NORMAL HISTOLOGY

PRESENTATION
ON
LYMPH NODE

Prepared by: Dr. Rajesh

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 INTRODUCTION
Lymph node is one of secondary lymphoid organ of immune system

They are distributed through out the body along the path of lymphatic vessels.

Immune system is anatomically and functionally highly complex and dynamic

Specific areas in the lymph nodes can show increased or decreased cellularity.

Hemosiderin pigment is normally seen in lymph node but its function is not known

Changes in cellularity of Paracortex suggest a T cell effect, whereas changes in the

follicles, germinal centres and plasma cells suggest a B-cell effect

Evaluation of every compartment becomes important for the pathologist to be

checked for presence of abnormal findings.

All changes observed for a given lymphoid organ should be interpreted in the context
of the complex interaction of different lymphoid organs, as well as hematologic and
clinical chemistry data.

During lymph node evaluation for presence of any abnormal changes in lymph node,
data available on gross and clinical pathology changes also add a value to make
accurate judgements.

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 Function:

Lymph nodes are important components of the defence mechanism

Their major functions are lymph filtration and phagocytosis of bacteria, or foreign
substances from the lymph, thereby preventing them from reaching the general
circulation.

They participate in localizing and preventing the spread of infection into the general
circulation and other organs.

Lymph nodes produce, store and recirculate B cells and T cells.

Lymph node is a place where lymphocytes can proliferate and the B cells can
transform into plasma cells.

Plasma cells produce antibodies, so the lymph that leaves the lymph nodes may
contain increased amount of antibodies that can then be distributed through out the
body.

Lymph nodes are also the site of antigenic recognition and antigenic activation of B
cells, which give rise to plasma cells and memory B cells.

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 Lymph node Panoramic view

101 @ 1x 102 @ 1x 103 @ 1x

104 @ 1x

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 Major components of lymph node are.,
1. Capsule & subcapsular sinus
2. Cortex & Paracortex
3. Medulla (Medullary chords
& Medullary sinus)

CT= Connective tissue capsule; C= Cortex; M= Medulla; P= Paracortex;

MS = Medullary chords; MS = Medullary sinus
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 Capsule & Subcapsular Sinus

Capsule is the portion which covers the lymph node.

Capsule is made of loose connective tissue and reticular fibres.
Capsule will show presence of blood vessels and surrounding adipose tissue

Subcapsular sinus is the region present just beneath the capsule.

Subcapsular sinus overlies the dark staining lymph node cortex.
Subcapsular sinus will shows presence of pink colour lymph, reticular cells and also darkly
stained small lymphocytes.
Numerous macrophages are also seen in the subcapsular sinus.
Endothelial cells line the sinuses and form an incomplete cover over the surface of the
lymphatic nodules of cortex.

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 Capsule & Subcapsular Sinus

Subcapsular sinus

Capsule

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 Cortex and Paracortex
Outer region of lymph node is the cortex.
Cortex is composed of numerous lymphatic nodules.
Many lymphatic nodules also shows presence of lighter staining germinal centre.
Germinal centre is characterized by
Presence of medium sized lymphocytes (mostly B lymphocytes)
Cells are larger, shows lighter nuclei and more cytoplasm as compared to
small lymphocytes.
Mitotic figure visible in the germinal centre.
The peripheral zone of lymphatic nodule stains dense due to presence of small
lymphocytes. Characterised by dark staining nuclei, condensed chromatin, and little
or no cytoplasm.

Deeper region in the cortex is called as Paracortex .

Paracortex is mostly occupied by T lymphocytes.
Paracortex region of lymph node contains post capillary venules.
This venule have unusual morphology, to facilitate migration of lymphocytes from
the blood into the lymph.
Venule is lined by tall cuboidal endothelium, instead of squamous endothelium.

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 Cortex and Paracortex

Cortex & Paracortex

Lymph node
medulla

@ 5x

Lymphocyte nodule
With germinal centre @ 40x

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 Medulla of lymph node
Inner region of lymph node is the medulla.
It stains lighter than outer dark staining cortex.
The cell types in medullary chords and sinuses are dependent on the
imnmunoactive state of lymph node.
Medulla is composed of medullary chords and medullary sinus
Medullary chords :
Chords composed of lymphoid cells supported in a reticulum stroma
Chords extend from hilus of lymph node towards the paracortex
Lymphoid cells present in chords are mostly B lymphocytes.

Medullary sinus:
Medullary sinuses composed of lymph (looks pink colour fluid in H&E stain),
macrophages, plasma cells and reticular cells.
Macrophages are cells bigger in size with eosinophilic cytoplasm
Macrophages are normally seen in medullary sinuses of mesenteric lymph
node. Whereas it is very few or absent in cervical and mandibular lymph node
Plasma cells are cells bigger than lymphocyte and nucleus is seen at periphery.
In hyperplastic lymph node, the concentration of plasma cells will increase
within the medullary sinuses
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 Medullary chords and sinuses
Medullary chords

@ 10x
@ 40x
Image showing medulla chords and medullary sinus @ low power
Image @ high magnification with labels
Medullary sinuses

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 THANK YOU

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