Primary Lymphoid organs (2)

- Thymus
- Red Bone marrow

Secondary Lymphoid organs (6)

- Lymph nodes
- Spleen
- Diffuse lymphoid tissue (found in the mucosa of the digestive system)
- Tonsils
- Peyer patches
- Appendix
Thymus

While immature B lymphocytes emerge from the bone marrow, the primary lymphoid organ in
which T cells are produced in the thymus, a bilobed structure in the mediastinum.

The main function of the thymus is induction of central tolerance, which along with regulatory T
cells prevents autoimmunity.

The Thymus is the site of T-lymphocyte differentiation and the selective removal of T cells
reactive against self-antigens, a key part of inducing self-tolerance

T lymphoblasts or thymocytes attach in the thymus to a cytoreticulum composed of thymic

epithelial cells (TECs)

TGE TECs also secrete many cytokines, compartmentalize the thymus into a cortex and a
medulla, and in the cortex surround blood vessels in the blood-thymus barrier.

Bone Marrow
Bone marrow is a soft, gelatinous tissue present in the central cavity of long bones such as the
femur and humerus. Blood cells and immune cells arise from the bone marrow; they develop
from immature stem cells (hemocytoblasts), which follow distinct developmental pathways to
become either erythrocytes, leucocytes, or platelets. Red bone marrow formation of the various
types of blood cells (hematopoiesis). Red in color because of the hemoglobin in red blood cells
(erythrocytes).
Cells destined to be B lymphocytes remain and differentiate further in the bone marrow.

Secondary Lymphoid structures, where most lymphocytes are activated by antigen

presentation, include the MALT, the lymph nodes, and the spleen.

Lymph Nodes
Lymph nodes are bean-shaped, encapsulated structures, generally 10 mm by 2.5 cm in size,
distributed throughout the body along lymphatic vessels. A total of 400-500 lymph nodes are
present in the axillae (armpits) and inguinal (groin), along major vessels of the neck, in the
thorax and abdomen, and in the visceral mesenteries. Each lymph node filters lymph and
provides a site for B-cell activation and differentiation to antibody-secreting plasma cells.

Embedded in loose connective tissue, a lymph node has a convex surface where afferent
lymphatics enter and a concave depression, the hilum where an efferent lymphatic leaves.

The most abundant cells of lymph nodes are lymphocytes of all types, plasma cells, dendritic
cells, macrophages, and other APCs (antigen-presenting cells)

A lymph node has three functional but not physically separate compartments: an outer cortex,
an underlying paracortex, and an inner medulla adjacent to the hilum and efferent lymphatic.
The outer Cortex

A Subcaspsular sinus, inside the capsule, receives lymph from afferent lymphatics. From this
space, cortical sinuses (or trabecular sinuses) branch internally among the lymphoid nodules
along trabeculae. These sinuses are lined by a very thin, discontinuous endothelium penetrated
by reticulum fibers and processes of dendritic cells.

Lymphoid nodules, with or without germinal centers, consist largely of B lymphocytes.

The underlying Paracortex

Does not have precise boundaries but can be distinguished from the outer cortex by its lack of
nodules. It contains lymphoid tissue rich in T cells. Specialized post-capillary venules called
high endothelial venules (HEVs) represent an entry point for most circulating lymphocytes into
lymph nodes.

Endothelial cells of these vessels become enlarged or cuboidal and express specific apical
surface glycoproteins that mediate the tethering cortex of the lymph node. HEVs also occur in
large accumulations of MALT

The inner Medulla

The medulla has medullary cords containing reticular fibers with many plasma cells,
macrophages, and other key leukocytes;

between the cords are lymph-filled medullary sinuses that converge at the efferent lymphatic.
These are dilated spaces lined with discontinuous endothelium that separate the medullary
cords. Contains many macrophages and neutrophils if the lymph node is draining an infected
region.

Spleen
Is a large lymphoid organ without a cortex/medulla structure; instead, it has two intermingled but
functionally different regions: white pulp and red pulp. The spleen is filled with reticular tissue
containing reticular fibers, many lymphocytes, other blood cells, macrophages, and APCs

White pulp: Consists of only 20% of the spleen, is secondary lymphoid tissue associated with
small central arterioles that are also enclosed by PALS of T cells

Red pulp: Filters blood, removes defective erythrocytes, and recycles hemoglobin iron, consists
of splenic cords with macrophages and blood cells of all kinds, and splenic sinusoids

The splenic sinusoids are linked by unusual endothelial cells called stave cells which are
elongated and aligned parallel to the blood flow, with open slits between cells.
Blood flow in red pulp is either a closed circulation, moving from capillaries into the venous
sinusoids, or an open circulation, with capillaries opening directly into the splenic cords.
Blood filtration in the open circulation involves interaction with splenic cord macrophages,
which remove old, swollen RBCs unable to slip between stave cells to reenter the venous blood
flow.

Mucosa-associated lymphoid tissue

Most of the immune cells in MALT are dispersed diffusely in the connective tissue, others are
found in aggregates forming large conspicuous structures such as the tonsils, the Peyer
patches in the ileum, and the appendix. Collectively the MALT is one of the largest lymphoid
organs, containing up to 70% of all the body’s immune cells.

Most of the lymphocytes here are B cells; among T cells, CD4* helper T cells predominate.

Tonsils
Are large, irregular masses of lymphoid tissue in the mucosa of the posterior oral cavity and
nasopharynx where their cells encounter antigens entering the mouth and nose.

Named by their location these masses are the palatine, lingual, and pharyngeal tonsils.

Palatine tonsils
located posteriorly on the soft palate are covered by stratified squamous epithelium. The
surface area of each is enlarged with tonsillar crypts in which the epithelial lining is densely
infiltrated with lymphocytes and other leukocytes. The lymphoid tissue is filled diffusely with
lymphocytes, with many secondary lymphoid nodules around crypts. The tissue is underlain by
dense connective tissue acting as a partial capsule.

Lingual tonsils
Are situated along the base of the tongue, are also covered by stratified squamous epithelium
with crypts, and have many of the same features as palatine tonsils but lack distinct capsules.

Pharyngeal tonsils
are situated in the posterior wall of the nasopharynx is covered by pseudostratified ciliated
columnar epithelium and has a thin underlying tissue and lymphoid nodules are invaginated with
shallow infoldings but without crypts.

Peyer Patches
Peyer's patches are a group of well-organized lymphoid follicles located in the lamina
propria and submucosa of the distal portion of the small intestine - the ileum and
jejunum and sometimes in the duodenum. Almost 50% of these patches are in the distal
ileum. It contains dozens of nodules with no underlying connective tissue capsule. The simple
columnar epithelium that covers the lymphoid nodules of Peyer patches includes scattered,
large epithelial M cells with apical folds.
M cells are unique epithelial cell types specialized for the uptake of particles and intact
organisms. The M cell has a large “pocket” open to the underlying lymphoid tissue through a
sieve-like basement membrane and containing a transient population of lymphocytes and
dendritic cells.

Appendix
Use a short, small-diameter projection from the cecum. Typically, the mucose of the appendix is
almost completely filled with lymphoid tissue, effacing the highlands otherwise found in the large
intestine wall. The lumen contains the normal bacterial flora of the large intestine and may serve
to retain some of these beneficial bacteria there during diarrheal illnesses.

MICROSCOPIC STRUCTURES OF LYMPHOID ORGANS

SPLEEN
APPENDIX