Lymphatic system

Introduction:
The lymphatic system in vertebrates is a network of conduits that carry a clear fluid called lymph. It also includes the lymphoid tissue through which the lymph travels. Lymphoid tissue is found in many organs, particularly the lymph nodes, and in the lymphoid follicles associated with the digestive system such as the tonsils. The system also includes all the structures dedicated to the circulation and production of lymphocytes, which includes the spleen, thymus, bone marrow and the lymphoid tissue associated with the digestive system. The lymphatic system as we know it today was first described independently by Olaus Rudbeck and Thomas Bartholin.

The blood does not directly come in contact with the parenchymal cells and tissues in the body, but constituents of the blood first exit the microvascular exchange blood vessels to become interstitial fluid, which comes into contact with the parenchymal cells of the body. Lymph is the fluid that is formed when interstitial fluid enters the initial lymphatic vessels of the lymphatic system. The lymph is then moved along the lymphatic vessel network by either intrinsic contractions of the lymphatic vessels or by extrinsic compression of the lymphatic vessels via external tissue forces (e.g. the contractions of skeletal muscles.

The lymphatic system has three interrelated functions. It is responsible for the removal of interstitial fluid from tissues. It absorbs and transports fatty acids and fats as chyle to the circulatory system. The last function of the lymphatic system is the transport of immune cells to and from the lymph nodes. The lymph transports antigen presenting cells (APCs), such as dendritic cells, to the lymph nodes where an immune response is stimulated. The lymph also carries lymphocytes from the efferent lymphatics exiting the lymph nodes.

The study of lymphatic drainage of various organs is important in diagnosis, prognosis, and treatment of cancer. The lymphatic system, because of its physical proximity to many tissues of the body, is responsible for carrying cancerous cells between the various parts of the body in a process called metastasis. The intervening lymph nodes can trap the cancer cells. If they are not successful in destroying the cancer cells the nodes may become sites of secondary tumors.
Diseases and other problems of the lymphatic system can cause swelling and other symptoms. Problems with the system can impair the body's ability to fight infections

Main functions:


1- to collect and return interstitial fluid, including plasma protein to the blood,
and thus help maintain fluid balance,


2- to defend the body against disease by producing lymphocytes,


3- to absorb lipids from the intestine and transport them to the blood.


Diseases of the lymphatic system

Lymphedema is the swelling caused by the accumulation of lymph fluid, which may occur if the lymphatic system is damaged or has malformations. It usually affects the limbs, though face, neck and abdomen may also be affected. An estimated 170 million people develop lymphedema, which progresses in three stages:
Stage 1: Pressing the swollen limb leaves a pit that takes a while to fill back in. Because there is little fibrosis (hardening) it is often reversible. Elevation reduces swelling.
Stage 2: Pressure does not leave a pit. Elevation does not help. If left untreated, the limb becomes fibrotic.
Stage 3: This stage of lymphedema is often called elephantiasis. It is generally only in the legs after lymphedema that has gone long untreated. While treatment can help a little, it is not reversible.

Some common causes of swollen lymph nodes include infections, infectious mononucleosis, and cancer, e.g. Hodgkin's and non-Hodgkin's lymphoma, and metastasis of cancerous cells via the lymphatic system. In elephantiasis, infection of the lymphatic vessels cause a thickening of the skin and enlargement of underlying tissues, especially in the legs and genitals. It is most commonly caused by a parasitic disease known as lymphatic filariasis. Lymphangiosarcoma is a malignant soft tissue tumor (soft tissue sarcoma), whereas lymphangioma is a benign tumor occurring frequently in association with Turner syndrome. Lymphangioleiomyomatosis is a benign tumor of the smooth muscles of the lymphatics that occurs in the lungs