Picture of lymph system. Immune and Lymphatic Systems: Anatomy, Functions, and Key Components

07.08.197024.07.2021 by alexxlab

How does the immune system protect our body. What are the main components of the lymphatic system. Why is the lymphatic system crucial for maintaining health. How do different types of white blood cells contribute to immunity. What role does bone marrow play in the immune system. How does the lymphatic system interact with the circulatory system.

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The Fundamentals of the Immune and Lymphatic Systems

The immune and lymphatic systems are vital components of the human body, working in tandem to protect against pathogens, maintain fluid balance, and support overall health. These intricate networks of organs, tissues, and cells form a complex defense mechanism that safeguards our body from harmful invaders and helps maintain homeostasis.

Understanding the anatomy and functions of these systems is crucial for grasping how our body fights diseases and maintains optimal health. Let’s delve into the key components and their roles in keeping us healthy.

Red Bone Marrow: The Birthplace of Immune Cells

Red bone marrow plays a pivotal role in the immune system as the primary site of hematopoiesis – the production of blood cells. This highly vascular tissue is found in the spaces between trabeculae of spongy bone, primarily in the ends of long bones and flat bones.

What makes red bone marrow so crucial for immunity? It contains stem cells that give rise to all types of blood cells, including leukocytes or white blood cells. These immune cells are the body’s first line of defense against pathogens and other harmful substances.

Types of Stem Cells in Red Bone Marrow

Myeloid stem cells
Lymphoid stem cells

Each type of stem cell produces different kinds of immune cells, contributing to the diverse array of defenses our body employs against various threats.

Myeloid Stem Cells and Their Progeny

Myeloid stem cells are responsible for producing several types of white blood cells that play crucial roles in the immune response. These cells include monocytes and granular leukocytes.

Monocytes: Versatile Defenders

Monocytes are agranular leukocytes that can differentiate into two important cell types:

Macrophages: These cells are phagocytes that engulf and destroy pathogens, damaged cells, and debris. They play a dual role in both preventing infection and cleaning up after an immune response.
Dendritic cells: Found in healthy tissues of the skin and mucous membranes, dendritic cells detect pathogenic antigens and activate T cells and B cells, initiating a targeted immune response.

Granular Leukocytes: Specialized Immune Cells

Granular leukocytes are a diverse group of cells with specific functions in the immune system. They include:

Eosinophils: These cells help reduce allergic inflammation and combat parasitic infections.
Basophils: Responsible for triggering inflammation by releasing heparin and histamine, basophils are particularly active during allergic reactions and parasitic infections.
Neutrophils: Acting as first responders to infection sites, neutrophils use chemotaxis to detect and quickly move towards pathogens. They engulf and destroy invaders through phagocytosis and release chemicals to trap and kill pathogens.

Lymphoid Stem Cells: Architects of Adaptive Immunity

Lymphoid stem cells give rise to lymphocytes, which are crucial components of the adaptive immune system. These cells provide targeted and long-lasting protection against specific pathogens.

T Lymphocytes: Versatile Immune Coordinators

T lymphocytes, or T cells, play multiple roles in the immune response:

Helper T cells: These cells assist other immune cells in mounting an effective response.
Cytotoxic T cells: These cells directly attack and destroy infected or abnormal cells.
Memory T cells: After an infection, these cells persist in the body to provide rapid response to subsequent encounters with the same pathogen.

B Lymphocytes: Antibody Factories

B lymphocytes, or B cells, are responsible for producing antibodies. When activated by contact with a pathogen, B cells transform into plasma cells that secrete antibodies. These proteins neutralize pathogens, making them easier targets for other immune cells. Memory B cells also persist after an infection, allowing for quick antibody production in case of reinfection.

Natural Killer Cells: Versatile Defenders

Natural killer (NK) cells are unique lymphocytes that can respond to a wide range of pathogens and cancerous cells without prior exposure. They circulate in the blood and are found in lymph nodes, the spleen, and red bone marrow, providing a rapid response to various types of infections.

The Lymphatic System: More Than Just Immunity

While closely linked to the immune system, the lymphatic system serves additional crucial functions in the body. It plays a vital role in fluid balance and nutrient transport.

Lymph Capillaries: Fluid Balance Regulators

Lymphatic capillaries are small, dead-end vessels that extend into tissues throughout the body. They serve a critical function in preventing fluid accumulation by absorbing excess interstitial fluid and returning it to the circulatory system.

How do lymph capillaries differ from blood capillaries? Unlike blood capillaries, lymph capillaries are closed at one end, allowing them to collect fluid rather than distribute it. This unique structure enables the lymphatic system to maintain proper fluid balance in tissues.

Lymph: More Than Just Fluid

The fluid collected by lymphatic capillaries is known as lymph. Its composition closely resembles blood plasma, consisting of:

90% water
10% solutes (proteins, cellular waste products, dissolved gases, and hormones)

Lymph can also contain other components, depending on the body’s current state:

Bacterial cells from infected tissues
White blood cells fighting pathogens
In cases of late-stage cancer, cancerous cells that have metastasized from tumors

The Lymphatic System’s Role in Nutrient Transport

Beyond its immune and fluid balance functions, the lymphatic system plays a crucial role in nutrient transport, particularly for lipids. How does the lymphatic system contribute to nutrient absorption?

The lymphatic system is responsible for transporting fatty acids from the intestines to the circulatory system. This process is essential for the absorption and distribution of fat-soluble vitamins and other lipid-based nutrients throughout the body.

The Path of Lipid Transport

Lipids are absorbed by specialized lymphatic vessels called lacteals in the small intestine.
These lipids are packaged into chylomicrons, large lipoprotein particles.
Chylomicrons enter the lymphatic system through the lacteals.
They travel through larger lymphatic vessels and eventually enter the bloodstream via the thoracic duct.

This unique pathway allows for the efficient transport of lipids, bypassing the liver and entering directly into systemic circulation.

Interaction Between the Lymphatic and Circulatory Systems

The lymphatic and circulatory systems are closely interconnected, working together to maintain fluid balance, transport nutrients, and support immune function. How do these two systems interact?

Fluid Exchange

As blood flows through capillaries, plasma diffuses into the surrounding tissues. While some of this fluid returns to the blood vessels, a significant portion becomes interstitial fluid. The lymphatic system collects this excess fluid, preventing tissue swelling and maintaining proper fluid balance.

Nutrient and Waste Transport

The lymphatic system complements the circulatory system by transporting substances that are too large to enter blood capillaries directly. This includes not only lipids but also proteins and other large molecules.

Immune Cell Circulation

Lymphocytes and other immune cells travel between the blood and lymphatic systems, allowing for comprehensive immune surveillance throughout the body. This constant circulation enables rapid response to infections or other threats in any part of the body.

The Importance of Lymph Nodes in Immune Function

Lymph nodes are small, bean-shaped structures located throughout the lymphatic system. They play a crucial role in filtering lymph and trapping pathogens, foreign particles, and abnormal cells. What makes lymph nodes so important for immune function?

Filtering and Trapping

As lymph flows through lymph nodes, it passes through a network of sinuses lined with macrophages and dendritic cells. These cells capture and destroy pathogens and other harmful particles, preventing their spread throughout the body.

Immune Cell Activation

Lymph nodes serve as meeting points for immune cells. When dendritic cells present antigens to T cells in the lymph nodes, it triggers an immune response. B cells in the lymph nodes can also be activated to produce antibodies against specific pathogens.

Monitoring and Early Detection

The strategic placement of lymph nodes throughout the body allows for early detection of infections or other threats. Swollen lymph nodes often indicate an active immune response in a particular area of the body.

Understanding the complex interplay between the immune and lymphatic systems provides insight into how our body maintains health and fights disease. From the production of immune cells in the bone marrow to the filtering of lymph in lymph nodes, each component plays a vital role in our body’s defense mechanisms. By appreciating the intricacies of these systems, we can better comprehend the importance of maintaining their health through proper nutrition, exercise, and lifestyle choices.

Immune and Lymphatic Systems – Anatomy Pictures and Information

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Continued From Above…
The lymphatic system also transports fatty acids from the intestines to the circulatory system.

Immune and Lymphatic System Anatomy

Red Bone Marrow and Leukocytes

Red bone marrow is a highly vascular tissue found in the spaces between trabeculae of spongy bone. It is mostly found in the ends of long bones and in the flat bones of the body. Red bone marrow is a hematopoietic tissue containing many stem cells that produce blood cells. All of the leukocytes, or white blood cells, of the immune system are produced by red bone marrow. Leukocytes can be further broken down into 2 groups based upon the type of stem cells that produces them: myeloid stem cells and lymphoid stem cells.

Myeloid Stem Cells

Myeloid stem cells produce monocytes and the granular leukocytes—eosinophils, basophils, and neutrophils.

Monocytes are agranular leukocytes that can form 2 types of cells: macrophages and dendritic cells.

Macrophages. Monocytes respond slowly to infection and once present at the site of infection, develop into macrophages. Macrophages are phagocytes able to consume pathogens, destroyed cells, and debris by phagocytosis. As such, they have a role in both preventing infection as well as cleaning up the aftermath of an infection.
Dendritic cells. Monocytes also develop into dendritic cells in healthy tissues of the skin and mucous membranes. Dendritic cells are responsible for the detection of pathogenic antigens which are used to activate T cells and B cells.

Granular Leukocytes include the following:

Eosinophils. Eosinophils are granular leukocytes that reduce allergic inflammation and help the body fight off parasites.
Basophils. Basophils are granular leukocytes that trigger inflammation by releasing the chemicals heparin and histamine. Basophils are active in producing inflammation during allergic reactions and parasitic infections.
Neutrophils. Neutrophils are granular leukocytes that act as the first responders to the site of an infection. Neutrophils use chemotaxis to detect chemicals produced by infectious agents and quickly move to the site of infection. Once there, neutrophils ingest the pathogens via phagocytosis and release chemicals to trap and kill the pathogens.

Lymphoid Stem Cells

Lymphoid stem cells produce T lymphocytes and B lymphocytes.

T lymphocytes. T lymphocytes, also commonly known as T cells, are cells involved in fighting specific pathogens in the body. T cells may act as helpers of other immune cells or attack pathogens directly. After an infection, memory T cells persist in the body to provide a faster reaction to subsequent infection by pathogens expressing the same antigen.
B lymphocytes. B lymphocytes, also commonly known as B cells, are also cells involved in fighting specific pathogens in the body. Once B cells have been activated by contact with a pathogen, they form plasma cells that produce antibodies. Antibodies then neutralize the pathogens until other immune cells can destroy them. After an infection, memory B cells persist in the body to quickly produce antibodies to subsequent infection by pathogens expressing the same antigen.
Natural killer cells. Natural killer cells, also known as NK cells, are lymphocytes that are able to respond to a wide range of pathogens and cancerous cells. NK cells travel within the blood and are found in the lymph nodes, spleen, and red bone marrow where they fight most types of infection.

Lymph Capillaries

As blood passes through the tissues of the body, it enters thin-walled capillaries to facilitate diffusion of nutrients, gases, and wastes. Blood plasma also diffuses through the thin capillary walls and penetrates into the spaces between the cells of the tissues. Some of this plasma diffuses back into the blood of the capillaries, but a considerable portion becomes embedded in the tissues as interstitial fluid. To prevent the accumulation of excess fluids, small dead-end vessels called lymphatic capillaries extend into the tissues to absorb fluids and return them to circulation.

Lymph

The interstitial fluid picked up by lymphatic capillaries is known as lymph. Lymph very closely resembles the plasma found in the veins: it is a mixture of about 90% water and 10% solutes such as proteins, cellular waste products, dissolved gases, and hormones. Lymph may also contain bacterial cells that are picked up from diseased tissues and the white blood cells that fight these pathogens. In late-stage cancer patients, lymph often contains cancerous cells that have metastasized from tumors and may form new tumors within the lymphatic system. A special type of lymph, known as chyle, is produced in the digestive system as lymph absorbs triglycerides from the intestinal villi. Due to the presence of triglycerides, chyle has a milky white coloration to it.

Lymphatic Vessels

Lymphatic capillaries merge together into larger lymphatic vessels to carry lymph through the body. The structure of lymphatic vessels closely resembles that of veins: they both have thin walls and many check valves due to their shared function of carrying fluids under low pressure. Lymph is transported through lymphatic vessels by the skeletal muscle pump—contractions of skeletal muscles constrict the vessels to push the fluid forward. Check valves prevent the fluid from flowing back toward the lymphatic capillaries.

Lymph Nodes

Lymph nodes are small, kidney-shaped organs of the lymphatic system. There are several hundred lymph nodes found mostly throughout the thorax and abdomen of the body with the highest concentrations in the axillary (armpit) and inguinal (groin) regions. The outside of each lymph node is made of a dense fibrous connective tissue capsule. Inside the capsule, the lymph node is filled with reticular tissue containing many lymphocytes and macrophages. The lymph nodes function as filters of lymph that enters from several afferent lymph vessels. The reticular fibers of the lymph node act as a net to catch any debris or cells that are present in the lymph. Macrophages and lymphocytes attack and kill any microbes caught in the reticular fibers. Efferent lymph vessels then carry the filtered lymph out of the lymph node and towards the lymphatic ducts.

Lymphatic Ducts

All of the lymphatic vessels of the body carry lymph toward the 2 lymphatic ducts: the thoracic duct and the right lymphatic ducts. These ducts serve to return lymph back to the venous blood supply so that it can be circulated as plasma.

Lymphatic Nodules

Outside of the system of lymphatic vessels and lymph nodes, there are masses of non-encapsulated lymphatic tissue known as lymphatic nodules. The lymphatic nodules are associated with the mucous membranes of the body, where they work to protect the body from pathogens entering the body through open body cavities.

Tonsils. There are 5 tonsils in the body—2 lingual, 2 palatine, and 1 pharyngeal. The lingual tonsils are located at the posterior root of the tongue near the pharynx. The palatine tonsils are in the posterior region of the mouth near the pharynx. The pharyngeal pharynx, also known as the adenoid, is found in the nasopharynx at the posterior end of the nasal cavity. The tonsils contain many T and B cells to protect the body from inhaled or ingested substances. The tonsils often become inflamed in response to an infection.
Peyer’s patches. Peyer’s patches are small masses of lymphatic tissue found in the ileum of the small intestine. Peyer’s patches contain T and B cells that monitor the contents of the intestinal lumen for pathogens. Once the antigens of a pathogen are detected, the T and B cells spread and prepare the body to fight a possible infection.
Spleen. The spleen is a flattened, oval-shaped organ located in the upper left quadrant of the abdomen lateral to the stomach. The spleen is made up of a dense fibrous connective tissue capsule filled with regions known as red and white pulp. Red pulp, which makes up most of the spleen’s mass, is so named because it contains many sinuses that filter the blood. Red pulp contains reticular tissues whose fibers filter worn out or damaged red blood cells from the blood. Macrophages in the red pulp digest and recycle the hemoglobin of the captured red blood cells. The red pulp also stores many platelets to be released in response to blood loss. White pulp is found within the red pulp surrounding the arterioles of the spleen. It is made of lymphatic tissue and contains many T cells, B cells, and macrophages to fight off infections.
Thymus. The thymus is a small, triangular organ found just posterior to the sternum and anterior to the heart. The thymus is mostly made of glandular epithelium and hematopoietic connective tissues. The thymus produces and trains T cells during fetal development and childhood. T cells formed in the thymus and red bone marrow mature, develop, and reproduce in the thymus throughout childhood. The vast majority of T cells do not survive their training in the thymus and are destroyed by macrophages. The surviving T cells spread throughout the body to the other lymphatic tissues to fight infections. By the time a person reaches puberty, the immune system is mature and the role of the thymus is diminished. After puberty, the inactive thymus is slowly replaced by adipose tissue.

Immune and Lymphatic System Physiology

Lymph Circulation

One of the primary functions of the lymphatic system is the movement of interstitial fluid from the tissues to the circulatory system. Like the veins of the circulatory system, lymphatic capillaries and vessels move lymph with very little pressure to help with circulation. To help move lymph towards the lymphatic ducts, there is a series of many one-way check valves found throughout the lymphatic vessels. These check valves allow lymph to move toward the lymphatic ducts and close when lymph attempts to flow away from the ducts. In the limbs, skeletal muscle contraction squeezes the walls of lymphatic vessels to push lymph through the valves and towards the thorax. In the trunk, the diaphragm pushes down into the abdomen during inhalation. This increased abdominal pressure pushes lymph into the less pressurized thorax. The pressure gradient reverses during exhalation, but the check valves prevent lymph from being pushed backwards.

Transport of Fatty Acids

Another major function of the lymphatic system is the transportation of fatty acids from the digestive system. The digestive system breaks large macromolecules of carbohydrates, proteins, and lipids into smaller nutrients that can be absorbed through the villi of the intestinal wall. Most of these nutrients are absorbed directly into the bloodstream, but most fatty acids, the building blocks of fats, are absorbed through the lymphatic system.

In the villi of the small intestine are lymphatic capillaries called lacteals. Lacteals are able to absorb fatty acids from the intestinal epithelium and transport them along with lymph. The fatty acids turn the lymph into a white, milky substance called chyle. Chyle is transported through lymphatic vessels to the thoracic duct where it enters the bloodstream and travels to the liver to be metabolized.

Types of Immunity

The body employs many different types of immunity to protect itself from infection from a seemingly endless supply of pathogens. These defenses may be external and prevent pathogens from entering the body. Conversely, internal defenses fight pathogens that have already entered the body. Among the internal defenses, some are specific to only one pathogen or may be innate and defend against many pathogens. Some of these specific defenses can be acquired to preemptively prevent an infection before a pathogen enters the body.

The body has many innate ways to defend itself against a broad spectrum of pathogens. These defenses may be external or internal defenses.

External defenses include the following:

The coverings and linings of the body constantly prevent infections before they begin by barring pathogens from entering the body. Epidermal cells are constantly growing, dying, and shedding to provide a renewed physical barrier to pathogens.
Secretions like sebum, cerumen, mucus, tears, and saliva are used to trap, move, and sometimes even kill bacteria that settle on or in the body. Stomach acid acts as a chemical barrier to kill microbes found on food entering the body. Urine and acidic vaginal secretions also help to kill and remove pathogens that attempt to enter the body.
The flora of naturally occurring beneficial bacteria that live on and in our bodies provide a layer of protection from harmful microbes that would seek to colonize our bodies for themselves.

Internal defenses include fever, inflammation, natural killer cells, and phagocytes. Let’s explore internal defenses in greater detail.

Fever

In response to an infection, the body may start a fever by raising its internal temperature out of its normal homeostatic range. Fevers help to speed up the body’s response system to an infection while at the same time slowing the reproduction of the pathogen.

Inflammation

The body may also start an inflammation in a region of the body to stop the spread of the infection. Inflammations are the result of a localized vasodilation that allows extra blood to flow into the infected region. The extra blood flow speeds the arrival of leukocytes to fight the infection. The enlarged blood vessel allows fluid and cells to leak out of the blood vessel to cause swelling and the movement of leukocytes into the tissue to fight the infection.

Natural Killer Cells

Natural killer (NK) cells are special lymphocytes that are able to recognize and kill virus-infected cells and tumor cells. NK cells check the surface markers on the surface of the body’s cells, looking for cells that are lacking the correct number of markers due to disease. The NK cells then kill these cells before they can spread infection or cancer.

Phagocytes

The term phagocyte means “eating cell” and refers to a group of cell types including neutrophils and macrophages. A phagocyte engulfs pathogens with its cell membrane before using digestive enzymes to kill and dissolve the cell into its chemical parts. Phagocytes are able to recognize and consume many different types of cells, including dead or damaged body cells.

Cell-mediated Specific Immunity

When a pathogen infects the body, it often encounters macrophages and dendritic cells of the innate immune system. These cells can become antigen-presenting cells (APCs) by consuming and processing pathogenic antigens. The APCs travel into the lymphatic system carrying these antigens to be presented to the T cells and B cells of the specific immune system.

Inactive T cells are found in lymphatic tissue awaiting infection by a pathogen. Certain T cells have antigen receptors that recognize the pathogen but do not reproduce until they are triggered by an APC. The activated T cell begins reproducing very quickly to form an army of active T cells that spread through the body and fight the pathogen. Cytotoxic T cells directly attach to and kill pathogens and virus-infected cells using powerful toxins. Helper T cells assist in the immune response by stimulating the response of B cells and macrophages.

After an infection has been fought off, memory T cells remain in the lymphatic tissue waiting for a new infection by cells presenting the same antigen. The response by memory T cells to the antigen is much faster than that of the inactive T cells that fought the first infection. The increase in T cell reaction speed leads to immunity—the reintroduction of the same pathogen is fought off so quickly that there are few or no symptoms. This immunity may last for years or even an entire lifetime.

Antibody-mediated Specific Immunity

During an infection, the APCs that travel to the lymphatic system to stimulate T cells also stimulate B cells. B cells are lymphocytes that are found in lymphatic tissues of the body that produce antibodies to fight pathogens (instead of traveling through the body themselves). Once a B cell has been contacted by an APC, it processes the antigen to produce an MHC-antigen complex. Helper T cells present in the lymphatic system bind to the MHC-antigen complex to stimulate the B cell to become active. The active B cell begins to reproduce and produce 2 types of cells: plasma cells and memory B cells.

Plasma cells become antibody factories producing thousands of antibodies.
Memory B cells reside in the lymphatic system where they help to provide immunity by preparing for later infection by the same antigen-presenting pathogen.

Antibodies are proteins that are specific to and bind to a particular antigen on a cell or virus. Once antibodies have latched on to a cell or virus, they make it harder for their target to move, reproduce, and infect cells. Antibodies also make it easier and more appealing for phagocytes to consume the pathogen.

Acquired Immunity

Under most circumstances, immunity is developed throughout a lifetime by the accumulation of memory T and B cells after an infection. There are a few ways that immunity can be acquired without exposure to a pathogen. Immunization is the process of introducing antigens from a virus or bacterium to the body so that memory T and B cells are produced to prevent an actual infection. Most immunizations involve the injection of bacteria or viruses that have been inactivated or weakened. Newborn infants can also acquire some temporary immunity from infection thanks to antibodies that are passed on from their mother. Some antibodies are able to cross the placenta from the mother’s blood and enter the infant’s bloodstream. Other antibodies are passed through breast milk to protect the infant.

Lymphatic System – Definition, Function, Structure

Definition

The lymphatic system is a network of low-pressure vessels which provide a route for the return of interstitial fluid to the blood vascular network. A network of lymph ducts is present throughout the body. It moves fluids back to the circulatory system, while also providing important immune functions.

Overview

To bathe the cells of the body and provide nutrients, nearly 20 liters of blood plasma is filtered through capillaries every day. A large proportion of this tissue fluid moves directly to the veins, and back to the heart. However, the lymphatic system processes nearly 20% of this fluid, which escapes from capillaries and cells.

The lymphatic system consists of open-ended vessels, lymph nodes, and organs such as the tonsils, spleen, and thymus. Unlike the blood vascular system, lymphatic circulation is not a closed loop. It creates a one-directional flow of lymph towards the heart. Lymph reenters the cardiovascular system at subclavian veins situated near the neck.

Lymphatic system diagram

Image shows the lymphatic circulation, with the network of lymph vessels, and major organs and nodes.

Lymphatic System Function

There are two major functions of the lymphatic system. The first is to drain interstitial fluid and maintain the fluid balance between blood and tissue fluid. The second is to fight infection and mediate immunity.

Fluid Homeostasis

Lymphatic circulation is necessary for homeostasis since it maintains the fluid balance between tissues and blood vessels. This role becomes apparent when there is an injury to a lymph node. Water retention, also known as lymphedema, in a limb is one of the side effects of a blockage within a lymphatic vessel or node. This is particularly true after cancer treatment since surgery, radiation therapy, and chemotherapy can injure this intricate network. Lymphedema can be mild or severe, sometimes even leading to the thickening of the skin and compromised immunity.

Lymphedema

In the image above, both the legs show some lymphedema, with the right foot showing greater swelling.

Immunity

Lymphocytes are a group of white blood cells that are found in the nodes and organs of the lymphatic system. They include B-cells, T-cells, and natural killer cells. Lymphatic vessels non-specifically collect the fluid surrounding tissues. This means that the lymphatic system often carries pathogens from different parts of the body towards lymph nodes.

B-cells and T-cells of the adaptive immune system reside in lymph nodes in addition to circulating through the body. The maturation of T-cells, as well as the production of antibodies from B-cells, is driven by their exposure to pathogens in the lymph nodes. Other immune cells like dendritic cells have a supporting function in the adaptive immune system, presenting antigens in a way that stimulates differentiation and antibody production.

The presence of macrophages, with extended finger-like projections called pseudopods, allows the lymph node to trap foreign objects, filter lymph, and remove microorganisms. Many other body defenses are carried out by the lymphatic system.

Lymphatic System Structure

Different lymphatic vessels drain into nodes situated across the body. Vessels from the head and arms drain into lymph nodes at the elbows and armpits. Lymphatic circulation from visceral organs drains into nodes between the lungs or situated around the intestines. These nodes become the central points at which the contents of interstitial fluid are examined and many harmful substances are removed.

While this usually means pathogens or cell debris, lymph nodes are also the first point of colonization for metastatic cancer cells. In fact, surgery for breast cancer can involve the removal of the major lymph nodes of the armpit as a precautionary measure. Traditional medicine in many countries pays attention to the lymph nodes and considers their optimal functioning as crucial for the maintenance of good health.

Lymphatic circulation is made up of lymph vessels, lymph nodes and organs such as the thymus, tonsils, and spleen.

Parts of the Lymphatic System

Lymph vessels

Lymph vessels have very thin walls. They have an inner layer of endothelial cells and a layer of smooth muscles and valves that prevent the backward flow of fluid. Lymph vessels are attached to surrounding tissue through connective tissues called adventitia.

Each lymphatic vessel consists of serially arranged structural and functional units called lymphangions. A lymphangion is a segment of a lymphatic vessel bound by semilunar valves on either side. When circular smooth muscles of these vessels contract, lymph is moved from one lymphangion to the next. The valves ensure unidirectional movement of lymph fluid. The contraction of skeletal muscles surrounding these vessels can also power the movement of lymph.

Lymph vessel

The image is a representation of how lymph is propelled along lymphatic vessels.

Lymph nodes

These organs are small bean-shaped structures made from intricately arranged tissues. They have a dual role in the circulatory and immune systems. The lymph nodes are present deep within the body near the lungs and the intestines as well as near the surface, as seen in the clusters of lymphatic tissues near the armpit and groin.

Afferent lymph vessels enter the node at the convex side. Efferent vessels leave from the hilum of the concave surface. Every lymph node is covered by a fibrous capsule that also creates finger-like projections into the lymph node itself. These projections provide mechanical support and structure while also dividing the lymph node into a number of lobules.

Lymph node structure

Image shows the cross-section of a lymph node, with the incoming and outgoing vessels, their valves, fibrous capsule, and the subcompartments called nodules. Connective tissues within the lymph node provide attachment sites for the cells of the immune system. The lymph node contains B-cells, T-cells, macrophages and dendritic cells. An infection causes the lymph nodes to enlarge.

Thymus

The thymus is a primary lymphoid organ where T-cells mature. The organ has two lobes, each divided into an external cortex and internal medulla. T-cell maturation is facilitated by the epithelial cells of the thymus when they present antigens to these evolving lymphocytes.

As T-cell precursors mature within the thymus, two events occur. The first is a positive selection that verifies if the T-cell has receptors capable of recognizing MHC molecules that will present antigens. The second is negative selection, which removes T-cells that attack the body’s tissues and resident flora because they respond to antigens from these cells.

Positive selection occurs in the thymic cortex before maturing T-cells move towards the medullary region for negative selection. A large proportion of T-cells do not successfully navigate these two stages of selection. When negative selection is not stringent, it can lead to auto-immune disorders.

Tonsils

Tonsils are lymphoid organs containing antigen presenting cells called M cells. These cells alert B-cells and T-cells within the organ. The tonsils are located towards the back of the throat, at the intersection of the respiratory and digestive passages. This makes the tonsils the first line of defense against ingested and inhaled pathogens.

Spleen

The spleen is primarily associated with RBC turnover, but it also plays a role in the lymphatic system, clearing bacteria and other pathogens that have been coated with antibodies. Cell-mediated immunity from T-cells is also seen in the spleen.

Lymphatic System Diseases

There are two common disorders affecting the lymphatic circulation – either water retention in tissues due to impaired lymphatic drainage, or swelling of the lymph nodes. Both of these disorders can arise from a number of causes, from injury to the vessels and nodes, to infection or cancer.

Lymphedema

Lymphedema can arise from some medications, radiation therapy, infections due to bacteria or even parasitic worms. Lymphatic filariasis, also known as elephantiasis, is a common disease in many tropical countries, which spreads through mosquito vectors. The causative agents are nematodes with a large proportion being caused by Wuchereria bancrofti and Brugia malayi. Occasionally, other diseases such as tuberculosis, leprosy, or repeated strep infections can also cause lymphatic drainage to be affected, and result in lymphedema.

Lymphoma

Lymphomas are a group of cancers that arise from the unchecked growth of lymphocytes. Most often lymphomas are diagnosed after a painless enlargement of a lymph node is detected. While there are many subtypes of lymphomas based on cell type and location, two main categories are Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Interestingly, intense itching is a common early symptom of lymphoma. It is likely mediated by small molecules called cytokines that can act as neuromodulators, therefore creating the sensation of itching.

Lupus

Lupus is an autoimmune disorder where the cells of the immune system attack body tissue. This disease can present differently in each person since it can involve practically every tissue in the body. Joint pain and fatigue are common symptoms. Progression of the disease leads to lymph node enlargement.

Quiz

Lymphoma Action | The lymphatic system

What is the lymphatic system?

The lymphatic system is a network of tubes, tissues and organs that runs throughout your body. It is part of your immune system, which helps protect you from infection.

Figure: The lymphatic system

The lymphatic system includes:

lymphatic vessels that carry a fluid called lymph
organs where immune cells develop:
organs and tissues where immune cells collect ready to fight infection:

Any part of the lymphatic system can be affected by lymphoma.

What does the lymphatic system do?

The lymphatic system has three main functions:

It drains fluid from your tissues and returns it to your bloodstream.
It protects your body from disease by removing germs (bacteria, viruses and parasites) and toxins (poisons), and helps to destroy cells that are old, damaged or abnormal.
It helps absorb fats and vitamins from your digestive system and transports them to your bloodstream.

Lymph

Lymph is the liquid that flows through your lymphatic system. It is formed from the fluid that surrounds all the cells in your body. This fluid drains from your tissues into tiny lymphatic vessels through flaps or valves in the vessel walls.

Lymph can contain:

water
sugars, proteins and fats
vitamins, minerals and salts
waste products from cells
germs or toxins that have got into your body
damaged or abnormal cells, including cancer cells.

Lymph travels through tubes called lymphatic vessels. Tiny lymphatic vessels in your tissues join to form gradually larger and larger lymphatic vessels, a bit like streams flowing into rivers. They eventually drain into large vessels called lymphatic ducts.

Lymph from the lymphatic ducts empties into large veins near your heart to enter your bloodstream. This removes excess fluid from around your body, which helps keep your blood pressure stable and prevents swelling.

Lymph is not pumped around your body by your heart. Instead, it is pushed along when your lymphatic vessels are squeezed by your muscles, and by gravity if the vessels are above your heart. There are also muscle cells in the walls of the lymphatic vessels that help squeeze the lymph along. One-way valves inside the vessels stop the lymph flowing backwards.

Lymph nodes

Lymphatic vessels pass through lots of ‘checkpoints’ called lymph nodes (sometimes known as lymph glands). Lymph nodes are small, bean-shaped structures. They are usually 1 to 2cm long.

Figure: Structure of a lymph node

Where are lymph nodes found?

You have hundreds of lymph nodes all over your body, except in your brain and spinal cord. They are often grouped together.

Some lymph node groups are near the surface of your skin – for example, in your neck (cervical lymph nodes), armpits (axillary lymph nodes) or groin (inguinal lymph nodes). You can sometimes feel these if they swell up. This often happens if you have an infection and isn’t usually a sign of something serious.

There are lots of other lymph nodes deep inside your body – for example, in your chest (mediastinal lymph nodes) or tummy (abdominal lymph nodes). You can’t feel these from the outside.

What do lymph nodes do?

Lymph nodes filter lymph. They trap germs and damaged or abnormal cells, and activate immune responses to help your body get rid of them.

Lymph nodes contain lots of white blood cells called lymphocytes. If you have an infection, the lymphocytes multiply inside your lymph nodes. They help fight the infection and make chemicals that activate other parts of your immune system. This is why your lymph nodes swell up when you have an infection. The swelling usually goes away in a couple of weeks, when the infection gets better.

Lymphocytes are the cells that grow out of control if you have lymphoma. If lymphoma cells build up inside your lymph nodes, the swelling does not usually go down.

Bone marrow

Bone marrow is the spongy tissue in the middle of some of the bigger bones in your body, such as your thigh bone (femur), breastbone (sternum), hip bone (pelvis) and back bones (vertebrae). Your bone marrow makes blood cells from special cells called stem cells. These are undeveloped cells that can divide and grow into all the different types of blood cell your body needs. These include red blood cells, platelets and white blood cells.

Figure: The different blood cells that develop in the bone marrow

Lymphocytes (the cells that grow out of control if you have lymphoma) are a type of white blood cell. They are made in your bone marrow. Some of them fully mature there. These are called B lymphocytes. Others mature in your thymus. These are called T lymphocytes.

Thymus

The thymus is a small, butterfly-shaped gland in your chest. It sits behind your breastbone, just above your heart.

In the thymus, white blood cells called T lymphocytes develop into active immune cells. They also learn to tell the difference between things that belong in your body and things that don’t, so they only respond to things that shouldn’t be there (for example, viruses and bacteria).

When fully developed, the T lymphocytes enter your bloodstream and lymphatic system.

Spleen

The spleen is an organ that filters your blood. It lies behind your ribcage on the left-hand side of your body, just behind your stomach. It is about the size of a clenched fist.

Your spleen contains lots of white blood cells, including lymphocytes. These cells help to protect you from infection by:

removing germs from your bloodstream
making antibodies
activating other parts of your immune system.

Your spleen also removes old and misshapen red blood cells and platelets from your bloodstream. It stores a small supply of healthy red blood cells and platelets for your body to use in an emergency. If your bone marrow isn’t working as it should, your spleen can also be a back-up site for making new blood cells.

Mucosa-associated lymphoid tissue

‘Mucosa’ is the moist, protective layer of cells that lines many parts of your body, such as your mouth, gut and airways. ‘Lymphoid tissue’ means a collection of lymphocytes (white blood cells). Mucosa-associated lymphoid tissue (MALT) is a collection of lymphocytes in your mucosa.

You have MALT in lots of places in your body, especially areas where germs might be able to enter easily. MALT includes:

the tonsils at the back of your throat
the adenoids at the back of your nose
bronchus-associated lymphoid tissue in your airways
gut-associated lymphoid tissue in your bowel.

The immune cells in MALT protect you by trapping and destroying germs and toxins before they get further inside your body.

All these different parts of your lymphatic system work together to help protect you from infection.

Lymph Node Biopsy | Michigan Medicine

Test Overview

A lymph node biopsy removes lymph node tissue to be looked at under a microscope for signs of infection or a disease, such as cancer. Other tests may also be used to check the lymph tissue sample, including a culture, genetic tests, or tests to study the body’s immune system (immunological tests).

Lymph nodes are part of the immune system. They are found in the neck, behind the ears, in the armpits, and in the chest, belly, and groin.

Lymph nodes in healthy people are usually hard to feel. But lymph nodes in the neck, armpit, or groin can get bigger and become tender. Swollen lymph nodes usually mean an infection. But the swelling can also be caused by a cut, a scratch, an insect bite, a tattoo, a drug reaction, or cancer.

There are several ways to do a lymph node biopsy. The lymph node sample will be looked at under a microscope for problems.

Fine-needle aspiration biopsy.: Your doctor inserts a thin needle into a lymph node and removes a sample of cells.
Core needle biopsy.: Your doctor inserts a needle with a special tip and removes a sample of tissue about the size of a grain of rice.
Open (surgical) biopsy.: Your doctor will make a small cut in the skin and remove a lymph node. If more than one lymph node is taken, the biopsy is called a lymph node dissection. Open biopsy and lymph node dissection let your doctor take a bigger sample than a needle biopsy.

Why It Is Done

Lymph node biopsy is done to:

Check the cause of enlarged lymph nodes that do not return to normal size on their own.
Check the cause of symptoms, such as an ongoing fever, night sweats, or weight loss.
Check to see if a known cancer has spread to the lymph nodes. This is called staging and is done to plan cancer treatment.
Remove cancer.

How To Prepare

If the biopsy will be done under general anesthesia, follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, do so using only a sip of water.

Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.

Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your test. Your doctor will tell you if you should stop taking any of them before the test and how soon to do it.

If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your test. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.

If a lymph node biopsy will be done under local anesthesia, you don’t need to do anything else to prepare for the biopsy.

Other tests, such as blood tests or X-rays, may be done before the lymph node biopsy.

How It Is Done

You may need to take off all or some of your clothes. If needed, you will be given a cloth or paper covering to use during the biopsy.

Fine-needle aspiration biopsy

A fine-needle lymph biopsy may be done in a surgery clinic or the hospital.

Your doctor numbs the area where the needle will be inserted. When the area is numb, the needle is put through the skin and into the lymph node. You must lie still while the biopsy is done.

The needle is then removed. Pressure is put on the needle site to stop any bleeding. A bandage is put on.

The biopsy sample is sent to a lab to be looked at under a microscope.

Core needle biopsy

In a core needle lymph biopsy, your doctor numbs the area where the needle will be inserted. When the area is numb, a small cut is made in the skin. A needle with a special tip is put through the skin and into the lymph node. You must lie still while the biopsy is done.

The needle is then removed. Pressure is put on the needle site to stop any bleeding. A bandage is put on.

Open biopsy and lymph node dissection

An open biopsy of a lymph node is done by a surgeon. For a lymph node near the surface of the skin, the biopsy site is numbed with local anesthetic. For a lymph node deeper in the body or for lymph node dissection, you may have general anesthesia. That means you will not be awake during the biopsy.

An intravenous line (IV) will be put in your arm, and a sedative medicine will be given before the biopsy.

A small cut will be made so the whole lymph node or a slice of it can be taken out.

Stitches are used to close the skin, and a bandage is put on. You will be taken to a recovery room until you are fully awake. After you wake up, the area may be numb from a local anesthetic that was put into the biopsy site. You will also feel sleepy for several hours.

How long the test takes

A fine-needle aspiration biopsy takes about 5 to 15 minutes.
A core needle biopsy takes about 20 minutes.
An open biopsy usually takes from 30 to 60 minutes. If you’ve had a lymph node dissection to remove cancer, the surgery may take longer.

How It Feels

You will feel only a quick sting from the needle if you have a local anesthesia to numb the biopsy area. If you have a core needle biopsy, you may feel some pressure when the biopsy needle is put in.

You may have general anesthesia if your lymph node biopsy is part of a larger surgery. If so, you won’t feel your biopsy at all.

Risks

There is a chance of an infection at the biopsy site. An infection can be treated with antibiotics.

Your skin may feel numb near the biopsy site. This is common.

After surgery you may have a buildup of fluid where lymph nodes were removed. This fluid is called seroma. Your body will reabsorb the fluid, but it may take some time. Or your doctor may decide to drain the fluid. If the area becomes painful or shows signs of infection, such as redness, warmth, or tenderness, call your doctor right away.

Having lymph nodes removed may increase your chance of getting lymphedema. This can happen months after you have the surgery. If you notice swelling or if your skin feels tighter than normal, be sure to contact your doctor.

Results

Test results are usually available within a few days. Finding some types of infections may take longer.

The lymph node sample is usually treated with special dyes (stains) that color the cells and make problems more visible.

Lymph node biopsy
	The structure of the lymph node and the appearance of the cells in it are normal.
Normal:	The lymph node has normal numbers of lymph node cells.
	No signs of infection are present.
Abnormal:	Signs of infection, such as mononucleosis (mono) or tuberculosis (TB), may be present.
Abnormal:	Cancer cells may be present. Cancer may begin in the lymph node, such as Hodgkin lymphoma, or may have spread from other sites, such as in metastatic breast cancer.

Credits

Current as of:
December 17, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Kathleen Romito MD – Family Medicine
Laura S. Dominici MD – General Surgery, Breast Surgical Oncology

Current as of: December 17, 2020

Author:
Healthwise Staff

Medical Review:Sarah Marshall MD – Family Medicine & E. Gregory Thompson MD – Internal Medicine & Kathleen Romito MD – Family Medicine & Laura S. Dominici MD – General Surgery, Breast Surgical Oncology

Lymphoma | Lab Tests Online

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October 23, 2019. National Institutes of Health. Adult Non-Hodgkin lymphoma treatment (PDQ®)—patient version. Available online at https://www.cancer.gov/types/lymphoma/patient/adult-nhl-treatment-pdq#_129. Accessed November 2020.

July 19, 2018. American Cancer Society. About Waldenstrom macroglobulinemia. Available online at https://www.cancer.org/cancer/waldenstrom-macroglobulinemia/about/what-is-wm.html. Accessed November 2020.

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August 1, 2018. American Cancer Society. Types of T-cell lymphoma. Available online at https://www.cancer.org/cancer/non-hodgkin-lymphoma/about/t-cell-lymphoma.html. Accessed November 2020.

November 2018. Leukemia & Lymphoma Society. Peripheral T-cell lymphomas fact sheet. Available online at https://www.lls.org/sites/default/files/file_assets/FS25_Peripheral_TCell_2018_drug_update.pdf. Accessed November 2020.

Steven H. Swerdlow, Elias Campo, Stefano A. Pileri, Nancy Lee Harris, Harald Stein, Reiner Siebert, Ranjana Advani, Michele Ghielmini, Gilles A. Salles, Andrew D. Zelenetz, Elaine S. Jaffe, The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood (2016) 127 (20): 2375–2390. Available online at https://ashpublications.org/blood/article/127/20/2375/35286/The-2016-revision-of-the-World-Health-Organization. Accessed November 2020.

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(2006 May 30). Detailed Guide: Lymphoma, Non-Hodgkin’s type, What Are the Key Statistics About Non-Hodgkin Lymphoma? American Cancer Society [On-line information]. Available online through http://www.cancer.org.

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(© 2006). Introduction to Non-Hodgkin Lymphomas (NHLs). University of Medicine and Dentistry of New Jersey [On-line information]. Available online at http://pleiad.umdnj.edu/~dweiss/lymph_intro/lymph_intro.html.

(© 2006). Classifying Non-Hodgkin’s Lymphomas. University of Medicine and Dentistry of New Jersey [On-line information]. Available online at http://pleiad.umdnj.edu/hemepath/classification/classification.html.

(2003 February 1, Revised). Hodgkin’s Disease. Merck Manual Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/sec14/ch277/ch277b.html.

(2003 February 1, Revised). Non-Hodgkin’s Lymphomas. Merck Manual Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/sec14/ch277/ch277c.html.

(2003 February 1, Revised). Biology of the Immune System, Merck Manual Home Edition. Merck Manual Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/sec16/ch283/ch283a.html#fg183_2.

Henry’s Clinical Diagnosis and Management by Laboratory Methods. 21st ed. McPherson, RA, Pincus, MR, eds. New York: Saunders, Elsevier: 2007.

Harrison’s Principles of Internal Medicine, Kasper, et al, 16th Edition, McGraw Hill, 2005.

(Revised 2010 September 29). Hodgkin Disease. American Cancer Society [On-line information]. PDF available for download at http://www.cancer.org/acs/groups/cid/documents/webcontent/003105-pdf.pdf. Accessed October 2010.

(Revised 2009 July 17). Non-Hodgkin Lymphoma. American Cancer Society [On-line information]. PDF available for download at http://www.cancer.org/acs/groups/cid/documents/webcontent/003126-pdf.pdf. Accessed October 2010.

(Revised 2010 August 19). Non-Hodgkin Lymphoma in Children. American Cancer Society [On-line information]. PDF available for download at http://www.cancer.org/acs/groups/cid/documents/webcontent/003127-pdf.pdf. Accessed October 2010.

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Lymphatic Malformation | Johns Hopkins Medicine

What is an LM?

Lymphatic malformation (LM) is a relatively uncommon vascular malformation that can occur anywhere on the body. It is most commonly on the head and neck.

The lymphatic system is part of the immune system that protects the body from infection. When we get sick, our immune system fights germs in our bodies to make us healthy again. Just as blood is carried in arteries and veins, lymph travels in our bodies in lymph vessels. The white blood cells in lymph help to fight infection and disease. Lymph vessels are tubes in the body that carry lymph from small bean-shaped glands called lymph nodes to the blood stream. Lymph nodes are found throughout the body and help to filter lymph to remove viruses and bacteria. An LM occurs when lymph vessels form abnormally.

An LM can be at the skin surface, with small bumps filled with clear or blue-purple liquid, or occur as a swelling deep under the skin. They can sometimes ooze, become infected, bleed and swell. Some LMs are deep inside the body and are found when X-rays or imaging are done for other reasons, or for symptoms such as swelling veins.

LM can be made up of macrocysts — large pockets containing lymph — or microcysts, which are very small pockets of lymph. Many LMs have both macrocysts and microcysts.

Infection is the most common complication of LM. Bleeding inside the LM can also occur. Both infection and bleeding can cause LMs to swell and enlarge. If the LM is on an arm or leg, this swelling could make that limb hard to use.

LMs are formed during a baby’s development before birth, but not all LMs are diagnosed at birth. For many people, LMs are first found on imaging studies after an accident or trauma or as a child grows into an adult (during puberty) or during pregnancy.

[[slideshow_lymphatic_malformation]]

How are LMs diagnosed?

Most LMs can be diagnosed by a doctor who has seen and treated malformations before. They will likely be able to diagnose a patient based on a physical exam and asking about the patient’s growth and development.

Most LMs are not passed from parent to child. Nothing that a mother does during pregnancy can cause or prevent these malformations.

If your doctor is concerned that you may have an LM, it is common to order an MRI, which is a scan or picture of the inside of the body. This will help to show the size and location of the LM. Also, an MRI will help doctors see what other important anatomy is near the LM. Anatomy that is close by could be affected by treatment.

An ultrasound is another useful test to diagnose and monitor the LM. It is a good method for young children because it can be done while a child is awake. However, an ultrasound is not as detailed as MRI, and does not provide as much information about nearby anatomy. Occasionally, a CT scan is used to see whether the LM is affecting a bone. A CT scan is like an MRI, except it uses X-rays instead of magnets.

How are LMs treated?

Most LMs grow as the patient grows. LMs can also grow after trauma, during puberty or during pregnancy. Although some LMs can be cured, many cannot be cured with treatment. These patients will need to be treated at different times throughout their life.

Treatment is typically designed to manage the LM to decrease the size and symptoms. Treatment can reduce problems caused by marks left on the skin. A team of doctors who specialize in treating vascular birthmarks will work together to treat an LM.

An interventional radiologist is a doctor who can read pictures and scans of the body and use these images to treat the LM without cutting the skin. This doctor will play a central role in both diagnosing and treating an LM. Other doctors on the team can include surgeons, hematologists, dermatologists and geneticists.

LMs are benign, which means they are not cancer. If an LM is not causing problems such as pain or loss of function, watchful waiting may be best. However, LMs can slowly expand over time. Once an LM starts causing problems, doctors will start treatment. If an LM is in a sensitive or dangerous area, or if it becomes infected often, doctors may need to treat it right away.

If you are concerned that you or your child may have an LM, you should see a specialist early. Treatment is individualized for each patient. Your doctors will partner with you to make sure you are getting the right treatment at the right time.

Medication for LM Treatment

Many doctors are working on new treatments for LM. A medicine called sirolimus (rapamycin) has worked for some patients. For most vascular anomalies, a combination of treatment methods is best. Your doctor will help you decide where to start. Sirolimus is taken by mouth as pills or as a liquid.

Sirolimus can be compounded at a special pharmacy into an ointment or cream to be applied to the affected skin. Other medicines are being tested to better treat LM. Your doctor will help determine whether these medicines would be safe and helpful for you, considering the location and size of the LM and any symptoms it is causing.

Sclerotherapy for LM

Sclerotherapy is a very useful treatment for LM. A doctor called an interventional radiologist usually performs this treatment. During sclerotherapy, a special medicine is injected using needles placed through the skin into the lymph vessels and cysts within the LM. The medicine injected into the LM damages and destroys the lymph vessels. This causes scars to form inside the abnormal lymph vessels and less lymph will flow through the area.

Sclerotherapy may take several treatments to get the most benefit. Treatments are usually at least six weeks apart. During a sclerotherapy treatment, a doctor will use ultrasound to target the LM, and X-ray imaging to help guide and monitor the treatment. The skin is not cut during these procedures. Only needles are used to deliver the medicine directly into the malformation.

A variety of medicines could be used for sclerotherapy. The fluid that is injected is called a sclerosant. Although many different types of sclerosants can be used, doxycycline (an antibiotic) is used commonly as a sclerosant when treating LM. Your doctor will advise you about which sclerosant is best for your LM.

Your doctor will prepare you for what happens normally after the procedure and for potential problems. For comfort, most patients are put to sleep under general anesthesia during sclerotherapy. Some patients get to go home the day of the procedure. Some stay overnight in the hospital to recover.

Following treatment, there can be swelling, skin irritation, bruising and pain at the treatment site. The most common complication of sclerotherapy is ulceration. This means that a sore or wound, called an ulcer, develops on the skin over the LM. Ulceration happens in less than 5 percent of cases. Your doctor will help you manage an ulcer until it heals.

Though sclerotherapy makes the LM get smaller, LMs can get bigger again over time. Most LMs cannot be cured; instead, they are managed throughout life. Many patients get multiple rounds of treatment throughout their lifetime. The goal is to make symptoms go away as much as possible.

Additional Treatments for LM

Radiofrequency ablation is a treatment sometimes used for LMs inside the mouth. It is usually performed by an interventional radiologist or a special surgeon called an otolaryngologist (a doctor who specializes in disorders of the ear, nose and throat).

Other therapies, such as cryoablation (freezing therapy), are currently being studied to see whether they are useful for treating lymphatic malformation.

Some patients may get surgery after sclerotherapy. Surgery can remove a mass, extra skin or a visible mark left by the LM. If an LM is not a good candidate for sclerotherapy — usually if the cysts are too small (microcysts) — surgery may be the first treatment offered.

However, the LM will often return after surgery. It is very difficult to entirely remove an LM with surgery. Surgery should be done by a surgeon with experience in treating these complicated malformations.

How to Check Lymph Nodes: 12 Steps (with Pictures)

About This Article

Medically reviewed by:

Master’s Degree, Nursing, University of Tennessee Knoxville

This article was medically reviewed by Luba Lee, FNP-BC, MS. Luba Lee, FNP-BC is a board certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006. This article has been viewed 3,159,389 times.

Co-authors: 20

Updated: April 8, 2021

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

Article SummaryX

Checking your lymph nodes once a month can help you detect any swelling that could indicate a medical issue. Lymph nodes are located in your head, neck, arms, armpits, and groin. An enlarged lymph node may feel like a pea or a grape, and it may feel tender. To check the lymph nodes in your head and neck, move your fingertips in a circular motion in front of and behind your ears, around your jaw, down the sides of your neck, and above your collar bone. Tilt your head toward the side of your neck you’re checking to make it easier to feel for lymph nodes. Bring your elbows forward and hunch your shoulders when checking the lymph nodes above your collar bone. To check the lymph nodes in your arms and armpits, remove your shirt and lift up one arm. Use the fingers on your opposite hand to feel the center of your armpit. Check the front and back borders of your armpit as well the inner border of your arm. Repeat on the other armpit. To check the lymph nodes in your groin, use your fingers to feel the horizontal chain of lymph nodes along the groin crease on each side. Then check the vertical chain of lymph nodes along the inner upper thigh on both legs. If you feel an enlarged lymph node or you’re unsure, let your doctor know right away. Swollen lymph nodes can occur because of an infection, or they can be a sign of a more serious illness. For more information from our Medical Review Board co-author, like what to expect when a doctor checks your lymph nodes, keep reading!

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Anatomy of the lymphatic system – Center for Lymphatic Surgery

The lymphatic system – an important part of the human cardiovascular system and complements it.

Unlike the circulatory system, the lymphatic system does not have its own pump and is open. The lymph circulating in it moves slowly and under little pressure. Lymph is a fluid that is constantly formed by the drainage of intercellular fluid into the lymphatic capillaries.

The structure of the lymphatic system includes:

• lymphatic capillaries
• lymphatic vessels
• lymph nodes
• lymphatic trunks and ducts

From the capillaries, lymph enters the lymphatic vessels, and then into the ducts and trunks: on the left into the thoracic duct (the largest duct), left jugular and left subclavian trunks; on the right into the right lymphatic duct, right jugular and right subclavian trunks.The ducts and trunks flow into the large veins of the neck, and then into the superior vena cava. In this way, lymph is transferred from the interstitial spaces back into the blood.

Lymphatic vessels pass through the lymph nodes. They are combined into several groups and are located along the vessels. Many carrying vessels carry the lymph into the node, and it flows from there only through one or two outgoing vessels. Lymph nodes are small formations of a round, oval, bean-shaped, less often ribbon-like shape up to 2 cm long.Here the lymph is filtered, foreign inclusions are separated and destroyed, and here lymphocytes are produced to fight the infection. Lymph nodes that play a barrier and immune role.

Basic functions of the lymphatic system:

• Transport function – carrying lymph, metabolic products from tissues into the venous bed.

• Drainage function – return of proteins, water, salts, toxins and metabolites from tissues to blood.Removal of fluid, pus, wound effusion, cavities. Stability of the “capillary lymphatic pump”

• Lymphocytopoiesis, hematopoietic function – formation, maturation, differentiation of lymphocytes involved in immune reactions.

• Immune, protective functions – formation of the body’s immune defense, neutralization of foreign particles, bacteria, viruses, fungi, protozoa that enter the body. filtration from impurities, tumor particles and cells.

Any failure or blockage of the lymphatic vessels or nodes entails a tumor or tissue edema, lymphadenitis, erysipelas, and lymphostasis occur. Experts, not without reason, believe that lymph could tell about what the blood is “silent” about, because many waste products of cells first enter the lymph, and then into the blood.

While most doctors can help us in the fight against many diseases, only individual doctors – lymphologists – can diagnose and treat disorders in the lymphatic system.

According to the statistics of the physicians themselves, in the CIS there are only a few lymphologists – specialists in the lymphatic system.

Lymphologists say: Your health is the purity of your lymphatic system!

Be healthy and happy!

Movement of lymph in the body – Marina Kostrova’s Body Aesthetics Studio

lymphatic system

lymphatic drainage massage

13.01.2020

Let’s finally figure out how lymph moves in the body: where does it come from and where does it go?

Lymph is a colorless liquid, it does not contain red blood cells, and the protein content in it is 2 less than in blood plasma.On average, the amount of lymphatic fluid in the body is 2 liters.

How is lymph formed?
First, a tissue fluid is formed from the blood plasma, which washes all organs and tissues, giving them nutrients and oxygen, then part of the tissue fluid is absorbed into the lymphatic capillaries and forms lymph.

Lymphatic capillaries sometimes begin blindly, taking the form of clavate extensions, their walls are formed by only one layer of epithelial cells, so the tissue fluid easily penetrates inside.

Lymph consists of lymphatic capillaries, vessels and nodes, and is present everywhere except the brain, spinal cord, cartilage and bone marrow. Lymphatic capillaries are interconnected to form lymphatic networks.

Lymph moves only upwards, valves located on the lymphatic vessels prevent it from moving down. They prevent the backflow of lymph.

Lymphatic fluid reaches the thoracic and right lymphatic ducts, both ducts drain the lymph into the superior vena cava of the large circulatory duct, near the heart.

By doing lymphatic drainage massage, we work out the places of stagnation of tissue fluid, accelerate the formation of lymph, thereby improving the cleansing of the body from toxins.
And massage movements – only in the direction of the lymph flow, that is – from the limbs of the arms and legs up to the cervicothoracic region.

An interesting fact: after eating fatty foods, part of the fat is absorbed from the intestines into it and the lymph changes color to milky white.

If you liked the article, share it on social networks!

And if you want to sign up for a lymphatic drainage massage, please fill out the feedback form!

Colon lymphoma in dogs and cats (cancer) | articles on veterinary oncology

Animals, like humans, have many natural tools for maintaining health.One of them is the lymphatic system, which is the most important part of the body’s defense against various infections. Lymphoid tissue is distributed throughout the body and consists of lymphocytes, white blood cells, whose task is to quickly respond to the invasion of bacteria or viruses and arrest possible infectious processes.

Sometimes the system itself fails and, due to some changes in the body or the action of external factors, lymphocytes begin to reproduce uncontrollably and become a pathogenic factor.When this happens, lymphoma (lymphosarcoma) develops – a cancer of the lymphatic system that affects all organs containing lymphoid tissue – lymph nodes, spleen, intestines, stomach and others.

Because lymphocytes are distributed throughout the body, cancer can develop anywhere in the body, including the gastrointestinal tract. Tumor foci initially can actively develop in a certain part of the stomach or intestines. In another variant of the development of lymphoma, diffuse growth occurs, which leads to a general thickening of the intestinal tissue.In any case, the lesion includes the lymph nodes and the walls of the organs of the gastrointestinal tract.

Incidence of lymphoma in cats and dogs 90 100

It was found that cats suffer from lymphoma much more often, the probability of developing pathology in these animals is 30-50% of all neoplasms.

According to age, there are two risk groups. The first group includes young animals up to three years old, which are predominantly carriers of feline leukemia virus (FeLV) and immunodeficiency virus (FIV).

Another group is cats aged 10-12 years, which, as a rule, do not carry the virus. In addition, the researchers note the genetic predisposition of Abyssinian cats to lymphoma.

In dogs, the disease is less common, and this type of cancer is detected in 10-20% of all cases of tumors. Older dogs, especially Boxers, Rottweilers, Shar Pei, Basset Hounds, and some other breeds, are prone to lymphoma.

Symptoms of intestinal lymphoma in dogs and cats 90 100

Like any other form of cancer, lymphoma can occur, especially at the first stage, without pronounced specific symptoms. Owners report lethargy, partial loss of appetite, attributing these symptoms to other illnesses. And often only with the exacerbation and progression of the disease, the animal is shown to a specialist. At the same time, only the oncologist of the veterinary service will be able to exclude or confirm the development of cancer.

Signs of developing intestinal lymphoma:

lack of appetite;
unusual sleepiness;
rapid weight loss;
swelling and enlargement of the lymph nodes;
periodic vomiting;
diarrhea, blood streaks in the stool;
soreness and bloating.

When observing any of these signs, and even more so when they are combined, you need to invite an oncologist of the veterinary service for the initial examination of the pet and the appointment of further diagnostics.

Diagnosis of intestinal lymphoma in cats and dogs 90 100

The diagnosis begins in the process of discussing with the owners of the animal the history of the disease in its development, as well as the details of the observed signs of pathology. When palpating the abdomen, in many cases, the oncologist manages to feel the tumor in the abdominal cavity.

Blood tests will definitely be taken and possible changes in it will be monitored, while anemia, leukocytosis, lymphocytosis and other disorders can be detected.

Further, instrumental examinations will be carried out, which include ultrasound of the abdominal cavity, which will determine the localization, size and prevalence of the tumor, the presence of pathological processes in other organs.

X-ray examination will help to detect or exclude the presence of tumor masses in the chest cavity.

When a tumor is found in the intestinal lumen, it is possible to carry out endoscopy to determine the nature of the formation, in addition, a biopsy is performed using a puncture under the control of ultrasound, also obtaining material for research.

In the case of surgical removal of the tumor, its histological analysis is carried out and at this stage the final diagnosis is made, which is important when prescribing further postoperative treatment.

Treatment of intestinal lymphoma in dogs and cats 90 100

Bowel lymphoma is an incurable form of cancer.However, if remedial measures are taken on time, it is possible to significantly control the development of the disease and the condition of the pet, prolong its life and significantly improve its quality.

Types of therapy

Surgical method of treatment is most often used in the case when the tumor is an obstacle, and its very presence threatens the life of the animal from intestinal obstruction.

Chemotherapy is used as a stand-alone form of treatment that is quite effective for abdominal lymphoma in cats, as well as for controlling the development of cancer cells after surgery.Specific drugs inhibit or destroy foreign cells without affecting healthy ones.

Radiation therapy is effective when the tumor is localized in a certain area of the intestine and the impossibility of its prompt removal. Most often, radiation is carried out in combination with the use of chemotherapy drugs.

Side effects

With any method of treatment, side effects are possible – nausea, vomiting, stool changes. Chemotherapy with certain drugs can lead to changes in the composition of the blood (leukopenia), disorders of the kidneys and bladder (nephritis and cystitis), intestines (diarrhea), and the nervous system (seizures).

However, despite the undesirable side effects, in many cases, animals cope with the disease and, thanks to treatment, their lifespan can be significantly extended.

Care During Therapy

Owners of a sick dog or cat should provide their pet with enhanced nutrition and additional care during and after treatment. The animal is placed in a quiet, calm place at home. The diet includes foods rich in proteins and omega-3 fatty acids, vegetables and dairy products are useful.

And in conclusion …

Practitioners note that cats, although they get sick more often, recover better after surgery and chemotherapy, and their average life span is two or more years.

Dogs, on the other hand, get more sick, and the earlier the lymphoma is detected and removed, the more likely these animals are to prolong their lives. At the same time, 2/3 of dogs, after successful treatment, can expect to live within one year, and 15% of patients will live for more than two years.

If animals with intestinal lymphoma are not treated, the average period of their painful life is about 2 months, and in this case the owner needs to seriously weigh the pros and cons of the possibility of euthanasia (euthanasia).

See also the information in the sections “Putting cats to sleep at home” and “Putting your dog to sleep at home”.

90,000 LYMPHATIC SYSTEM – A FORGOTTEN AREA? | Itkin

1.Nadolski GJ, Itkin M. Feasibility of ultrasound-guided intranodallymphangiogram for thoracic duct embolization. J. Vasc. Interv. Radiol. 2012; 23 (5): 613-616. doi: 10.1016 / j.jvir.2012.01.078.

2. Dori Y, Keller MS, Rome JJ et al. Percutaneous Lymphatic Embolization of Abnormal Pulmonary Lymphatic Flow as Treatment of Plastic Bronchitis in Patients With Congenital Heart Disease. Circulation. 2016; 133 (12): 1160-1170.

3. Dori Y, Zviman MM, Itkin M. Dynamic Contrast-enhanced MR Lymphangiography: Feasibility Study in Swine. Radiology. 2014; 273 (2): 410-416.

4. Cope C. Percutaneous transabdominal embolization of thoracic duct lacerations in animals. J. Vasc. Interv. Radiol. 1996; 7 (5): 725-731.

5.Cope C. Percutaneous thoracic duct cannulation: feasibility study in swine. J. Vasc. Interv. Radiol. 1995; 6 (4): 559-564.

6. Laurence KM. Congenital pulmonary cystic lymphangiectasis. J. Pathol. Bacteriol. 1955; 70 (2): 325-333.

7. Frank J, Piper PG. Congenital pulmonary cystic lymphangiectasis. J. Am. Med. Assoc. 1959; 171: 1094-1098.

8. Toltzis RJ, Rosenthal A, Fellows K, Castaneda AR, Nadas AS. Chylous refl ux syndrome involving the pericardium and lung. Chest. 1978; 74 (4): 457-458.

9. Kerlan RK, Laberge JM. Intranodal lymphangiography: coming soon to a hospital near you. J. Vasc. Interv. Radiol. 2012; 23 (5): 617.

10.Rocha G, Fernandes P, Rocha P, Quintas C, Martins T, Proença E. Pleural effusions in the neonate. Acta. Paediatr. 2006; 95 (7): 791-798.

11. Wilson RD, Baxter JK, Johnson MP et al. Thoracoamniotic shunts: fetal treatment of pleural effusions and congenital cystic adenomatoid malformations. Fetal Diagn. Ther. 2004; 19 (5): 413-420.

12.Moreno AH, Ruzicka FF, Rousselot LM et al. Functional Hepatography. Radiology. 1963; 81 (1): 65-79.

13. Gray M, Kovatis KZ, Stuart T et al. Treatment of congenital pulmonary lymphangiectasia using ethiodized oil lymphangiography. Journal of Perinatology. 2014; 34 (9): 720-722.

14. Teramoto K, Kawamura T, Okamoto H et al. Percutaneous transhepatic lymphography method to image and treat intra-abdominal lymph node metastasis in patients with unresectablehepatobiliary pancreatic cancer.Surgery. 2002; 131 (5): 529-533.

15. Clain D, McNulty J. A radiological study of the lymphatics of the liver. British Journal of Radiology. 1968; 41 (489): 662-668.

16. Starling EH. The Influence of Mechanical Factors on Lymph Production. J. Physiol. (Lond). 1894; 16 (3-4): 224-267.

17.Dumont AE, Mulholland JH. Flow rate and composition of thoracic-duct lymph in patients with cirrhosis. N. Engl. J. Med. 1960; 263: 471-474.

18. Ludwig J, Linhart P, Baggenstoss AH. Hepatic lymph drainage in cirrhosis and congestive heart failure. A postmortem lymphangiographic study. Arch. Pathol. 1968; 86 (5): 551-562.

90,000 Me, my brother, our cancer and our pictures

Oliver Jarvis
BBC Stories

January 5, 2020

Photo by Carly Clarke

When Carly Clark was diagnosed with cancer in 2012, she decided take pictures of how its appearance is changing.By a cruel coincidence, seven years later, she photographs her brother in the same way – he also has cancer.

“My hair is on my arms, on my clothes and on the bottom of the bath. When I wash or brush it, more and more of it falls out.”

“In the mirror you can see how my appearance changes every day.”

Carly Clark shows me one of the many self-portraits taken during her agonizing six-month treatment.

At one point, she asked her father to shave off the remaining hair from her head.She was 26 years old.

“I had thick hair. Now I look like a cancer patient,” she says.

Photo by Carly Clarke

Six months before these pictures were taken, Carly was finishing a university project in Canada, photographing the life of poor neighborhoods in East Vancouver.

By that time she had been feeling unwell for several months – a terrible cough, pain in the chest and back, loss of appetite. Doctors made a variety of diagnoses, from pneumonia to asthma, and warned that her lungs might not be able to withstand the flight home.Carly disobeyed the doctors.

“I wasn’t going to let illness – whatever it be – interfere with my life,” she says. “While photographing in Vancouver, I empathized with the sick and addicts. Concern about my own health helped me with this.”

Photo by Carly Clarke

Many of those with whom she spoke on the cold streets of Vancouver became addicted after taking strong opiates in hospitals, where they were treated for serious illnesses, including cancer.

And after three months she already needed morphine herself – otherwise the pains in her back and chest would not let her sleep.

Canadian doctors eventually convinced Carly to go home, and in March 2012 she was diagnosed with lymphogranulomatosis, also known as Hodgkin’s lymphoma, a rare and highly aggressive form of cancer. Carly’s right lung has already developed a tumor the size of a grapefruit.

“When I heard about the diagnosis at a London hospital, I burst into tears,” says Carly. “I didn’t know if I would survive chemotherapy at such a late stage of the disease.I was scared. “

Photo by Carly Clarke

The family was also terrified.

” My parents’ heart sank. In our family, cancer was rare, – continues Carly. “My boyfriend, too, was heartbroken and flew from California to England to be with me.”

Back home in Eastbourne, Carly scribbled the dates of hospital visits and medication schedule on a calendar that had been filled with deadlines just a few months ago term papers and photo sessions.

Photo by Carly Clarke

“My life slowed down, I lived in the moment, from drug to drug, with endless examinations, giant needles, biopsies deep into the bone, tubes in my throat and hoping that one day the pain will go away.” , says Carly.

Chest pain gradually spread to her arm, fluid in her lungs made it difficult to breathe, and she coughed incessantly.

“Through a plastic tube in a vein, they pumped me with medicine, which made me sick.It cured cancer, but it took away my strength, ”she continues. – The bones showed through the skin, reminding of the lost pounds. Suddenly my life was on the map. “

Her view of the world – and of herself – also changed. And Carly decided to capture it in photographs.

Photo by Carly Clarke

” I thought some creative activity would help I distract myself from reality for a minute or two and look at my situation from the other side, “she says.

A series of photographs called Reality Trauma (by analogy with the” reality show “) was supposed to capture her changing appearance, life in a hospital and beyond, and its resilience.

During visits to the hospital, which sometimes lasted several days, doctors allowed her to use a tripod and a self-timer, and sometimes pressed the camera button themselves.

“I was thinking about how people would perceive these pictures and whether I would live to see it,” says Carly.

She wanted to help other patients “look cancer in the eyes” and not let it completely take over their thoughts and feelings.

Over time, Carly began to notice that her skin in photographs looks paler and more tightly attached to the bones, and she looks less and less like herself.

Photo by Carly Clarke

In two months she lost 12 kilograms, she needed regular blood transfusions due to circulatory problems – her body did not receive enough oxygen and gradually turned blue.

“People were afraid to look at me. Especially the parents of children who were also being treated for cancer – probably because, looking at me, they imagined what would happen to their own children,” says Carly. “I myself was scared to look at myself.”

Soon she had to visit the hospital so often that she was admitted there on a permanent basis.

Photo author, Carly Clarke

During the most difficult period of treatment, Carly either slept or was sick, she did not eat at all, and on some days she did not have the strength to pick up a camera or call her boyfriend.

Now she coughed up blood, and sometimes woke up in a pool of her own sweat.

But one day, after three months of chemotherapy, the cough stopped. The rest of the symptoms started to go away too.

Looks like the treatment has paid off, Carly thought.The biopsy confirmed that the cancer was receding.

Her perception of life has changed again.

“Hopelessness gave way to hope, and then euphoria. When you are so close to death, you want to live life to the fullest,” says Carly.

Photo by Carly Clarke

The hospital ward has turned from a torture chamber into a house. The staff and other patients became friends.

Carly began to leave the room. Patients of all ages gathered around the aquarium in the common lobby.

An elderly couple treated for two different types of terminal leukemia often received chemotherapy at the same time as Carly. One day a man told her that, according to doctors, his wife would not live to see Christmas.

“I remember that I hugged her and wished her all the best – and this couple will forever remain in my memory,” recalls Carly.

Carly’s health gradually improved, and life went beyond the hospital walls. Friends began to invite her to dinner, sometimes they went to the coast.

Photo by Carly Clarke

From conversations with students and teachers, Carly realized that her photographs have an impact on others.

They not only captured the physical and emotional impact of cancer and its treatment, but also the positive side of this process – it does not have to be intimidating and scary, says Carly.

“I look at these photos and I think they gave me strength – they show that, although I am on the verge of death, some part of me still believes that I can handle it.”

Carly shared her pictures with other patients and began photographing some of them. An impromptu photo shoot became a way to strike up an acquaintance or just make them smile.

Photo by Carly Clarke

“If a simple smile, a small gesture of help or a kind word can change how a person feels and positively affect every cell in the body, then a positive photographic story can help change someone’s life.” , she says.

“This can be a decisive factor, give the necessary inner strength so that people continue to experience suffering in the hope that it will soon end. In my opinion, this is what keeps us alive, no matter what.”

Carly’s treatment ended in September 2012. All stages of her journey, from diagnosis to recovery, are recorded in 150 photographs.

Photo author, Carly Clarke

Caption,

Carly’s photo entitled “The Last Day of Chemotherapy” was nominated for the Portrait of Britain prize in 2018

It was a holiday.The return home was coming, and it was not easy. Packing boxes of unused medicines, she sadly realized that she was leaving the hospital.

“The staff and some of the patients have become almost a family for me – we have become very good friends over these few months.”

A few months later, Carly flew to her boyfriend in California and spent most of the next year there.

She returned home several times for examinations. Getting to the hospital, I felt at home – there were all the same faces of nurses and patients with whom she spent so much time.

Once, a few years after completing the course, Carly found herself in the emergency room with one woman – they were waiting for their turn to see a doctor.

“We looked at each other and I suddenly burst into tears,” she says.

This was the same woman whose husband told Carly in 2012 that she would not live to see Christmas.

“I couldn’t believe I was sitting next to her,” recalls Carly. “It was a great moment.”

Carly again took a great interest in photography, capturing the lives of others.In 2014, she spent four months in India.

Photo by Carly Clarke

Her work on that trip received an honorable mention at the 2018 International Photo Awards. In the same year, her photo “The Last Day of Chemotherapy” from the Reality Trauma series was included in the list of nominees for the “Portrait of Britain” award.

She began working with photographer Michael Worley, filming advertisements for the 2020 UK film Summerland.

The work was getting more and more.And at the same time, with the help of the local hospice in St. Wilfred, she began to develop a concept for a project of portraits of patients with cancer in the last stages of life.

She wanted to show how incurable diseases affect the psychological state of people and how patients spend the last remaining moments trying new hobbies or saying goodbye to the world and loved ones.

Suddenly, everything stopped: in September 2018, Carly got a call from her older brother Lee and said that her younger brother, Joe, had been diagnosed with Hodgkin’s lymphoma.

They both cried.

Photo by Carly Clarke

Joe was 16 years old and just starting college. He was diagnosed with cancer at an earlier stage than Carly. But like his sister a few years earlier, he had been ill for several months.

At first, doctors attributed the severe itching to “dry skin” or the patient’s imagination.

“The diagnosis took him by surprise. And all of us,” says Carly.

Hodgkin’s lymphoma

Hodgkin’s lymphoma is an uncommon cancer that develops in the lymphatic system.The disease can spread rapidly throughout the body, but at the same time, it is one of the most easily treatable forms of cancer.

Joe tried to live as usual: he spent time with his girlfriend, learned to drive and made plans for the future.

But as he spent more and more time in the hospital, his academic achievements suffered and he began to lose touch with some of his friends.

Carly wanted to spend more time with her brother. At the beginning of 2019, with his consent, she began photographing him in the same way as she used to photograph herself.

Photo by Carly Clarke

Carly is 16 years older than her brother, and began to live an independent life when he was still a child. But, being the only sister, she always felt responsible for him. As a child, she taught him to draw.

But when Carly moved to study in London, they saw each other only occasionally. And each time she noticed how Joe grows a little taller, his voice sounds lower.

However, in hospital photographs, the changes are much more obvious.

Photo by Carly Clarke

At first, Joe dyed his hair bright colors. Like Carly, they began to fall out in clumps, and he eventually shaved them off to keep them from sticking to clothes and the hospital floor.

In the photographs, he began to cover his head and began to think about the wig.

Due to the steroids he was prescribed to prepare for the next stage of chemotherapy, Joe looks much older and has become very fat.

“Joe gained weight in such a way that it became difficult to recognize him,” recalls Carly.

Photo by Carly Clarke

Increasingly, Joe turned to Carly for advice and support. In his youth, he watched her fight against cancer, saw how the disease changed his sister and how she defeated her.

“Although he had doubts, the fact that I was able to recover from the illness meant that he had something to hope for. My example gave him the strength to continue treatment,” says Carly.

Photo by Carly Clarke

However, the first phase of chemotherapy was unsuccessful.

“This news shocked everyone. Our relationship has changed, it has become less stable,” says Carly.

After a relapse, Joe had four more months of chemotherapy and a stem cell transplant. His hair, which had grown back, fell out again.

Joe refused to be photographed – and Carly understood him perfectly. However, after a month, he changed his mind.

“My favorite shot is where he turns away and looks into the distance. He knew what was in store for him,” says Carly.“The photo shows how he has changed and adapted to this new role of the young cancer patient.”

Photo by Carly Clarke

Contrary to the advice of doctors, Joe refused stem cell therapy. He feared that the side effects were breathing problems and skin, jaundice and diarrhea, which can occur if the donor cells do not take root, will ruin his life.

Soon after, in May, test results showed no cancer.The remission that began allowed Joe to take his family on vacation to Menorca, and then and attend the wedding of Lee’s older brother.

Joe will now have regular check-ups for several months. But he has already lost weight and his hair is growing back.

Photo by Carly Clarke

Carly claims that her photographs are a vivid example of how the life of their family changed when her – and then her brother – “body, mind and soul were subjected to the most severe test.”

“The pictures of me and Joe evoke painful memories in me; however, they also remind me of the amazing ability of the human body to withstand such hellish tests,” says Carly.“These pictures can only give a rough idea of what it’s like. But I hope that they can discern not only the terrible details of the disease, but also the hope that cancer survivors give other patients. “

Photos: Karlie Clarke

Sigmoid colon cancer: symptoms, diagnosis, treatment

The sigmoid colon is the section of the colon that passes into the rectum. Malignant neoplasms in this section are called sigmoid colon cancer.The formation of malignant tumors causes intoxication of the intestinal walls due to stagnation of feces, which are formed under the influence of improper nutrition, poor-quality products and an unhealthy lifestyle. Oncology of the sigmoid colon is considered the most difficult to diagnose due to the thickness of the intestinal walls, which do not miss the signs of cancer.

Causes of pathology 90 100

Sigmoid colon cancer can be caused by a myriad of factors, of which even the smallest ones matter:

hereditary predisposition;
chronic diseases of the colon, for example, all kinds of colitis;
predisposition to the formation of polyps in the intestine, although most doctors characterize this condition as precancerous;
Natural aging of a person causes age-related diseases, for example, atony;
overweight and obesity due to diabetes mellitus;
a sedentary lifestyle reduces intestinal motility;
violation of the rules of healthy eating;
intoxication of the body with alcohol, tobacco, carcinogens, etc.

Symptoms and signs 90 100

The initial signs of cancer of the sigmoid colon are practically absent, and the first symptoms are blurred.

Symptoms of primary manifestation of sigmoid colon cancer:

increased flatulence;
belching with accompanying bad breath,
rumbling in the stomach;
pain during bowel movements;
the presence of blood, mucous and purulent clots in the feces, indicating the movement of polyps;
Frequent change in the nature of the stool – constipation, diarrhea;
Cramping or dull pain in the iliac region.

Later stages of development of sigmoid colon oncology are characterized by the following features:

increased fatigue and weakness;
signs of intoxication – nausea, vomiting, fever, migraines, dizziness, headaches, lack of appetite;
jaundice;
Characteristic earthy gray skin;
anemia;
Ascites is the accumulation of excess fluid in the abdominal cavity;
drastic weight loss;
enlargement of the liver;
an increase in the volume of the abdomen due to the accumulation of feces.

Symptoms of sigmoid colon cancer appear only in the late stages of the disease, for this reason this type of tumor is difficult to treat.

Stages and Classification

Cancer of the sigmoid colon by stages does not differ from other oncological diseases:

I – tumor growth does not go beyond the tissue mucosa,
II – has two types: type A involves spreading along the length of the intestine, type B is characterized by growth into the walls of the intestine,
III – is divided into type A and type B: the first occupies almost the entire intestinal lumen and does not form metastases, the second is characterized by metastases in regional lymph nodes,
IV – characterized by active growth of metastases and damage to neighboring organs.

The final stages of sigmoid colon cancer cannot be treated; patients are only helped to reduce the intensity of pain.

Sigmoid colon cancer with metastases is characterized by the following ways of metastatic growth:

lymphogenous – spreading through the lymphatic vessels;
hematogenous – spreads through the blood vessels;
implantation – it spreads only after the tumor leaves the affected organ.

For sigmoid colon cancer, the stage of growth of metastases is defined as the third, while type A does not form metastases at all. Intestinal neoplasms can be benign and malignant. The malignant type of tumor occurs in two types – inside the intestinal wall or along its length. In this case, the symptoms of sigmoid colon cancer are the same symptoms.

Diagnostics

At the first degrees of cancer of the sigmoid colon, diagnosis can be made only as part of a therapeutic examination, since there are no symptoms of the course of the disease.

Diagnostics of intestinal oncology is carried out by all available methods. The first method of examination is palpation, then a blood test for tumor markers is prescribed. Specific examination methods are the following procedures:

endoscopic – colonoscopy, sigmoidoscopy – are distinguished by the painfulness of the process for the patient, are contraindicated in the elderly and in poor health. In the process, a tissue sample is taken for biopsy;
Irrigoscopy consists in carrying out an X-ray examination of the patient’s body, who has previously taken a barium solution;
MRI is aimed at assessing the size of the tumor, its localization, as well as determining the presence of sigmoid colon cancer with metastases and the extent of their spread;
Ultrasound of the abdominal cavity.

A biopsy is done to identify the tissues that make up the tumor and classify it as benign or malignant.

Oncology center “Sofia”

At the Sofia Cancer Center of Medicina JSC (Academician Roitberg’s clinic), located in the center of Moscow near the Mayakovskaya metro station, patients will be provided with the necessary medical care by oncologists trained in leading foreign clinics, as well as psychologists aimed at the correct perception of the set diagnosis and the patient’s desire for cure.

Here we are ready to offer you the most modern diagnostic methods that allow you to make an accurate diagnosis and start an adequate treatment. The following procedures are used to diagnose sigmoid colon cancer – MRI, CT, SPECT, PET, radiography, fluoroscopy, ultrasound, laboratory tests.

Treatment

The Cancer Center provides comprehensive treatment for sigmoid colon cancer, consisting of surgery, chemotherapy and radiation therapy.The central method in this case is surgical intervention. Without surgery, other methods will not be able to overcome the disease.

Surgical intervention is based on the initial removal of the infected tissue, further removal of the affected areas with metastases and the subsequent restoration of the integrity of the intestinal tube. With a small size of the neoplasm, the operation is performed by the method of laparotomy, based on several punctures.

In advanced stages of sigmoid colon cancer, treatment by surgery involves the complete removal of the sigmoid colon and removal of the vent tube during the postoperative period.After a few months, if the operation is successful, the feces will come out in the usual way.

Chemotherapy is a medical treatment. It is based on the introduction of special chemicals, the action of which is aimed at destroying the affected tissues and reducing the activity of tumor cells to divide. The method is applied both before and after the operation to consolidate the effect of the surgical intervention. Allocate mono- and polychemotherapy. Its effect is aimed at reducing the size of the tumor, preventing recurrence and inhibiting the progression of the disease.

Radiation therapy for sigmoid colon cancer is used with extreme caution, due to the risk of developing perforation of the intestinal walls. In addition, it has a mild effect for intestinal oncology. The beneficial effect is the destruction of cancerous tissue in the area between the excised material and healthy tissue.

Forecast

The prognosis of sigmoid colon cancer depends on the stage of tumor development. At stages 1-2, a complete cure is possible with a 90% probability.At the third stage, this probability does not exceed 50%. In the fourth stage, the survival rate barely reaches 14%.

How to make an appointment with a doctor

You can make an appointment by calling 8 (495) 775-73-60, the Clinic is located at the address: Moscow, 2nd Tverskoy-Yamskaya lane, 10.

Hodgkin’s lymphoma – what is this disease, causes, stages and treatment of cancer of the lymphatic system | 72.ru

Trepanobiopsy of the ilium is a mandatory procedure, since it is the only method that confirms or excludes a specific lesion of the bone marrow.Consultation and examination of an ENT doctor help to establish a lesion in the throat, perform a biopsy of the tonsil and differential diagnosis with other lymphomas, in which this localization of the lesion is common.

Diagnostic method – positron emission tomography (radionuclide tomographic method for examining internal organs). This method can be used before treatment to clarify the extent of the lesion and identify subclinical foci. However, positron emission tomography is of greatest importance in Hodgkin’s lymphoma for confirming the completeness of remission and predicting relapse, especially in cases where there are residual tumor masses.

– How many residents of Tyumen were diagnosed with this disease in the past, 2017?

– This diagnosis was made in 32 people. Of these, 13 cases are between the ages of 25 and 39.

– How is Hodgkin’s lymphoma treated in Tyumen?

– According to the standards and treatment protocols developed for this pathology. New innovative drugs are also used. The main method of therapy for patients with Hodgkin’s lymphoma at any prevalence of the process is combined chemoradiation treatment – chemotherapy followed by irradiation of the areas of the initial lesion.

Criteria for adequate treatment: reduction or even disappearance of some symptoms of lymphoma, reduction of lymph nodes in size, tumor cells disappear during the study.

– What are the chances of a complete cure?

– Hodgkin’s disease is considered a “favorable” cancer, the patient has a great chance of getting rid of the disease. The main thing is to identify the disease in time. In the early stages, more than 85 percent of cases are completely cured.After treatment, the disease may return in 15-25 percent of patients, depending on the initial stage of the disease. With a relapse, the prognosis is disappointing. Sometimes Hodgkin’s disease simply does not respond to any form of therapy. However, this is extremely rare.

There are no clear guidelines for the prevention of the disease. It is recommended to protect yourself from infection with viruses and HIV, exposure to carcinogens, and also to treat herpes of various types in time. To do this, you just need vigilance and the passage of an annual medical examination.

As part of the weekly heading “Oncolikbez”, the 72.ru correspondent talks with oncologists, who explain what cancer of different localizations is and how you can fight it.

Earlier, the chief oncologist of the city, Mikhail Naumov, told about the reasons why Tyumen residents most often get cancer and what happens in their bodies during the development of malignant tumors.