the armpit and stomach/gut and linked by lymph vessel. Lymph nodes are garrisons of B cell, T cell, and other white
blood cell. Lymph nodes are found all through the body, and act as filters or traps for foreign particles. They are
important in the proper functioning of the immune system.

Lymph nodes also have clinical significance. They become inflamed or enlarged in various conditions, which may
range from trivial, such as a pharyngitis, to life-threatening such as cancer. In the latter, the condition of lymph nodes
is so significant that it is used for cancer staging, which decides the treatment to be employed, and for determining the
prognosis.

Lymph nodes can also be diagnosed by biopsy whenever they are inflamed. Certain diseases affect lymph nodes with
characteristic consistency and location.
Function
pathogen, or germs, can set up infections anywhere in the body. However, lymphocyte, a type of white blood cell, will
meet the antigen, or protein, in the peripheral lymphoid organs, which includes lymph nodes. The antigens are
displayed by specialized cells in the lymph nodes. Naive lymphocytes (meaning the cells have not encountered an
antigen yet) enter the node from the bloodstream, through specialized capillary venule, known as high endothelial
venules. After the lymphocytes specialize they will exit the lymph node through the efferent lymphatic vessel with the
rest of the lymph. The lymphocytes continuously recirculate the peripheral lymphoid organs and the state of the lymph
nodes depends on infection. During an infection of fermintation, the lymph nodes can expand due to intense B cell
proliferation in the germinal centers, a condition commonly referred to as "swollen glands".

Structure

The lymph node is surrounded by a fibrous lymph node capsule, and inside the lymph node the fibrous lymph node
capsule extends to form trabeculae. The substance of the lymph node is divided into the outer cortex and the inner
medulla surrounded by the former all around except for at the hilum, where the medulla comes in direct contact with
the surface.

Thin reticular fibers, elastin and reticular fiber form a supporting meshwork called reticular network (RN) inside the
node, within which the white blood cell (WBCs), the most prominent ones being lymphocytes, are tightly packed as
follicles in the cortex. Elsewhere, there are only occasional WBCs. The RN provides not just the structural support,
but also will provide surface for adhesion of the dendritic cell, macrophage and lymphocytes. It allows for exchange
of material with blood through the high endothelial venules and provides the growth and regulatory factors necessary
for activation and maturation of immune cells.

The number and composition of follicles can change especially when challenged by an antigen, when they develop a
geminial center.

A lymph sinus is a channel within the lymph node lined by the endothelial cells along with fibroblastic reticular cells
and allows for smooth flow of lymph through them. Thus, subcapsular sinus is a sinus immediately deep to the
capsule, and its endothelium is continuous with that of the afferent lymph vessel. It is also continuous with similar
sinuses flanking the trabeculae and within the cortex (cortical sinuses). The cortical sinuses and that flanking the
trabeculae drain into the medullary sinuses, from where the lymph flows into the efferent lymph vessel.

Multiple afferent lymph vessel that branch and network extensively within the capsule bring lymph into the lymph
node. This lymph enters the subcapsular sinus. The innermost lining of the afferent lymph vessels is continuous with
the cells lining the lymph sinuses. The lymph gets slowly filtered through the substance of the lymph node and
ultimately reaches the medulla. In its course it encounters the lymphocytes and may lead to their activation as a part of
adaptive immune system.

The concave side of the lymph node is called the hilum of lymph node. The efferent lymphatic vessel attaches to the
hilum by a relatively dense reticulum present there, and carries the lymph out of the lymph node.
Cortex

In the cortex, the subcapsular sinus drains to trabecular sinuses, and then the lymph flows into the "medullary
sinuses".

The outer cortex consists mainly of the B cell arranged as follicles, which may develop a germinal center when
challenged with an antigen, and the deeper cortex mainly consisting of the T cell. There is a zone known as the
subcortical zone where T-cells (or cells that are mainly red) mainly interact with dendritic cells, and where the
reticular network is dense.

Medulla

There are two named structures in the medulla:

 The medullary cords are cords of lymphatic tissue, and include plasma cell, macrophages, and B cell
 The medullary sinuses (or sinusoids) are vessel-like spaces separating the medullary cords. The Lymph flows into the
medullary sinuses from cortical sinuses, and into efferent lymphatic vessels. Medullary sinuses contain histiocyte
(immobile macrophages) and reticular cell.

Shape and size

Human lymph nodes are bean-shaped and range in size from a few millimeters to about 1–2 cm in their normal
[Link] may become enlarged due to a tumor or infection, or inflamed due to leukimia. Lymphocytes, also known
as white blood cells, are located within honeycomb structures of the lymph nodes. Lymph nodes are enlarged when
the body is infected, primarily because there is an elevated rate of trafficking of lymphocytes into the node from the
blood, exceeding the rate of outflow from the node, and secondarily as a result of the activation and proliferation of
antigen-specific T and B cells (clonal expansion). In some cases, they may feel enlarged because of a previous
infection; although one may be healthy, one may still feel them residually enlarged.

Lymphatic circulation
lymph circulates to the lymph node via afferent lymphatic vessels and drains into the node just beneath the capsule in
a space called the subcapsular sinus. The subcapsular sinus drains into trabecular sinuses and finally into medullary
sinuses. The sinus space is criss-crossed by the pseudopod of macrophage, which act to trap foreign particles and filter
the lymph. The medullary sinuses converge at the hilum and lymph then leaves the lymph node via the efferent
lymphatic vessel towards either a more central lymph node or ultimately for drainage into a central subclavian vein,
most via the postcapillary venule, and cross its wall by the process of diapedesis.

 The B cells migrate to the nodular cortex and medulla.

 The T cells migrate to the deep cortex ("paracortex").

When a lymphocyte recognizes an antigen, B cells become activated and migrate to germinal center (by definition, a
"secondary nodule" has a germinal center, while a "primary nodule" does not). When antibody-producing plasma cells
are formed, they migrate to the medullary cords. Stimulation of the lymphocytes by antigens can accelerate the
migration process to about 10 times normal, resulting in characteristic swelling of the lymph nodes.

The spleen and tonsil are large lymphoid organs that serve similar functions to lymph nodes, though the spleen filters
blood cells rather than lymph.

Distribution
Regional lymph tissue

Humans have approximately 500-600 lymph nodes distributed throughout the body, with clusters found in the
underarms, groin, neck, chest, and abdomen.

Lymph nodes of the head and neck

 Cervical lymph nodes

o Anterior cervical: These nodes, both superficial and deep, lie above and beneath the sternocleidomastoid
muscles. They drain the internal structures of the throat as well as part of the posterior pharynx, tonsil, and
thyroid gland.
o Posterior cervical: These nodes extend in a line posterior to the sternocleidomastoids but in front of the
trapezius, from the level of the temporal bone to the clavicle. They are frequently enlarged during upper
respiratory tract infection.
 Tonsillar OR Sub-mandibular: These nodes are located just below the angle of the human mandible, along the
underside of the jaw on either side. They drain the tonsillar and posterior pharyngeal region, including the structures in
the floor of the mouth and the maxillary anterior, bicuspid and 1st and 2nd molars. They also drain all of the
mandibular teeth except the central incisors.

Retropharyngeal: Drains lymph from the soft palate and the 3rd molars.

 Sub-mental: These nodes are just below the chin. They drain the central incisors and midline of lower lip and tip of the
tongue.
 Subclavicular lymph nodes: These nodes are in the hollow above the clavicle, just lateral to where it joins the sternum.
They drain a part of the thoracic cavity and abdomen. Virchow node is a left supraclavicular lymph node that receives
the lymph drainage from most of the body (especially the abdomen) via the thoracic duct and is thus an early site of
metastasis for various malignancies.

Lymph nodes of the thorax

 Lymph nodes of the lungs: The lymph is drained from the lung tissue through subsegmental, segmental, lobar and
interlobar lymph nodes to the hilar lymph nodes, which are located around the hilum (the pedicle, which attaches the
lung to the mediastinal structures, containing the pulmonary artery, the pulmonary veins, the main bronchus for each
side, some vegetative nerves and the lymphatics) of each lung. The lymph flows subsequently to the mediastinal lymph
nodes.
 Mediastinum lymph nodes: They consist of several lymph node groups, especially along the vertebra trachea (5 groups),
along the esophagus and between the lung and the thoracic diaphragm. In the mediastinal lymph nodes arises
lymphatic ducts, which draines the lymph to the left subclavian vein (to the venous angle in the confluence of the
subclavian and deep jugular veins).
The mediastinal lymph nodes along the esophagus are in tight connection with the abdominal lymph nodes along the
esophagus and the stomach. That fact facilitates spreading of tumors cells through these lymphatics in cases of cancers
of the stomach and particularly of the esophagus. Through the mediastinum, the main lymphatic drainage from the
abdominal organs goes via the thoracic duct (ductus thoracicus), which drains majority of the lymph from the
abdomen to the above mentioned left venous angle.

Lymph nodes of the arm

These drain the whole of the arm, and are divided into two groups, superficial and deep. The superficial nodes are
supplied by lymphatics that are present throughout the arm, but are particularly rich on the palm and flexor aspects of
the digits.

 Superficial lymph glands of the arm:

o Supratrochlear glands: Situated above the medial epicondyle of the humerus, medial to the basilic vein, they
drain the C7 and C8 dermatomic area.
o Deltoideopectoral glands: Situated between the pectoralis major and deltoid muscle inferior to the clavicle.

 Deep lymph glands of the arm: These comprise the axillary glands, which are 20-30 individual glands and can be
subdivided into:
o Lateral glands
o Anterior or pectoral glands
o Posterior or subscapular glands
o Central or intermediate glands
o Medial or subclavicular glands

Lower limbs

 Inguinal lymph nodes

 Deep inguinal lymph nodes
 Popliteal lymph nodes

Pathology

Lymphadenopathy is a term meaning "disease of the lymph nodes." It is, however, almost synonymously used with
"swollen/enlarged lymph nodes." In this case, the lymph nodes are palpable, and is a sign of various infections and
diseases.