This gland is shaped like a red bean

Lymph fluid will flow and be filtered in spaces in the gland called the cortex. Each gland is also protected
by an outer layer called a capsule

Lymph Node Structure:

Capsule
The capsule of the lymph node is dense connective tissue stroma and collagenous fibers. The capsule
sends trabeculae inside the lymph node, which pass inward, radiating towards the center.
Subscapular Sinus
The subcapsular sinus is the space between the capsule and the cortex, which allows the transportation
of the lymphatic fluid.; this is also called the lymph path, the lymph sinus, or the marginal sinus. The
subcapsular sinus is present beneath the capsule and is traversed by both reticular fibers and cells. It
receives the afferent vessels, continues with the trabecular sinuses, and joins the medullary sinus in the
medulla of the lymph node.
Cortex
The cortex of the lymph node is the layer beneath the subcapsular sinus. The cortex is formed of the
outer cortex and the inner part known as the paracortex. The outer cortex layer is also named the B-cell
layer, is rich in CXCR5 chemokines, and consists mainly of B-cells arranged into follicles. The immature B-
cells develop into a germinal center when challenged with an antigen. Following this, resting B-cell and
dendritic cells surround the germinal center to form a mantle zone. The paracortex layer, also called the
T-cell layer, consists of T-cells that interact with the dendritic cells and is rich in CCR7 chemokines
Medulla
The medulla is the innermost layer of the lymph node and contains large blood vessels, sinuses, and
medullary cords. The medullary cords contain antibody-secreting plasma cells, B-cells, and macrophages.
The medullary sinuses (or sinusoids) are vessel-like spaces that separate the medullary cords. The
medullary sinuses receive lymph from the trabecular sinuses and cortical sinuses and contain reticular
cells and histocytes. The medullary sinus drains the lymph into the efferent lymphatic vessels.
Function of Lymph Node
The primary function of lymph nodes is filtering interstitial fluid collected from soft tissues and
eventually returning it to the vascular system. Filtering this exudative fluid allows for exposure of T-cells
and B-cells to a wide range of antigens. For antigen-specific B and T cells to activate, they must first
suffer exposure to antigens with the aid of antigen-presenting cells, dendritic cells, and follicular
dendritic cells. These form part of both the innate immune response and play a role in adaptive
immunity.

Lymphadenopathy refers to the swelling of lymph nodes which can be secondary to bacterial, viral, or
fungal infections, autoimmune disease, and malignancy.
Etiology
 There are several potential causes of lymphadenopathy, ranging from infectious, autoimmune,
malignant, and lymphoproliferative.
 Lymphadenopathy can be localized or diffuse. About 75% of most lymphadenopathies are
localized, and about 50% of those occur in the head and neck regions. Generalized
lymphadenopathy, which involves two or more non-contiguous regions, is reported to occur in
25% of lymphadenopathies
Epidemiologi
 A majority of patients with lymphadenopathy will have a benign etiology. Age is an important
factor in characterizing the epidemiology of lymphadenopathy, and thus, can be divided into
children and adults.
 Children more commonly appear to have benign causes of lymphadenopathy.
 Adults also appear to have a low prevalence of malignancy.
physical examination.
When palpating lymphadenopathy, one must keep in mind location, size, firmness, and pain.
 Location:
o Anterior cervical lymph nodes are superior and inferior to the sternocleidomastoid
muscle. Posterior cervical lymph nodes are posterior to the sternocleidomastoid
muscle.
o One should also inspect for supraclavicular, axillary, and inguinal
lymphadenopathy bilaterally.
o Local lymphadenopathy suggests a more localized disease as compared to
widespread lymphadenopathy.[1]
 Size:
o Cervical lymph nodes and axillary nodes are atypical if > 1 cm, as compared to
supraclavicular > 0.5 cm, and inguinal nodes >1.5 cm.
 Firmness:
o Generally, if a lymph node is readily mobile, it is less concerning for a malignant
condition.
 Pain:
o Pain can be a sign of inflammation, an acute reaction to an infection, and is less
o concerning for a malignant process.
The staging of non-Hodgkin and Hodgkin lymphoma is based on the Lugano classification,
which is based on the Ann Arbor system.[17]
 Stage I: Lymphoma found in 1 lymph node or in only one lymphoid organ
 Stage II: Lymphoma is found in 2 or more groups of lymph nodes on the ipsilateral side
of the diaphragm
 Stage II: Lymphoma involvement bilaterally in reference to the diaphragm
 Stage IV: Lymphoma has metastasized to one organ beyond the lymphatic system