Lymph node

Medically Reviewed by Anatomy Team

A lymph node is a small, bean-shaped structure that is part of the lymphatic system. It acts as a filter for lymph, a fluid containing white blood cells that circulates throughout the body. Lymph nodes are composed of a network of lymphoid tissue and contain immune cells, such as lymphocytes and macrophages. They are critical for detecting and responding to pathogens, infections, and foreign particles.

Location

Lymph nodes are located throughout the body, often clustered in regions like the neck (cervical lymph nodes), armpits (axillary lymph nodes), groin (inguinal lymph nodes), and abdomen. They are also found along the lymphatic vessels, which transport lymph fluid from tissues back to the bloodstream.

Structure and Anatomy

Lymph nodes are small, oval-shaped structures that play a critical role in the lymphatic and immune systems. They vary in size, typically ranging from 1 to 25 millimeters in diameter. Lymph nodes are composed of a complex arrangement of cells and tissues, organized to filter lymph fluid and trap pathogens. Below is a detailed description of the anatomy of a lymph node:

External Structure

The lymph node has a well-defined outer capsule and an internal structure divided into several regions. Each component plays a role in filtering lymph and supporting the immune response.

Capsule

The capsule is the tough, fibrous outer covering of the lymph node, composed of dense connective tissue. It encloses and protects the internal structures of the lymph node. The capsule also contains trabeculae, which are inward extensions of the capsule that divide the node into smaller compartments.

Hilum

The hilum is the concave indentation on the surface of the lymph node where blood vessels, nerves, and efferent lymphatic vessels enter and exit. It is the main site for lymph and blood circulation into and out of the node.

Afferent Lymphatic Vessels

Afferent lymphatic vessels bring lymph fluid into the lymph node from surrounding tissues. These vessels enter the lymph node through various points around the capsule, not through the hilum. Afferent vessels carry lymph to the subcapsular sinus, where it is filtered by immune cells.

Efferent Lymphatic Vessels

Efferent lymphatic vessels carry filtered lymph away from the lymph node. These vessels exit the node at the hilum, directing the lymph toward larger lymphatic vessels or back into the bloodstream.

Internal Structure

Inside the lymph node, there are several distinct regions where lymph is filtered, and immune cells are activated. The internal structure is divided into the cortex, paracortex, and medulla, each with specialized functions.

Cortex

The cortex is the outermost layer of the lymph node, just beneath the capsule. It contains densely packed immune cells, particularly lymphoid follicles. These follicles are spherical collections of immune cells (mostly B lymphocytes) that serve as the primary sites for immune cell activation.

Primary and Secondary Follicles

  • Primary Follicles: These are inactive follicles containing naïve B cells.
  • Secondary Follicles: These are active follicles, characterized by a central germinal center, which forms in response to an immune challenge. The germinal center contains proliferating B cells, supported by follicular dendritic cells.

Paracortex

The paracortex is the region located beneath the cortex and is primarily populated by T lymphocytes. This area is involved in T cell activation and proliferation. It contains high endothelial venules (HEVs), specialized blood vessels that allow lymphocytes to enter the lymph node from the bloodstream.

Medulla

The medulla is the innermost region of the lymph node, located adjacent to the hilum. It contains medullary cords and medullary sinuses:

  • Medullary Cords: Strands of lymphoid tissue that contain macrophages, plasma cells (antibody-secreting B cells), and lymphocytes.
  • Medullary Sinuses: Spaces between the medullary cords where lymph fluid collects before exiting the node via the efferent lymphatic vessels. Macrophages in the sinuses help filter the lymph and capture pathogens.

Lymphatic Circulation

Lymphatic circulation within the node allows lymph fluid to be efficiently filtered and exposed to immune cells.

Subcapsular Sinus

Lymph from afferent lymphatic vessels enters the lymph node through the subcapsular sinus, which lies just beneath the capsule. This sinus is the first area where lymph is exposed to macrophages and dendritic cells that patrol for pathogens.

Cortical and Medullary Sinuses

From the subcapsular sinus, lymph flows through cortical sinuses, located in the cortex, and medullary sinuses, located in the medulla. As lymph passes through these sinuses, it is exposed to additional immune cells, including macrophages and lymphocytes, which help eliminate foreign particles.

Efferent Lymphatic Vessels

After passing through the medullary sinuses, filtered lymph exits the lymph node via efferent lymphatic vessels located at the hilum. These vessels carry the lymph toward the bloodstream or other lymph nodes.

Blood Supply

The lymph node has a rich blood supply that supports the metabolic needs of immune cells and allows lymphocytes to enter and exit the node.

Arteries and Veins

Blood enters the lymph node through small arterioles, which branch into capillaries that supply oxygen and nutrients to the lymphoid tissues. The blood is collected into venules and then drained from the node through small veins, which exit via the hilum.

High Endothelial Venules (HEVs)

HEVs are specialized venules in the paracortex that allow lymphocytes circulating in the blood to enter the lymph node. These venules have unique endothelial cells that facilitate the migration of T cells and B cells from the bloodstream into the lymphatic tissue.

Cellular Composition

Lymph nodes contain a variety of immune cells that work together to detect and respond to pathogens, antigens, and other foreign particles.

Lymphocytes

  • B Lymphocytes (B Cells): Predominantly found in the cortex within the lymphoid follicles. B cells are responsible for producing antibodies and responding to antigens.
  • T Lymphocytes (T Cells): Concentrated in the paracortex, T cells play a crucial role in cell-mediated immunity, including activating other immune cells and directly attacking infected cells.

Macrophages

Macrophages are distributed throughout the lymph node, especially in the subcapsular sinus, medullary cords, and sinuses. They engulf and digest foreign particles, dead cells, and pathogens through phagocytosis.

Dendritic Cells

Dendritic cells are found in the subcapsular sinus and paracortex. They capture antigens from the lymph and present them to T cells to initiate the immune response.

Follicular Dendritic Cells

These specialized dendritic cells reside in the lymphoid follicles and support B cell function by presenting antigens and aiding in the formation of the germinal center.

Function

Lymph nodes are essential components of the immune system and the lymphatic system. Their primary role is to filter lymph fluid, monitor it for foreign invaders like bacteria and viruses, and activate an immune response when necessary. Lymph nodes also facilitate the interaction between immune cells and help maintain fluid balance in the body. Below is a detailed description of the functions of the lymph node:

Filtration of Lymph Fluid

The primary function of lymph nodes is to filter lymph fluid, which is collected from tissues throughout the body. This filtration process ensures that harmful substances are trapped and neutralized before the lymph reenters the bloodstream.

Capture of Foreign Particles

As lymph fluid flows into the lymph node through afferent lymphatic vessels, it enters the subcapsular sinus, where it is exposed to macrophages and dendritic cells. These immune cells patrol the lymph for foreign particles such as bacteria, viruses, toxins, and debris.

Phagocytosis by Macrophages

Macrophages, present in the subcapsular sinus and medullary sinuses, play a crucial role in engulfing and digesting harmful pathogens through a process called phagocytosis. This helps prevent infections from spreading further into the body.

Retention of Antigens

The lymph node traps and holds antigens (substances that trigger an immune response), ensuring that immune cells can recognize and respond to them. This is an essential step in activating an immune response.

Immune Surveillance and Activation

Lymph nodes act as hubs for immune surveillance, where immune cells can encounter antigens and initiate a coordinated immune response. The architecture of the lymph node supports the interaction of various immune cells to mount an effective defense.

Activation of B Lymphocytes

B cells, located in the lymphoid follicles of the cortex, are responsible for producing antibodies in response to antigens. When B cells encounter their specific antigen within the lymph node, they become activated and proliferate. This process occurs in the germinal centers of secondary follicles, where B cells undergo clonal expansion and differentiation into plasma cells that secrete antibodies.

Activation of T Lymphocytes

T cells, which reside in the paracortex, are activated by antigens presented by dendritic cells and macrophages. Activated T cells can then differentiate into helper T cells, which support B cell function, or cytotoxic T cells, which directly attack infected or abnormal cells. The interaction between dendritic cells and T cells is critical for initiating cell-mediated immunity.

Antigen Presentation by Dendritic Cells

Dendritic cells are professional antigen-presenting cells (APCs) that capture antigens in peripheral tissues and carry them to the lymph nodes. Inside the lymph node, dendritic cells present these antigens to T cells in the paracortex, initiating an adaptive immune response.

Memory Cell Formation

During an immune response, both B and T cells can differentiate into memory cells that remain in the lymph node or circulate in the body. Memory cells are long-lived and provide a faster, more robust response if the body encounters the same pathogen again in the future.

Production of Antibodies

One of the critical functions of lymph nodes is the production of antibodies, which are proteins that specifically target and neutralize foreign invaders.

Plasma Cell Differentiation

After B cells are activated and proliferate in the germinal centers of the cortex, they differentiate into plasma cells. Plasma cells are specialized for producing large amounts of antibodies specific to the invading antigen.

Antibody Secretion

Plasma cells migrate to the medullary cords of the lymph node, where they secrete antibodies into the lymph and bloodstream. These antibodies bind to pathogens, marking them for destruction by other immune cells or directly neutralizing them.

Regulation of Fluid Balance

The lymphatic system, including lymph nodes, helps maintain fluid balance by draining excess fluid from tissues and returning it to the bloodstream.

Lymph Fluid Collection

Lymph fluid is collected from the interstitial spaces between tissues and transported through the lymphatic vessels to the lymph nodes. This fluid contains proteins, waste products, and immune cells, along with any pathogens or foreign particles present in the tissues.

Return of Filtered Lymph to Bloodstream

After the lymph fluid has been filtered in the lymph node, it exits through efferent lymphatic vessels and eventually returns to the circulatory system. This process helps prevent the accumulation of excess fluid in tissues, which can cause swelling or edema.

Generation of Lymphocytes

Lymph nodes serve as important sites for the generation and maturation of lymphocytes (B cells and T cells), which are crucial for the body’s adaptive immune system.

B Cell Proliferation

B cells proliferate and mature in the lymphoid follicles of the lymph node in response to antigen stimulation. The germinal centers of secondary follicles are the primary sites where B cells undergo clonal expansion.

T Cell Activation

T cells are activated and undergo clonal expansion in the paracortex after encountering antigen-presenting cells (APCs). These T cells can then leave the lymph node to travel to sites of infection, where they help eliminate infected cells or activate other immune cells.

Filtration of Cancer Cells and Debris

Lymph nodes can also trap and filter cancer cells that break away from tumors. This is a crucial step in the prevention of metastasis, where cancer cells spread from their original site to other parts of the body.

Trapping of Cancer Cells

Cancer cells that enter the lymphatic system may become trapped in nearby lymph nodes. This can lead to the formation of secondary tumors in the lymph nodes, but it also provides an opportunity for immune cells to target and destroy cancerous cells.

Signal of Metastasis

The presence of cancer cells in lymph nodes is often an indicator of metastasis and can help doctors assess the stage of cancer. Surgeons may remove nearby lymph nodes during cancer surgery to evaluate the spread of the disease.

Lymphocyte Trafficking

Lymph nodes act as transit hubs for lymphocytes, facilitating their movement between the bloodstream, lymphatic system, and tissues. This movement allows immune cells to monitor the body for pathogens and respond to infections.

Entry Through High Endothelial Venules (HEVs)

T cells and B cells enter the lymph node from the bloodstream through high endothelial venules (HEVs) located in the paracortex. This specialized structure allows immune cells to exit the blood and enter the lymphatic tissue.

Circulation and Surveillance

Once inside the lymph node, lymphocytes circulate through the lymphoid tissue, encountering antigens presented by dendritic cells or macrophages. If they do not encounter their specific antigen, they can leave the lymph node through the efferent lymphatic vessels and continue circulating in the body.

Homeostasis and Waste Removal

Lymph nodes help remove waste products from the body by filtering out debris, dead cells, and foreign materials from the lymph fluid.

Phagocytosis of Debris

Macrophages within the lymph node engulf and digest cellular debris, dead cells, and other waste materials from the lymph fluid. This process helps keep the lymph and blood clean and free from harmful substances.

Recycling of Components

Macrophages break down waste materials and recycle useful components, such as proteins and lipids, back into the body for reuse. This contributes to overall tissue health and homeostasis.

Clinical Significance

Lymph nodes play a critical role in the body’s immune defense and are often used as indicators of health or disease. Infections, inflammation, or cancer can cause lymph nodes to become swollen or tender, a condition known as lymphadenopathy. This is commonly seen during bacterial or viral infections, such as the common cold or mononucleosis. Swollen lymph nodes near a site of infection signal an active immune response.

Lymph nodes are also significant in the diagnosis and staging of cancers. Cancer cells can spread to nearby lymph nodes, where they may form secondary tumors. The presence of cancer in the lymph nodes often indicates metastasis, which helps in determining the stage and prognosis of cancers such as breast, lung, or prostate cancer. Lymph node biopsy is a common diagnostic tool used to detect the spread of cancer or to diagnose conditions like lymphoma, an immune system cancer that originates in the lymph nodes.

In this Article: