Lymph node: filter and immune station

Local vessels and regional nodes · Many in, one out

Several afferent vessels pierce the capsule and empty into the subcapsular sinus while a single efferent leaves at the hilum, and the mismatch slows flow so macrophages and lymphocytes can strip antigen and trapped tumour cells from the lymph.

Traced from the start

  1. Lymphatic capillaries (initial lymphatics)
  2. Lymph node: filter and immune station

Detail

Afferents
Many, entering through the convex surface
Efferent
Usually one, leaving at the hilum
Cortex
B-cell follicles with germinal centres
Paracortex
T cells and high endothelial venules for lymphocyte recirculation
Medulla
Medullary cords of plasma cells and sinus macrophages

When it goes wrong

Reactive hyperplasia in infection

Tender, mobile, rubbery node that regresses

Metastatic carcinoma replacing nodal architecture

Hard, painless node, fixed or matted to surrounding tissue

Practise this structure

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