Lymph nodes are small bean-shaped filters, usually a few millimetres to about 2 cm long, placed along lymphatic vessels in clusters. Lymph enters through several afferent vessels, trickles through sinuses lined with immune cells and leaves through an efferent vessel at the hilum. The outer cortex holds B cell follicles, the deeper paracortex T cells, and the medulla plasma cells.
| Location | Along lymphatic vessels throughout the body, concentrated in the neck, axilla, groin, mediastinum, mesentery and along the aorta and iliac vessels |
|---|---|
| Secretes |
|
| Blood Supply | Small arteries entering at the hilum |
| Venous drainage |
|
Filters lymph, trapping microbes, debris and cancer cells, and provides a meeting place where antigen-presenting cells activate B and T lymphocytes to start an immune response.
Nodes enlarge when they react to infection (tender, soft, mobile) or are invaded by cancer or lymphoma (often hard, painless, fixed or rubbery). Persistent nodes over 1-2 cm, or nodes in the supraclavicular region, merit investigation. Sentinel node biopsy samples the first node draining a tumour to see whether cancer has spread.
Enlargement of nodes in response to nearby infection or inflammation, usually tender and settling within weeks.
Spread of cancer cells to regional nodes, a key factor in cancer staging and prognosis.
Infection of a lymph node itself, causing a painful swollen node that may form an abscess.
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