HATAHET ANATOMY

Lymphatic Tissue III

Lecture: Anatomy 3
Pages: 5
 Anatomy 3: Lymphatic Tissue III

❖ The lymphatic system as we know consists of: Organs, Tissues, Cells, Lymph. In this lecture we will discuss the lymphatic organs only
❖ Organs have a delicate capsule, but a tissue does not

“The difference between a lymphatic organ and a lymphatic tissue is the presence of a capsule that divides it into lobes”

Organs of the Lymphatic system

Tonsils
➢ Tonsils are the first line of defence in the respiratory and digestive tracts
➢ they belong to the MALT (Mucosa-Associated Lymphatic Tissue)
➢ but since they have a partial capsule, they are considered Lymphatic organs
➢ we have 4 different tonsils that are arranged in a ring called (Waldeyer’s ring)

 Palatine tonsils  Pharyngeal tonsil  Lingual tonsils  Tubal tonsils

Palatine Tonsils

• pair of tonsils found in the oropharynx, between the palatoglossal fold and palatopharyngeal fold
• Capsule: a dense CT capsule partially separates the tonsil from surrounding structures
• Epithelium: covered from one side by stratified squamous epithelium
• histology of palatine tonsils:
Low magnification High magnification
 Crypts

- 10-20 deep grooves on each tonsil

- located at the epithelium side, not the capsule side
- they increase surface area and are infiltrated with lymphocytes

 Lymphatic nodules

- follicles filled with lymphocytes

- located at the edges and all around the crypts
(C): Capsule (1°Ln): Primary nodule
- there are 2 types of lymphatic nodules:
(E): Epithelium (2°Ln): Secondary nodule
 Primary nodules  inactive, dark, and lack germinal centers (Ln): Lymphatic nodule
(Cr): Crypt
 Secondary nodules  active, light, and have germinal centers

• Clinical note: if the palatine tonsils are inflamed and swallowed with
a formation of pus more than 3 times a-year, they must be removed

Low magnification High magnification

Pharyngeal Tonsil (Adenoid Tonsil)

• a single tonsil located in the posterosuperior wall of the nasopharynx

• Capsule: very thin dense CT capsule
• Epithelium: pseudostratified ciliated columnar epithelium
• histology of pharyngeal tonsil:

 No crypts whatsoever
 thin sheet of lymphatic nodules and diffuse lymphocytes

• Clinical note: when enlarged, it is referred to as the (Adenitis),

which can obstruct airflow, especially in children. In adults, the notice the pseudostratified ciliated columnar epithelium
pharyngeal tonsil is often atrophied

***Note: Another name for the pseudostratified ciliated columnar epithelium is the Respiratory epithelium
Lingual Tonsils

• multiple small tonsils located at the base of the tongue

• Epithelium: covered by stratified squamous epithelium
• Capsule: lingual tonsils lack a capsule; because they’re composed
of diffuse lymphoid tissue that blends into surrounding tongue
rather than being enclosed in a distinct fibrous covering
• histology of lingual tonsils:

 Crypts

- each lingual tonsil has one single crypt

 Diffuse lymphoid nodules (DLn): Diffuse lymphoid nodules

(Cr): Crypt
- similar to the palatine tonsils but without a distinct capsule
notice that there are 3 visible crypts, so 3 lingual tonsils

Tubal tonsils
Dr. Ziad said there will be a question in the mid
• located at the posterior side of the nasopharynx exam about the types of epithelium of each tonsil
• they are close to Eustachian tube; hence the name “Tubal”

Lymph nodes

➢ Lymph nodes are small, bean-shaped structures found along lymphatic vessels throughout the body
➢ they act as filters, trapping microorganisms and cancer cells from the lymph while providing an environment for immune responses
➢ before lymph enters the bloodstream, it is filtered and enriched with antibodies by at least one lymph node
➢ histology of lymph nodes:

• each lymph node is enclosed in a CT capsule made of collage type-1

• the lymph nodes have:

 Convex surface

- it is where the afferent lymphatic vessels enter the node

 Concave surface

- the hilum of the lymph node is located in this surface

- it is where the efferent lymphatic vessel, blood vessels, nerves exit

• the lymph node has 3 main regions:

 Cortex (Outer layer), contains the following:

A. Subcapsular sinuses

- spaces beneath the lymph node capsule that allow lymph to flow
- contain lots of macrophages
- it is where the lymphatic vessels drain lymph before it enters medulla
- subcapsular sinuses have extensions that radiate deep into the
cortex called Trabecular sinuses

B. Primary lymphatic nodules

- follicles that house B-cells

- in immune response, B-cells will active by what is called (Antigen challenge)
becoming plasma cells, and the primary nodules will transform into the
Secondary nodules with lightly-stained Germinal centers
(C): Capsule
C. Trabeculae (Cx): Cortex
(P): Paracortex
- connective tissue extensions from the capsule (S): Subcapsular sinus
- they run through the trabecular sinuses of the subcapsular space (T): Trabecula
(F): Follicle, another name for lymphoid nodules
- trabeculae guide blood vessels into the lymph node (M): Medulla
(Ms): Medullary sinus
(Mc): Medullary cord
  Paracortex (Juxtamedullary zone)

 the intermediate region between cortex and medulla

 lacks any lymphatic nodules but is rich in T-cells

 Medulla (Inner region), contains the following:

A. Medullary sinuses

- the light-stained area of the medulla

- they contain the lymph coming from afferent lymph vessels
- contain the following cells:

 Dendritic cells, antigen-presenting cell

 Macrophages, antigen-presenting cells (1): Macrophage, notice the kidney-shaped nucleus
 Plasma cells, clears lymph from pathogens and cellular debris (2): Dendritic cells, notice the extensions
(3): Medullary cord
B. Medullary cords

- the dark-stained area embedded in the medullary sinuses

- they contain a special type of cells called Reticular cells which produce a meshwork (‫ )شبكة‬of reticulin fibers of collagen type-III
that maintains the shape of the lymph node

Thymus gland

➢ Thymus gland is bilobed, thyme leaf-shaped gland located in the thorax

➢ situated between the aorta and the sternum in the superior mediastinum
➢ unlike the lymph nodes, the thymus regions are separated by epithelial barriers
➢ divided into small lobules by inward extension of the capsule called (Trabeculae)
➢ Embryology: thymus gland is developed from the R&L ventral endoderm of the 3rd pharyngeal pouch
➢ thymus lobules are incomplete; this means that the medulla of each lobule is not fully surrounded by the cortex

➢ histology of thymus gland, each lobule consists of two main regions:

 Cortex (Outer, dark-stained)

• contains immature (naïve) T-cells

• it is the site of Positive selection, assisted by dendritic and macrophages

 Medulla (Inner, light-stained)

• contains mature T-cells

• it is the site of Negative selection to eliminate self-reactive T-cells

➢ T-cell maturation in the thymus

• T-cells develop from hematopoietic stem cells in the bone marrow and
migrate to the thymus for maturation. This process involves positive selection and negative selection to ensure functional, T-cells
• the process is done as follows:
 ❖ Positive Selection (in the Cortex)

 for the T-cell to be mature, it must be able to recognize MHC molecules to be able to fight infections
 T-cells must recognize and weakly bind to self-MHC molecules to survive
 those that fail to bind undergo apoptosis; because they will have their CDs damaged and will not respond to future infections

 Purpose of Positive selection  test if the T-cells have healthy and functional CDs that can bind to MHC

❖ Negative Selection (in the Medulla)

 T-cells who survive the positive selection will enter the medulla
 a dendritic cells called Hassal’s corpuscles will present all the self-antigens, including a piece of every single cell in human body
 T-cells that bind too strongly to self-antigens are eliminated to prevent autoimmunity; they will attack healthy cells if left alive
 only 2–5% of T-cells survive both selections and become functional and ready to migrate to the bloodstream

 Purpose of Negative selection  eliminate T-cells that can recognize, bind, and damage the healthy body cells

During the T-cells maturation, there will be 6 types

of epithelial cells acting, these cells are:

➢ Epithelial cells type-I

 forms the Thymus-Blood Barrier (TBB) which is located in

the cortex and protects the thymus glands from pathogens

➢ Epithelial cells type-II

 present inside the cortex & involved in Positive selection

➢ Epithelial cells type-III & type-IV

 form a boundary between the cortex and medulla

➢ Epithelial cells type-V

 provides structural support for medullary T-cells

➢ Epithelial cells type-VI

 forms Hassall’s corpuscles in the medulla

“The Patient Bob Seems Healthy”

‫ن‬
‫عاليمي بس عشان تشوفوا أماكن الست خاليا بس ال أكث‬ ‫الل‬
‫و الصورة ي‬

***Note: With age, the thymus undergoes atrophy

➢ Clinical Note: DiGeorge Syndrome is the hypoplasia or aplasia

of the thymus gland, resulting in dysfunctional and immature
(naïve) T-cells

Spleen

➢ Spleen is the largest lymphoid organ

➢ located at the left hypochondriac region, between stomach & diaphragm
➢ functions as a blood filter and plays a role in immunity
➢ Its medial (visceral) surface has 3 impressions (depressions):

 Gastric (anterior)  Stomach

 Colic (inferior)  Left colic flexure
 Renal (medial)  Left kidney
➢ histology of the spleen

 Capsule

• a dense CT capsule surrounding the entire spleen except the hilum

 Trabeculae

• extensions of the splenic capsule into the parenchyma

• they penetrate the organ, providing structural support and carrying blood vessels,
lymphatics, and nerves into the splenic pulp
(C): Capsule
 Splenic pulps (T): Trabecula
(W): White pulp
• the spleen consists of reticular cells, lymphocytes, and lots of macrophages (R): Red pulp
• it has 2 main components:

A. Red Pulp (80% of the spleen)

 Structure:

 Splenic Sinusoids

- lined by specialized endothelial cells, allowing passage of healthy blood cells

while trapping old or damaged RBCs

 Splenic Cords (Cords of Billroth)

- contains all the leukocytes and involved in blood cells removal

 Function:

 Destruction of old erythrocytes, sinusoids trap old RBCs, cords eliminate them
 Storage of platelets (33% of body’s total)
 Fetal hemopoiesis

B. White Pulp (20% of the spleen) (C): Cord

(S): Sinusoid
 Structure: (Arrow): Specialized endothelial cells

 Peri-arterial lymphatic sheath (PALS) notice how the nuclei of the endothelial
cells are bulging toward the sinusoids
- located around the central arterioles
- rich in T-cells

 Lymphoid nodules

- rich in B-cells

 Marginal zone

- the margin between white pulp and red pulp

- rich in macrophages

 Penicillar arteries

- small arterial branches that distribute blood to the red pulp (Ca): Central arteriole
(PALS): Peri-arterial lymphatic sheath
 Function: (Ln): Lymphoid nodule
(Mz): Marginal zone
 Immunity, both cell-mediated immunity (T-cells) and humoral immunity (B-cells) (Gc): Germinal center

Closed circulation Vs. Open circulation

ًّ‫ًّما‬،‫اًّبسًّهاضًّالمطلوب‬
ًّ ًّ‫حرفي‬
‫قكم‬
ًّ ‫ورةًّتعج‬
ًّ ‫فيًّداعيًّأليًّص‬
In the spleen there are 2 internal blood circulation, each one with its own function:

❖ Closed circulation  Blood flows directly from arteries to veins, staying inside blood vessels & delivering blood to splenic sinusoids
❖ Open circulation  Blood leaves vessels, enters the splenic cords for old RBC elimination, then re-enters veins