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Lymphatic system

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</style><div role="note" class="hatnote navigation-not-searchable">"Lymphatic drainage" redirects here. For the massage technique, see <a href="Manual_lymphatic_drainage" title="Manual lymphatic drainage">Manual lymphatic drainage</a>.</div>

<div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="Limbic_system" title="Limbic system">Limbic system</a>.</div>

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</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color:dimgray; color: white">Lymphatic system</th></tr><tr><td colspan="2" class="infobox-image"><div class="infobox-caption">Human lymphatic system</div></td></tr><tr><th colspan="2" class="infobox-header" style="background-color: #efefef">Details</th></tr><tr><th colspan="2" class="infobox-header" style="background-color: #efefef">Identifiers</th></tr><tr><th scope="row" class="infobox-label" style="padding-right:0.25em"><a href="Latin" title="Latin">Latin</a></th><td class="infobox-data">systema lymphoideum</td></tr><tr><th scope="row" class="infobox-label" style="padding-right:0.25em"><a href="Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D008208">D008208</a></td></tr><tr><th scope="row" class="infobox-label" style="padding-right:0.25em"><a href="Terminologia_Anatomica" title="Terminologia Anatomica">TA98</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://ifaa.unifr.ch/Public/EntryPage/TA98%20Tree/Entity%20TA98%20EN/13.0.00.000%20Entity%20TA98%20EN.htm">A13.0.00.000</a></td></tr><tr><th scope="row" class="infobox-label" style="padding-right:0.25em"><a href="Terminologia_Anatomica" title="Terminologia Anatomica">TA2</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://ta2viewer.openanatomy.org/?id=5149">5149</a></td></tr><tr><th scope="row" class="infobox-label" style="padding-right:0.25em"><a href="Foundational_Model_of_Anatomy" title="Foundational Model of Anatomy">FMA</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://bioportal.bioontology.org/ontologies/FMA/?p=classes&conceptid=http%3A%2F%2Fpurl.org%2Fsig%2Font%2Ffma%2Ffma74594,">7162 74594, 7162</a></td></tr><tr><td colspan="2" class="infobox-below"><a href="Anatomical_terminology" title="Anatomical terminology">Anatomical terminology</a><div style="text-align: right;"></div></td></tr></tbody></table>

The lymphatic system, or lymphoid system, is an <a href="Organ_system" title="Organ system">organ system</a> in <a href="Vertebrate" title="Vertebrate">vertebrates</a> that is part of the <a href="Immune_system" title="Immune system">immune system</a> and complementary to the <a href="Circulatory_system" title="Circulatory system">circulatory system</a>. It consists of a large network of <a href="Lymphatic_vessel" title="Lymphatic vessel">lymphatic vessels</a>, <a href="Lymph_node" title="Lymph node">lymph nodes</a>, lymphoid organs, lymphatic tissue and <a href="Lymph" title="Lymph">lymph</a>.<a href="#cite_note-Gray's2016-1">[1]</a><a href="#cite_note-Moore-2">[2]</a> Lymph is a clear fluid carried by the lymphatic vessels back to the heart for re-circulation. The Latin word for lymph, lympha, refers to the deity of fresh water, "<a href="Lympha" title="Lympha">Lympha</a>".<a href="#cite_note-3">[3]</a>

Unlike the circulatory system that is a <a href="Closed_system" title="Closed system">closed system</a>, the lymphatic system is open.<a href="#cite_note-4">[4]</a><a href="#cite_note-5">[5]</a> The human circulatory system processes an average of 20 litres of <a href="Blood" title="Blood">blood</a> per day through <a href="Starling_equation" title="Starling equation">capillary filtration</a>, which removes <a href="Blood_plasma" title="Blood plasma">plasma</a> from the <a href="Blood" title="Blood">blood</a>. Roughly 17 litres of the filtered blood is reabsorbed directly into the <a href="Blood_vessel" title="Blood vessel">blood vessels</a>, while the remaining three litres are left in the <a href="Interstitial_fluid" class="mw-redirect" title="Interstitial fluid">interstitial fluid</a>. One of the main functions of the lymphatic system is to provide an accessory return route to the blood for the surplus three litres.<a href="#cite_note-6">[6]</a>

The other main function is that of immune defense. Lymph is very similar to blood plasma, in that it contains waste products and <a href="https://en.wiktionary.org/wiki/cellular_debris" class="extiw external" title="wikt:cellular debris">cellular debris</a>, together with <a href="Bacteria" title="Bacteria">bacteria</a> and <a href="Protein" title="Protein">proteins</a>. The cells of the lymph are mostly <a href="Lymphocyte" title="Lymphocyte">lymphocytes</a>. Associated lymphoid organs are composed of lymphoid tissue, and are the sites either of lymphocyte production or of lymphocyte activation. These include the <a href="Lymph_node" title="Lymph node">lymph nodes</a> (where the highest lymphocyte concentration is found), the <a href="Spleen" title="Spleen">spleen</a>, the <a href="Thymus" title="Thymus">thymus</a>, and the <a href="Tonsil" title="Tonsil">tonsils</a>. Lymphocytes are initially generated in the <a href="Bone_marrow" title="Bone marrow">bone marrow</a>. The lymphoid organs also contain other types of cells such as <a href="Stromal_cell" title="Stromal cell">stromal cells</a> for support.<a href="#cite_note-Mak(Ph.D.)2008-7">[7]</a> Lymphoid tissue is also associated with <a href="Mucosa" class="mw-redirect" title="Mucosa">mucosas</a> such as <a href="Mucosa-associated_lymphoid_tissue" title="Mucosa-associated lymphoid tissue">mucosa-associated lymphoid tissue</a> (MALT).<a href="#cite_note-grays-8">[8]</a>

Fluid from circulating blood leaks into the tissues of the body by capillary action, carrying nutrients to the cells. The fluid bathes the tissues as interstitial fluid, collecting waste products, bacteria, and damaged cells, and then drains as lymph into the lymphatic capillaries and lymphatic vessels. These vessels carry the lymph throughout the body, passing through numerous lymph nodes which filter out unwanted materials such as bacteria and damaged cells. Lymph then passes into much larger lymph vessels known as <a href="Lymph_duct" title="Lymph duct">lymph ducts</a>. The <a href="Right_lymphatic_duct" title="Right lymphatic duct">right lymphatic duct</a> drains the right side of the region and the much larger left lymphatic duct, known as the <a href="Thoracic_duct" title="Thoracic duct">thoracic duct</a>, drains the left side of the body. The ducts empty into the <a href="Subclavian_vein" title="Subclavian vein">subclavian veins</a> to return to the blood circulation. Lymph is moved through the system by muscle contractions.<a href="#cite_note-Peyrot-9">[9]</a> In some vertebrates, a <a href="Lymph_heart" title="Lymph heart">lymph heart</a> is present that pumps the lymph to the veins.<a href="#cite_note-Peyrot-9">[9]</a><a href="#cite_note-Jeltsch-10">[10]</a>

The lymphatic system was first described in the 17th century independently by <a href="Olaus_Rudbeck" title="Olaus Rudbeck">Olaus Rudbeck</a> and <a href="Thomas_Bartholin" title="Thomas Bartholin">Thomas Bartholin</a>.<a href="#cite_note-Eriksson-11">[11]</a>

<div class="mw-heading mw-heading2"><h2 id="Structure">Structure</h2></div>

The lymphatic system consists of a conducting network of lymphatic vessels, lymphoid organs, lymphoid tissues, and the circulating <a href="Lymph" title="Lymph">lymph</a>.<a href="#cite_note-Gray's2016-1">[1]</a>

<div class="mw-heading mw-heading3"><h3 id="Primary_lymphoid_organs">Primary lymphoid organs</h3></div>

The primary (or central) lymphoid organs, including the thymus, bone marrow, <a href="Fetal_liver" class="mw-redirect" title="Fetal liver">fetal liver</a> and <a href="Yolk_sac" title="Yolk sac">yolk sac</a>, are responsible for generating <a href="Lymphocyte" title="Lymphocyte">lymphocytes</a> from immature <a href="Progenitor_cell" title="Progenitor cell">progenitor cells</a> in the absence of antigens.<a href="#cite_note-12">[12]</a> The <a href="Thymus" title="Thymus">thymus</a> and the <a href="Bone_marrow" title="Bone marrow">bone marrow</a> constitute the primary lymphoid organs involved in the production and early <a href="Clonal_selection" title="Clonal selection">clonal selection</a> of lymphocyte tissues.

<a href="Bird" title="Bird">Bird</a> species' primary lymphoid organs include the bone marrow, thymus, <a href="Bursa_of_Fabricius" title="Bursa of Fabricius">bursa of Fabricius</a>, and yolk sac.<a href="#cite_note-13">[13]</a>

<div class="mw-heading mw-heading4"><h4 id="Bone_marrow">Bone marrow</h4></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Bone_marrow" title="Bone marrow">Bone marrow</a></div>

Bone marrow is responsible for both the creation of <a href="T_cell" title="T cell">T cell</a> precursors and the production and maturation of <a href="B_cell" title="B cell">B cells</a>, which are important cell types of the immune system. From the bone marrow, B cells immediately join the circulatory system and travel to secondary lymphoid organs in search of pathogens. T cells, on the other hand, travel from the bone marrow to the thymus, where they develop further and mature. Mature T cells then join B cells in search of pathogens. The other 95% of T cells begin a process of <a href="Apoptosis" title="Apoptosis">apoptosis</a>, a form of <a href="Programmed_cell_death" title="Programmed cell death">programmed cell death</a>: T cells that cannot interact strongly enough with self-antigens are eliminated during <a href="T_cell#Positive_selection" title="T cell">T cell § Positive selection</a>, and T cells that attack the body's own proteins are eliminated during <a href="T_cell#Negative_selection" title="T cell">T cell § Negative selection</a>.

<div class="mw-heading mw-heading4"><h4 id="Thymus">Thymus</h4></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Thymus" title="Thymus">Thymus</a></div>

The thymus increases in size from birth in response to postnatal antigen stimulation. It is most active during the neonatal and pre-adolescent periods. The thymus is located between the inferior neck and the superior thorax. At puberty, by the early teens, the thymus begins to atrophy and regress, with adipose tissue mostly replacing the thymic stroma. However, residual T cell lymphopoiesis continues throughout adulthood, providing some immune response. The thymus is where the T lymphocytes mature and become immunocompetent. The loss or lack of the thymus results in severe immunodeficiency and subsequent high susceptibility to infection. In most species, the thymus consists of lobules divided by septa, which are made up of epithelium, which is often considered an epithelial organ. T cells mature from thymocytes, proliferate, and undergo a selection process in the thymic cortex before entering the medulla to interact with epithelial cells.

Research on <a href="Bony_fish" class="mw-redirect" title="Bony fish">bony fish</a> showed a buildup of T cells in the thymus and spleen of lymphoid tissues in <a href="Salmon" title="Salmon">salmon</a> and showed that there are not many T cells in non-lymphoid tissues.<a href="#cite_note-Koppang-14">[14]</a>

The thymus provides an inductive environment for developing T cells from hematopoietic progenitor cells. In addition, thymic stromal cells allow for the selection of a functional and self-tolerant T cell repertoire. Therefore, one of the most important roles of the thymus is the induction of central tolerance. However, the thymus is not where the infection is fought, as the T cells have yet to become immunocompetent.

<div class="mw-heading mw-heading3"><h3 id="Secondary_lymphoid_organs">Secondary lymphoid organs</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Further information: <a href="Clonal_selection" title="Clonal selection">Clonal selection</a></div>

The secondary (or peripheral) lymphoid organs, which include <a href="Lymph_node" title="Lymph node">lymph nodes</a> and the <a href="Spleen" title="Spleen">spleen</a>, maintain mature naive lymphocytes and initiate an <a href="Adaptive_immune_system" title="Adaptive immune system">adaptive immune response</a>.<a href="#cite_note-15">[15]</a> The secondary lymphoid organs are the sites of lymphocyte activation by <a href="Antigen" title="Antigen">antigens</a>.<a href="#cite_note-16">[16]</a> Activation leads to <a href="Clonal_selection" title="Clonal selection">clonal selection</a> and <a href="Affinity_maturation" title="Affinity maturation">affinity maturation</a>. Mature lymphocytes recirculate between the blood and the secondary lymphoid organs until they encounter their specific antigen.

<div class="mw-heading mw-heading4"><h4 id="Spleen">Spleen</h4></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Spleen" title="Spleen">Spleen</a></div>

The main functions of the spleen are:

<ol><li>to produce <a href="Immune_cell" class="mw-redirect" title="Immune cell">immune cells</a> to fight <a href="Antigen" title="Antigen">antigens</a>,</li>

<li>to remove <a href="Particulate_matter" title="Particulate matter">particulate matter</a> and aged blood cells, mainly <a href="Red_blood_cell" title="Red blood cell">red blood cells</a>, and</li>

<li>to produce blood cells during fetal life.</li></ol>

The spleen synthesizes <a href="Antibodies" class="mw-redirect" title="Antibodies">antibodies</a> in its <a href="White_pulp" title="White pulp">white pulp</a> and removes antibody-coated bacteria and antibody-coated blood cells by way of blood and <a href="Lymph_node" title="Lymph node">lymph node</a> circulation. The white pulp of the spleen provides immune function due to the lymphocytes housed there. The spleen also consists of red pulp, which is responsible for getting rid of aged red blood cells and pathogens. This is carried out by macrophages present in the red pulp. A study published in 2009 using mice found that the spleen contains, in its reserve, half of the body's <a href="Monocyte" title="Monocyte">monocytes</a> within the <a href="Red_pulp" title="Red pulp">red pulp</a>.<a href="#cite_note-Swirski-17">[17]</a> These monocytes, upon moving to injured tissue (e.g., the heart), turn into <a href="Dendritic_cell" title="Dendritic cell">dendritic cells</a> and <a href="Macrophage" title="Macrophage">macrophages</a> while promoting tissue healing.<a href="#cite_note-Swirski-17">[17]</a><a href="#cite_note-Jia-18">[18]</a><a href="#cite_note-19">[19]</a> The spleen is a center of activity of the <a href="Mononuclear_phagocyte_system" title="Mononuclear phagocyte system">mononuclear phagocyte system</a> and can be considered analogous to a large lymph node, as its absence causes a predisposition to certain <a href="Infection" title="Infection">infections</a>. Notably, the spleen is essential for a multitude of functions. The spleen removes pathogens and old erythrocytes from the blood (red pulp) and produces lymphocytes for immune response (white pulp). The spleen also is responsible for recycling some erythrocyte components and discarding others. For example, hemoglobin is broken down into amino acids that are reused.

Research on <a href="Bony_fish" class="mw-redirect" title="Bony fish">bony fish</a> has shown that a high concentration of T cells is found in the spleen's white pulp.<a href="#cite_note-Koppang-14">[14]</a>

Like the <a href="Thymus" title="Thymus">thymus</a>, the spleen has only <a href="Efferent_lymphatic_vessels" class="mw-redirect" title="Efferent lymphatic vessels">efferent lymphatic vessels</a>. Both the <a href="Short_gastric_arteries" title="Short gastric arteries">short gastric arteries</a> and the <a href="Splenic_artery" title="Splenic artery">splenic artery</a> supply it with blood.<a href="#cite_note-20">[20]</a> The <a href="Germinal_centers" class="mw-redirect" title="Germinal centers">germinal centers</a> are supplied by <a href="Arteriole" title="Arteriole">arterioles</a> called penicilliary radicles.<a href="#cite_note-21">[21]</a>

In humans, until the fifth month of <a href="Prenatal_development" title="Prenatal development">prenatal development</a>, the spleen creates <a href="Red_blood_cells" class="mw-redirect" title="Red blood cells">red blood cells</a>; after birth, the <a href="Bone_marrow" title="Bone marrow">bone marrow</a> is solely responsible for <a href="Hematopoiesis" class="mw-redirect" title="Hematopoiesis">hematopoiesis</a>. As a major lymphoid organ and a central player in the reticuloendothelial system, the spleen retains the ability to produce lymphocytes. The spleen stores <a href="Red_blood_cells" class="mw-redirect" title="Red blood cells">red blood cells</a> and lymphocytes. It can store enough blood cells to help in an emergency. Up to 25% of lymphocytes can be stored at any one time.<a href="#cite_note-Spleen:_Information,_Surgery_and_Functions-22">[22]</a>

<div class="mw-heading mw-heading4"><h4 id="Lymph_nodes">Lymph nodes</h4></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Lymph_node" title="Lymph node">Lymph node</a></div><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="List_of_lymph_nodes_of_the_human_body" title="List of lymph nodes of the human body">List of lymph nodes of the human body</a></div>

A <a href="Lymph_node" title="Lymph node">lymph node</a> is an organized collection of lymphoid tissue through which the lymph passes on its way back to the blood. Lymph nodes are located at intervals along the lymphatic system. Several <a href="Afferent_lymph_vessel" class="mw-redirect" title="Afferent lymph vessel">afferent lymph vessels</a> bring in lymph, which percolates through the substance of the lymph node and is then drained out by an <a href="Efferent_lymph_vessel" class="mw-redirect" title="Efferent lymph vessel">efferent lymph vessel</a>. Of the nearly 800 lymph nodes in the human body, about 300 are located in the head and neck.<a href="#cite_note-SinghV-23">[23]</a> Many are grouped in clusters in different regions, as in the underarm and abdominal areas. Lymph node clusters are commonly found at the proximal ends of limbs (e.g., groin or armpits) and in the neck, where lymph is collected from body regions likely to sustain pathogen contamination from injuries. Lymph nodes are particularly numerous in the <a href="Mediastinum" title="Mediastinum">mediastinum</a> in the chest, neck, pelvis, <a href="Axilla" title="Axilla">axilla</a>, <a href="Groin" title="Groin">groin</a> (or inguinal region), and in association with the blood vessels of the intestines.<a href="#cite_note-grays-8">[8]</a>

The substance of a lymph node consists of lymphoid follicles in an outer portion called the <a href="Cortex_(anatomy)" title="Cortex (anatomy)">cortex</a>. The inner portion of the node is called the <a href="Medulla_of_lymph_node" class="mw-redirect" title="Medulla of lymph node">medulla</a>, which is surrounded by the cortex on all sides except for a portion known as the <a href="Hilum_of_lymph_node" class="mw-redirect" title="Hilum of lymph node">hilum</a>. The hilum presents as a depression on the surface of the lymph node, causing the otherwise spherical lymph node to be bean-shaped or ovoid. The efferent lymph vessel directly emerges from the lymph node at the hilum. The arteries and veins supplying the lymph node with blood enter and exit through the hilum. The region of the lymph node called the paracortex immediately surrounds the medulla. Unlike the cortex, which has primarily immature T cells (or <a href="Thymocytes" class="mw-redirect" title="Thymocytes">thymocytes</a>), the paracortex has a mixture of immature and mature T cells. Lymphocytes enter the lymph nodes through specialised <a href="High_endothelial_venule" class="mw-redirect" title="High endothelial venule">high endothelial venules</a> found in the paracortex.

A lymph follicle is a dense collection of lymphocytes, the number, size, and configuration of which change in accordance with the functional state of the lymph node. For example, the follicles expand significantly when encountering a foreign antigen. The selection of <a href="B_cell" title="B cell">B cells</a> (also known as B lymphocytes) occurs in the <a href="Germinal_centre" class="mw-redirect" title="Germinal centre">germinal centre</a> of the lymph nodes.

Secondary lymphoid tissue provides the environment for the foreign or altered native molecules (antigens) to interact with the lymphocytes. It is exemplified by the <a href="Lymph_node" title="Lymph node">lymph nodes</a>, and the lymphoid follicles in <a href="Tonsil" title="Tonsil">tonsils</a>, <a href="Peyer's_patch" title="Peyer's patch">Peyer's patches</a>, <a href="Spleen" title="Spleen">spleen</a>, <a href="Adenoid" title="Adenoid">adenoids</a>, <a href="Skin" title="Skin">skin</a>, etc. that are associated with the <a href="Mucosa-associated_lymphoid_tissue" title="Mucosa-associated lymphoid tissue">mucosa-associated lymphoid tissue</a> (MALT).

In the <a href="Gastrointestinal_wall" title="Gastrointestinal wall">gastrointestinal wall</a>, the <a href="Vermiform_appendix" class="mw-redirect" title="Vermiform appendix">appendix</a> has mucosa resembling that of the colon, but it is heavily infiltrated with lymphocytes here.

<div class="mw-heading mw-heading3"><h3 id="Tertiary_lymphoid_organs">Tertiary lymphoid organs</h3></div>

Tertiary lymphoid organs (TLOs) are abnormal lymph node-like structures that form in peripheral tissues at sites of <a href="Chronic_inflammation" class="mw-redirect" title="Chronic inflammation">chronic inflammation</a>, such as chronic infection, <a href="Transplanted_organs" class="mw-redirect" title="Transplanted organs">transplanted organs</a> undergoing <a href="Graft_rejection" class="mw-redirect" title="Graft rejection">graft rejection</a>, some <a href="Cancer" title="Cancer">cancers</a>, and <a href="Autoimmune" class="mw-redirect" title="Autoimmune">autoimmune</a> and autoimmune-related diseases.<a href="#cite_note-TLOpowerhouses-24">[24]</a> TLOs are often characterized by CD20+ B cell zone, which is surrounded by CD3+ T cell zone, similar to the lymph follicles in secondary lymphoid organs (SLOs) and are regulated differently from the normal process whereby lymphoid tissues are formed during <a href="Ontogeny" title="Ontogeny">ontogeny</a>, being dependent on <a href="Cytokines" class="mw-redirect" title="Cytokines">cytokines</a> and <a href="Hematopoietic" class="mw-redirect" title="Hematopoietic">hematopoietic</a> cells, but still drain <a href="Interstitial_fluid" class="mw-redirect" title="Interstitial fluid">interstitial fluid</a> and transport lymphocytes in response to the same chemical messengers and gradients.<a href="#cite_note-:2-25">[25]</a><a href="#cite_note-Ruddle2013-26">[26]</a> Mature TLOs often have an active <a href="Germinal_center" title="Germinal center">germinal center</a>, surrounded by a network of <a href="Follicular_dendritic_cells" title="Follicular dendritic cells">follicular dendritic cells</a> (FDCs).<a href="#cite_note-27">[27]</a> Although the specific composition of TLSs may vary, within the T cell compartment, the dominant subset of T cells is CD4+ T follicular helper (TFH) cells, but certain number of <a href="Cytotoxic_T_cell" title="Cytotoxic T cell">CD8+ cytotoxic T cells</a>, CD4+ T helper 1 (TH1) cells, and <a href="Regulatory_T_cell" title="Regulatory T cell">regulatory T cells</a> (Tregs) can also be found within the T cell zone.<a href="#cite_note-:2-25">[25]</a> The B cell zone contains two main areas. The mantle is located at the periphery and composed of naive <a href="Immunoglobulin_D" title="Immunoglobulin D">immunoglobulin D</a> (IgD)+ B cells surrounding the germinal centre. The latter is defined by the presence of proliferating Ki67+CD23+ B cells and a CD21+ FDC network, as observed in SLOs.<a href="#cite_note-:3-28">[28]</a> TLOs typically contain far fewer lymphocytes, and assume an immune role only when challenged with <a href="Antigen" title="Antigen">antigens</a> that result in <a href="Inflammation" title="Inflammation">inflammation</a>. They achieve this by importing the lymphocytes from blood and lymph.<a href="#cite_note-goldsby-29">[29]</a>

According to the composition and activation status of the cells within the lymphoid structures, at least three organizational levels of TLOs have been described. The formation of TLOs starts with the aggregating of lymphoid cells and occasional DCs, but FDCs are lacking at this stage. The next stage is immature TLOs, also known as primary follicle-like TLS, which have an increased number of T cells and B cells with distinct T cell and B cell zones and the formation of FDCs network, but without germinal centres. Finally, fully mature (also known as secondary follicle-like) TLOs often have active germinal centres and <a href="High_endothelial_venules" title="High endothelial venules">high endothelial venules</a> (HEVs), demonstrating a functional capacity by promoting T cell and B cell activation and then leading to expansion of TLS through cell proliferation and recruitment. During TLS formation, T and B cells are separated into two different but adjacent zones, with some cells having the ability to migrate from one to the other, which is a crucial step in developing an effective and coordinated immune response.<a href="#cite_note-:3-28">[28]</a><a href="#cite_note-30">[30]</a>

TLOs may play a key role in the immune response to cancer and serve as a prognostic marker for immunotherapy. TLOs have been reported to present in different cancer types such as <a href="Melanoma" title="Melanoma">melanoma</a>, <a href="Non-small-cell_lung_cancer" title="Non-small-cell lung cancer">non-small-cell lung cancer</a> and <a href="Colorectal_cancer" title="Colorectal cancer">colorectal cancer</a> (reviewed by Sautès-Fridman and colleagues<a href="#cite_note-31">[31]</a> in 2019), as well as <a href="Glioma" title="Glioma">glioma</a>.<a href="#cite_note-32">[32]</a> TLOs are also been seen as a read-out of treatment efficacy. For example, in patients with pancreatic ductal adenocarcinoma (PDAC), vaccination led to the formation of TLOs in responders. Within these patients, lymphocytes in TLOs displayed an activated phenotype, and in vitro experiments showed their capacity to perform effector functions.<a href="#cite_note-:3-28">[28]</a> Patients with the presence of TLOs tend to have a better prognosis,<a href="#cite_note-:0-33">[33]</a><a href="#cite_note-:1-34">[34]</a> even though some certain cancer types showed an opposite effect.<a href="#cite_note-35">[35]</a> Besides, TLOs with an active <a href="Germinal_center" title="Germinal center">germinal center</a> seem to show a better prognosis than those with TLOs without a germinal center.<a href="#cite_note-:0-33">[33]</a><a href="#cite_note-:1-34">[34]</a> The reason that these patients tend to live longer is that TLOs can promote an immune response against the tumors. TLOs may also enhance anti-tumor response when patients are treated with immunotherapy such as <a href="Immune_checkpoint_blockade" class="mw-redirect" title="Immune checkpoint blockade">immune checkpoint blockade</a> treatment.<a href="#cite_note-36">[36]</a>

<div class="mw-heading mw-heading3"><h3 id="Other_lymphoid_tissue">Other lymphoid tissue</h3></div>

Lymphoid tissue associated with the lymphatic system is concerned with immune functions in defending the body against <a href="Infection" title="Infection">infections</a> and the spread of <a href="Tumour" class="mw-redirect" title="Tumour">tumours</a>. It consists of <a href="Connective_tissue" title="Connective tissue">connective tissue</a> formed of <a href="Reticular_fiber" title="Reticular fiber">reticular fibers</a>, with various types of <a href="Leukocyte" class="mw-redirect" title="Leukocyte">leukocytes</a> (white blood cells), mostly <a href="Lymphocyte" title="Lymphocyte">lymphocytes</a> enmeshed in it, through which the lymph passes.<a href="#cite_note-37">[37]</a> Regions of the lymphoid tissue that are densely packed with lymphocytes are known as lymphoid follicles. Lymphoid tissue can either be structurally well organized as lymph nodes or may consist of loosely organized lymphoid follicles known as the <a href="Mucosa-associated_lymphoid_tissue" title="Mucosa-associated lymphoid tissue">mucosa-associated lymphoid tissue</a> (MALT).

The <a href="Central_nervous_system" title="Central nervous system">central nervous system</a> also has lymphatic vessels. The search for T cell gateways into and out of the <a href="Meninges" title="Meninges">meninges</a> uncovered functional <a href="Meningeal_lymphatic_vessels" title="Meningeal lymphatic vessels">meningeal lymphatic vessels</a> lining the <a href="Dural_venous_sinuses" title="Dural venous sinuses">dural sinuses</a>, anatomically integrated into the membrane surrounding the brain.<a href="#cite_note-Neural_immune_system-38">[38]</a>

<div class="mw-heading mw-heading3"><h3 id="Lymphatic_vessels">Lymphatic vessels</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Lymphatic_vessel" title="Lymphatic vessel">Lymphatic vessel</a></div>

The <a href="Lymphatic_vessel" title="Lymphatic vessel">lymphatic vessels</a>, also called lymph vessels, are thin-walled vessels that conduct lymph between different parts of the body.<a href="#cite_note-Robbins18-39">[39]</a> They include the tubular vessels of the <a href="Lymph_capillaries" class="mw-redirect" title="Lymph capillaries">lymph capillaries</a>, and the larger collecting vessels – the <a href="Right_lymphatic_duct" title="Right lymphatic duct">right lymphatic duct</a> and the <a href="Thoracic_duct" title="Thoracic duct">thoracic duct</a> (the left lymphatic duct). The lymph capillaries are mainly responsible for the absorption of interstitial fluid from the tissues, while lymph vessels propel the absorbed fluid forward into the larger collecting ducts, where it ultimately returns to the bloodstream via one of the <a href="Subclavian_veins" class="mw-redirect" title="Subclavian veins">subclavian veins</a>.

The tissues of the lymphatic system are responsible for maintaining the balance of the <a href="Body_fluid" title="Body fluid">body fluids</a>. Its network of capillaries and collecting lymphatic vessels efficiently drain and transport extravasated fluid, along with proteins and antigens, back to the circulatory system. Numerous intraluminal valves in the vessels ensure a unidirectional flow of lymph without reflux.<a href="#cite_note-40">[40]</a> Two valve systems, a primary and a secondary valve system, are used to achieve this unidirectional flow.<a href="#cite_note-41">[41]</a> The capillaries are blind-ended, and the valves at the ends of capillaries use specialised junctions together with anchoring filaments to allow a unidirectional flow to the primary vessels. When interstitial fluid increases, it causes swelling that stretches collagen fibers anchored to adjacent connective tissue, opening the unidirectional valves at the ends of these capillaries and facilitating the entry and subsequent drainage of excess lymph fluid. The collecting lymphatics, however, propel the lymph by the combined actions of the intraluminal valves and lymphatic muscle cells.<a href="#cite_note-42">[42]</a>

<div class="mw-heading mw-heading2"><h2 id="Development">Development</h2></div>

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The development of the lymphatic vascular system is a highly coordinated process essential for maintaining fluid <a href="Homeostasis" title="Homeostasis">homeostasis</a>, <a href="Immune_surveillance" class="mw-redirect" title="Immune surveillance">immune surveillance</a>, and lipid absorption. <a href="Lymphangiogenesis" title="Lymphangiogenesis">Lymphangiogenesis</a>, the formation of lymphatic vessels from pre-existing ones, is primarily driven by the migration and differentiation of lymphatic <a href="Endothelial_cells" class="mw-redirect" title="Endothelial cells">endothelial cells</a> (LECs) under the influence of molecular signals such as vascular endothelial growth factor C (<a href="VEGF-C" class="mw-redirect" title="VEGF-C">VEGF-C</a>). The maturation and specialization of lymphatic vessels involve complex interactions with surrounding tissues, ensuring the proper function of lymphatic drainage and <a href="Immune_cell_trafficking" class="mw-redirect" title="Immune cell trafficking">Immune cell trafficking</a>. Recent advances in vitro and in vivo studies have provided deeper insights into the mechanisms regulating lymphatic vascular development, as well as the processes governing its maintenance and aging. Understanding these pathways is critical, as disruptions in lymphatic development are implicated in <a href="Congenital_disorders" class="mw-redirect" title="Congenital disorders">congenital disorders</a>, inflammatory diseases,<a href="#cite_note-43">[43]</a> and <a href="Cancer_metastasis" class="mw-redirect" title="Cancer metastasis">cancer metastasis</a>.

Lymphatic tissues begin to develop by the end of the fifth week of embryonic development. Lymphatic vessels develop from <a href="Lymph_sacs" title="Lymph sacs">lymph sacs</a> that arise from developing veins, which are derived from <a href="Mesoderm" title="Mesoderm">mesoderm</a>. The first lymph sacs to appear are the paired jugular lymph sacs at the junction of the internal jugular and <a href="Subclavian_vein" title="Subclavian vein">subclavian veins</a>. From the jugular lymph sacs, lymphatic capillary plexuses spread to the thorax, upper limbs, neck, and head. Some of the plexuses enlarge and form lymphatic vessels in their respective regions. Each jugular lymph sac retains at least one connection with its jugular vein, the left one developing into the superior portion of the thoracic duct. The <a href="Spleen" title="Spleen">spleen</a> develops from mesenchymal cells between layers of the dorsal mesentery of the stomach. The <a href="Thymus" title="Thymus">thymus</a> arises as an outgrowth of the third pharyngeal pouch.<a href="#cite_note-44">[44]</a>

<div class="mw-heading mw-heading2"><h2 id="Function">Function</h2></div>

The lymphatic system has multiple interrelated functions:<a href="#cite_note-45">[45]</a><a href="#cite_note-46">[46]</a><a href="#cite_note-47">[47]</a><a href="#cite_note-48">[48]</a><a href="#cite_note-49">[49]</a><a href="#cite_note-50">[50]</a><a href="#cite_note-51">[51]</a>

<ul><li>It is responsible for the removal of <a href="Interstitial_fluid" class="mw-redirect" title="Interstitial fluid">interstitial fluid</a> from tissues</li>

<li>It absorbs and transports <a href="Fatty_acid" title="Fatty acid">fatty acids</a> and <a href="Fat" title="Fat">fats</a> as <a href="Chyle" title="Chyle">chyle</a> from the digestive system</li>

<li>It transports <a href="White_blood_cells" class="mw-redirect" title="White blood cells">white blood cells</a> to and from the lymph nodes into the bones</li>

<li>The lymph transports <a href="Antigen-presenting_cell" title="Antigen-presenting cell">antigen-presenting cells</a>, such as <a href="Dendritic_cells" class="mw-redirect" title="Dendritic cells">dendritic cells</a>, to the lymph nodes where an immune response is stimulated.</li></ul>

<div class="mw-heading mw-heading3"><h3 id="Fat_absorption">Fat absorption</h3></div>

<a href="Lymph_vessel" class="mw-redirect" title="Lymph vessel">Lymph vessels</a> called <a href="Lacteal" title="Lacteal">lacteals</a> are at the beginning of the <a href="Gastrointestinal_tract" title="Gastrointestinal tract">gastrointestinal tract</a>, predominantly in the small intestine. While most other nutrients absorbed by the <a href="Small_intestine" title="Small intestine">small intestine</a> are passed on to the <a href="Portal_venous_system" title="Portal venous system">portal venous system</a> to drain via the <a href="Portal_vein" title="Portal vein">portal vein</a> into the <a href="Liver" title="Liver">liver</a> for processing, fats (<a href="Lipids" class="mw-redirect" title="Lipids">lipids</a>) are passed on to the lymphatic system to be transported to the blood circulation via the <a href="Thoracic_duct" title="Thoracic duct">thoracic duct</a>. (There are exceptions, for example <a href="Medium-chain_triglycerides" class="mw-redirect" title="Medium-chain triglycerides">medium-chain triglycerides</a> are fatty acid esters of glycerol that passively diffuse from the GI tract to the portal system.) The enriched lymph originating in the lymphatics of the <a href="Small_intestine" title="Small intestine">small intestine</a> is called <a href="Chyle" title="Chyle">chyle</a>. The nutrients that are released into the circulatory system are processed by the <a href="Liver" title="Liver">liver</a>, having passed through the systemic circulation.

<div class="mw-heading mw-heading3"><h3 id="Immune_function">Immune function</h3></div>

The lymphatic system plays a major role in the body's immune system, as the primary site for cells relating to <a href="Adaptive_immune_system" title="Adaptive immune system">adaptive immune system</a> including <a href="T-cell" class="mw-redirect" title="T-cell">T-cells</a> and <a href="B-cells" class="mw-redirect" title="B-cells">B-cells</a>.

Cells in the lymphatic system react to <a href="Antigen_presentation" title="Antigen presentation">antigens presented</a> or found by the cells directly or by other <a href="Dendritic_cells" class="mw-redirect" title="Dendritic cells">dendritic cells</a>.

When an antigen is recognized, an immunological cascade begins involving the activation and recruitment of more and more cells, the production of <a href="Antibody" title="Antibody">antibodies</a> and <a href="Cytokines" class="mw-redirect" title="Cytokines">cytokines</a> and the recruitment of other immunological cells such as <a href="Macrophages" class="mw-redirect" title="Macrophages">macrophages</a>.

<div class="mw-heading mw-heading2"><h2 id="Clinical_significance">Clinical significance</h2></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Lymphatic_disease" title="Lymphatic disease">Lymphatic disease</a></div>

The study of lymphatic drainage of various organs is important in the diagnosis, prognosis, and treatment of cancer. The lymphatic system, because of its closeness to many tissues of the body, is responsible for carrying cancerous cells between the various parts of the body in a process called <a href="Metastasis" title="Metastasis">metastasis</a>. 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 tumours.

<a href="#cite_note-52">[52]</a> The lymphatic system (LS) comprises lymphoid organs and a network of vessels responsible for transporting interstitial fluid, antigens, lipids, cholesterol, immune cells, and other materials throughout the body. Dysfunction or abnormal development of the LS has been linked to numerous diseases, making it critical for fluid balance, immune cell trafficking, and inflammation control. Recent advancements, including single-cell technologies, clinical imaging, and biomarker discovery, have improved the ability to study and understand the LS, providing potential pathways for disease prevention and treatment. Studies have shown that the lymphatic system also plays a role in modulating immune responses, with dysfunction linked to chronic inflammatory and autoimmune conditions, as well as cancer progression.

<div class="mw-heading mw-heading3"><h3 id="Imaging_techniques">Imaging techniques</h3></div>

Recent advancements in imaging modalities have significantly enhanced the visualization and understanding of the lymphatic system. Dynamic contrast-enhanced magnetic resonance <a href="Lymphangiogram" class="mw-redirect" title="Lymphangiogram">lymphangiogram</a> (DCMRL) technology has emerged as a non-invasive technique providing <a href="High_resolution" class="mw-redirect" title="High resolution">high resolution</a> images of lymphatic vessels and nodes, aiding in the diagnosis of lymphatic disorders and guiding interventional procedures.<a href="#cite_note-53">[53]</a>

Near-infrared fluorescence (NIRF) imaging utilizes <a href="Indocyanine_green" title="Indocyanine green">indocyanine green</a> as a contrast agent to offer real-time visualization of superficial lymphatic flow, proving valuable in both clinical and research settings. These technologies have revolutionized the assessment of lymphatic function and <a href="Pathology" title="Pathology">pathology</a>, facilitating early detection and treatment of related diseases.<a href="#cite_note-54">[54]</a>

<div class="mw-heading mw-heading3"><h3 id="Enlarged_lymph_nodes">Enlarged lymph nodes</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Lymphadenopathy" title="Lymphadenopathy">Lymphadenopathy</a></div>

<a href="Lymphadenopathy" title="Lymphadenopathy">Lymphadenopathy</a> refers to one or more enlarged lymph nodes. Small groups or individually enlarged lymph nodes are generally reactive in response to <a href="Infection" title="Infection">infection</a> or <a href="Inflammation" title="Inflammation">inflammation</a>. This is called local lymphadenopathy. When many lymph nodes in different areas of the body are involved, this is called generalised lymphadenopathy. Generalised lymphadenopathy may be caused by <a href="Infection" title="Infection">infections</a> such as <a href="Infectious_mononucleosis" title="Infectious mononucleosis">infectious mononucleosis</a>, <a href="Tuberculosis" title="Tuberculosis">tuberculosis</a> and <a href="HIV" title="HIV">HIV</a>, <a href="Connective_tissue_disease" title="Connective tissue disease">connective tissue diseases</a> such as <a href="Systemic_lupus_erythematosis" class="mw-redirect" title="Systemic lupus erythematosis">SLE</a> and <a href="Rheumatoid_arthritis" title="Rheumatoid arthritis">rheumatoid arthritis</a>, and <a href="Cancer" title="Cancer">cancers</a>, including both cancers of tissue within lymph nodes, discussed below, and <a href="Metastasis" title="Metastasis">metastasis</a> of cancerous cells from other parts of the body, that have arrived via the lymphatic system.<a href="#cite_note-DAVIDSONS2010B-55">[55]</a><a href="#cite_note-Moore1961-56">[56]</a>

<div class="mw-heading mw-heading3"><h3 id="Lymphedema">Lymphedema</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Lymphedema" title="Lymphedema">Lymphedema</a></div>

<a href="Lymphedema" title="Lymphedema">Lymphedema</a> is the <a href="Edema" title="Edema">swelling</a> caused by the accumulation of lymph, which may occur if the lymphatic system is damaged or has malformations. It usually affects limbs, though the face, neck and abdomen may also be affected. In an extreme state, called <a href="Elephantiasis" title="Elephantiasis">elephantiasis</a>, the edema progresses to the extent that the skin becomes thick with an appearance similar to the skin on <a href="Elephant" title="Elephant">elephant</a> limbs.<a href="#cite_note-57">[57]</a>

Causes are unknown in most cases, but sometimes there is a previous history of severe infection, usually caused by a <a href="Parasitic_disease" title="Parasitic disease">parasitic disease</a>, such as <a href="Lymphatic_filariasis" title="Lymphatic filariasis">lymphatic filariasis</a>.

<a href="Lymphangiomatosis" title="Lymphangiomatosis">Lymphangiomatosis</a> is a disease involving multiple cysts or lesions formed from lymphatic vessels.

Lymphedema can also occur after <a href="Lymphadenectomy" title="Lymphadenectomy">surgical removal of lymph nodes</a> in the armpit (causing the arm to swell due to poor lymphatic drainage) or groin (causing swelling of the leg). Conventional treatment is by <a href="Manual_lymphatic_drainage" title="Manual lymphatic drainage">manual lymphatic drainage</a> and <a href="Compression_garment" title="Compression garment">compression garments</a>. Two drugs for the treatment of lymphedema are in clinical trials: Lymfactin<a href="#cite_note-lymfactin-58">[58]</a> and <a href="Ubenimex" title="Ubenimex">Ubenimex</a>/<a href="Bestatin" class="mw-redirect" title="Bestatin">Bestatin</a>. There is no evidence to suggest that the effects of manual lymphatic drainage are permanent.<a href="#cite_note-59">[59]</a>

<div class="mw-heading mw-heading3"><h3 id="Cancer">Cancer</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Lymphoma" title="Lymphoma">Lymphoma</a></div>

<a href="Cancer" title="Cancer">Cancer</a> of the lymphatic system can be primary or secondary. <a href="Lymphoma" title="Lymphoma">Lymphoma</a> refers to cancer that arises from <a href="Lymphatic_tissue" class="mw-redirect" title="Lymphatic tissue">lymphatic tissue</a>. Lymphoid leukaemias and lymphomas are now considered to be tumours of the same type of cell lineage. They are called "leukaemia" when in the blood or marrow and "lymphoma" when in lymphatic tissue. They are grouped together under the name "lymphoid malignancy".<a href="#cite_note-FauciBraunwald2009-60">[60]</a>

Lymphoma is generally considered as either <a href="Hodgkin_lymphoma" title="Hodgkin lymphoma">Hodgkin lymphoma</a> or <a href="Non-Hodgkin_lymphoma" title="Non-Hodgkin lymphoma">non-Hodgkin lymphoma</a>. Hodgkin lymphoma is characterised by a particular type of cell, called a <a href="Reed%E2%80%93Sternberg_cell" title="Reed–Sternberg cell">Reed–Sternberg cell</a>, visible under microscope. It is associated with past infection with the <a href="Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a>, and generally causes a painless "rubbery" lymphadenopathy. It is <a href="Cancer_staging" title="Cancer staging">staged</a>, using <a href="Ann_Arbor_staging" title="Ann Arbor staging">Ann Arbor staging</a>. <a href="Chemotherapy" title="Chemotherapy">Chemotherapy</a> generally involves the <a href="ABVD" title="ABVD">ABVD</a> and may also involve <a href="Radiotherapy" class="mw-redirect" title="Radiotherapy">radiotherapy</a>.<a href="#cite_note-DAVIDSONS2010B-55">[55]</a> Non-Hodgkin lymphoma is a cancer characterised by increased proliferation of <a href="B-cell" class="mw-redirect" title="B-cell">B-cells</a> or <a href="T-cells" class="mw-redirect" title="T-cells">T-cells</a>, generally occurs in an older age group than Hodgkin lymphoma. It is treated according to whether it is <a href="Grading_(tumors)" title="Grading (tumors)">high-grade</a> or low-grade, and carries a poorer prognosis than Hodgkin lymphoma.<a href="#cite_note-DAVIDSONS2010B-55">[55]</a>

<a href="Lymphangiosarcoma" title="Lymphangiosarcoma">Lymphangiosarcoma</a> is a malignant <a href="Soft_tissue_sarcoma" class="mw-redirect" title="Soft tissue sarcoma">soft tissue tumour</a>, whereas <a href="Lymphangioma" class="mw-redirect" title="Lymphangioma">lymphangioma</a> is a benign tumour occurring frequently in association with <a href="Turner_syndrome" title="Turner syndrome">Turner syndrome</a>. <a href="Lymphangioleiomyomatosis" title="Lymphangioleiomyomatosis">Lymphangioleiomyomatosis</a> is a benign tumour of the smooth muscles of the lymphatics that occurs in the lungs.

<a href="Lymphoid_leukaemia" class="mw-redirect" title="Lymphoid leukaemia">Lymphoid leukaemia</a> is another form of cancer where the host is devoid of different lymphatic cells.

<div class="mw-heading mw-heading3"><h3 id="Other">Other</h3></div>

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<ul><li><a href="Castleman's_disease" class="mw-redirect" title="Castleman's disease">Castleman's disease</a></li>

<li><a href="Chylothorax" title="Chylothorax">Chylothorax</a></li>

<li><a href="Kawasaki_disease" title="Kawasaki disease">Kawasaki disease</a></li>

<li><a href="Kikuchi_disease" title="Kikuchi disease">Kikuchi disease</a></li>

<li><a href="Lipedema" title="Lipedema">Lipedema</a></li>

<li><a href="Lymphangitis" title="Lymphangitis">Lymphangitis</a></li>

<li><a href="Lymphatic_filariasis" title="Lymphatic filariasis">Lymphatic filariasis</a></li>

<li><a href="Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">Lymphocytic choriomeningitis</a></li>

<li><a href="Solitary_lymphatic_nodule" title="Solitary lymphatic nodule">Solitary lymphatic nodule</a></li></ul>

</div>

<div class="mw-heading mw-heading2"><h2 id="History">History</h2></div>

<a href="Hippocrates" title="Hippocrates">Hippocrates</a>, in the 5th century BC, was one of the first people to mention the lymphatic system. In his work On Joints, he briefly mentioned the lymph nodes in one sentence. Rufus of <a href="Ephesus" title="Ephesus">Ephesus</a>, a Roman physician, identified the axillary, inguinal and mesenteric lymph nodes as well as the thymus during the 1st to 2nd century AD.<a href="#cite_note-Ambrose2006-61">[61]</a> The first mention of lymphatic vessels was in the 3rd century BC by <a href="Herophilos" title="Herophilos">Herophilos</a>, a Greek anatomist living in <a href="Alexandria" title="Alexandria">Alexandria</a>, who incorrectly concluded that the "absorptive veins of the lymphatics," by which he meant the <a href="Lacteal" title="Lacteal">lacteals</a> (lymph vessels of the intestines), drained into the <a href="Hepatic_portal_vein" class="mw-redirect" title="Hepatic portal vein">hepatic portal veins</a>, and thus into the liver.<a href="#cite_note-Ambrose2006-61">[61]</a> The findings of Ruphus and Herophilos were further propagated by the Greek physician <a href="Galen" title="Galen">Galen</a>, who described the lacteals and mesenteric lymph nodes which he observed in his dissection of apes and pigs in the 2nd century AD.<a href="#cite_note-Ambrose2006-61">[61]</a>

In the mid 16th century, <a href="Gabriele_Falloppio" title="Gabriele Falloppio">Gabriele Falloppio</a> (discoverer of the <a href="Fallopian_tube" title="Fallopian tube">fallopian tubes</a>), described what is now known as the lacteals as "coursing over the intestines full of yellow matter."<a href="#cite_note-Ambrose2006-61">[61]</a> In about 1563 <a href="Bartolomeo_Eustachi" title="Bartolomeo Eustachi">Bartolomeo Eustachi</a>, a professor of anatomy, described the thoracic duct in horses as vena alba thoracis.<a href="#cite_note-Ambrose2006-61">[61]</a> The next breakthrough came when in 1622 a physician, <a href="Gaspare_Aselli" title="Gaspare Aselli">Gaspare Aselli</a>, identified lymphatic vessels of the intestines in dogs and termed them venae albae et lacteae, which are now known as simply the lacteals. The lacteals were termed the fourth kind of vessels (the other three being the artery, vein and nerve, which was then believed to be a type of vessel), and disproved Galen's assertion that chyle was carried by the veins. But, he still believed that the lacteals carried the chyle to the liver (as taught by Galen).<a href="#cite_note-flourens-62">[62]</a> He also identified the thoracic duct but failed to notice its connection with the lacteals.<a href="#cite_note-Ambrose2006-61">[61]</a> This connection was established by <a href="Jean_Pecquet" title="Jean Pecquet">Jean Pecquet</a> in 1651, who found a white fluid mixing with blood in a dog's heart. He suspected that fluid to be <a href="Chyle" title="Chyle">chyle</a> as its flow increased when abdominal pressure was applied. He traced this fluid to the thoracic duct, which he then followed to a chyle-filled sac he called the chyli receptaculum, which is now known as the <a href="Cisterna_chyli" title="Cisterna chyli">cisternae chyli</a>; further investigations led him to find that lacteals' contents enter the venous system via the thoracic duct.<a href="#cite_note-Ambrose2006-61">[61]</a><a href="#cite_note-flourens-62">[62]</a> Thus, it was proven convincingly that the lacteals did not terminate in the <a href="Liver" title="Liver">liver</a>, thus disproving Galen's second idea: that the chyle flowed to the liver.<a href="#cite_note-flourens-62">[62]</a> <a href="Johann_Veslingius" class="mw-redirect" title="Johann Veslingius">Johann Veslingius</a> drew the earliest sketches of the lacteals in humans in 1641.<a href="#cite_note-63">[63]</a>

The idea that blood recirculates through the body rather than being produced anew by the liver and the heart was first accepted as a result of works of <a href="William_Harvey" title="William Harvey">William Harvey</a>—a work he published in 1628. In 1652, <a href="Olaus_Rudbeck" title="Olaus Rudbeck">Olaus Rudbeck</a> (1630–1702) discovered certain transparent vessels in the liver that contained clear fluid (and not white), and thus named them hepatico-aqueous vessels. He also learned that they emptied into the thoracic duct and that they had valves.<a href="#cite_note-flourens-62">[62]</a> He announced his findings in the court of <a href="Christina%2C_Queen_of_Sweden" title="Christina, Queen of Sweden">Queen Christina of Sweden</a>, but did not publish his findings for a year,<a href="#cite_note-eriksson-64">[64]</a> and in the interim similar findings were published by <a href="Thomas_Bartholin" title="Thomas Bartholin">Thomas Bartholin</a>, who additionally published that such vessels are present everywhere in the body, not just in the liver. He is also the one to have named them "lymphatic vessels."<a href="#cite_note-flourens-62">[62]</a> This had resulted in a bitter dispute between one of Bartholin's pupils, Martin Bogdan,<a href="#cite_note-65">[65]</a> and Rudbeck, whom he accused of <a href="Plagiarism" title="Plagiarism">plagiarism</a>.<a href="#cite_note-eriksson-64">[64]</a>

Galen's ideas prevailed in medicine until the 17th century. It was thought that blood was produced by the liver from chyle contaminated with ailments by the intestine and stomach, to which various spirits were added by other organs, and that this blood was consumed by all the organs of the body. This theory required that the blood be consumed and produced many times over. Even in the 17th century, his ideas were defended by some physicians.<a href="#cite_note-66">[66]</a><a href="#cite_note-67">[67]</a><a href="#cite_note-68">[68]</a>

<a href="Alexander_Monro_(secundus)" class="mw-redirect" title="Alexander Monro (secundus)">Alexander Monro</a>, of the <a href="University_of_Edinburgh_Medical_School" title="University of Edinburgh Medical School">University of Edinburgh Medical School</a>, was the first to describe the function of the lymphatic system in detail.<a href="#cite_note-69">[69]</a>

<a href="University_of_Virginia_School_of_Medicine" title="University of Virginia School of Medicine">UVA School of Medicine</a> researchers Jonathan Kipnis and Antoine Louveau discovered previously unknown vessels connecting the <a href="Human_brain" title="Human brain">human brain</a> directly to the lymphatic system. The discovery "redrew the map" of the lymphatic system, rewrote medical <a href="Textbook" title="Textbook">textbooks</a>, and struck down long-held beliefs about how the <a href="Immune_system" title="Immune system">immune system</a> functions in the brain. The discovery may help greatly in combating neurological diseases from <a href="Multiple_sclerosis" title="Multiple sclerosis">multiple sclerosis</a> to <a href="Alzheimer's_disease" title="Alzheimer's disease">Alzheimer's disease</a>.<a href="#cite_note-70">[70]</a>

<div class="gallerytext"><a href="Galen" title="Galen">"Claude Galien"</a>. Lithograph by Pierre Roche Vigneron. (Paris: Lith de Gregoire et Deneux, <abbr title="circa">c.</abbr> 1865)</div>

</li>

<div class="gallerytext"><a href="Gabriele_Falloppio" title="Gabriele Falloppio">Gabriele Falloppio</a></div>

</li>

<div class="gallerytext">Portrait of <a href="Bartolomeo_Eustachi" title="Bartolomeo Eustachi">Eustachius</a></div>

</li>

<div class="gallerytext"><a href="Olaus_Rudbeck" title="Olaus Rudbeck">Olaus Rudbeck</a> in 1696.</div>

</li>

<div class="gallerytext"><a href="Thomas_Bartholin" title="Thomas Bartholin">Thomas Bartholin</a></div>

</li>

</ul>

<div class="mw-heading mw-heading3"><h3 id="Etymology">Etymology</h3></div>

Lymph originates in the <a href="Classical_Latin" title="Classical Latin">Classical Latin</a> word lympha "water",<a href="#cite_note-71">[71]</a> which is also the source of the English word limpid. The spelling with y and ph was influenced by <a href="Folk_etymology" title="Folk etymology">folk etymology</a> with <a href="Ancient_Greek" title="Ancient Greek">Greek</a> νύμϕη (nýmphē) "<a href="Nymph" title="Nymph">nymph</a>".<a href="#cite_note-72">[72]</a>

The adjective used for the lymph-transporting system is lymphatic. The adjective used for the tissues where lymphocytes are formed is lymphoid. Lymphatic comes from the Latin word lymphaticus, meaning "connected to water."

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<ul><li><a href="List_of_lymph_nodes_of_the_human_body" title="List of lymph nodes of the human body">List of lymphatic nodes of the human body</a></li>

<li><a href="American_Society_of_Lymphology" class="mw-redirect" title="American Society of Lymphology">American Society of Lymphology</a></li>

<li><a href="Glymphatic_system" title="Glymphatic system">Glymphatic system</a> and <a href="Meningeal_lymphatic_vessels" title="Meningeal lymphatic vessels">Meningeal lymphatic vessels</a> - equivalent for the <a href="Central_nervous_system" title="Central nervous system">central nervous system</a></li>

<li><a href="Innate_lymphoid_cell" title="Innate lymphoid cell">Innate lymphoid cells</a></li>

<li><a href="Lymphangiogenesis" title="Lymphangiogenesis">Lymphangiogenesis</a></li>

<li><a href="Lymphangion" title="Lymphangion">Lymphangion</a></li>

<li><a href="Mononuclear_phagocyte_system" title="Mononuclear phagocyte system">Mononuclear phagocyte system</a></li>

<li><a href="Waldemar_Olszewski" title="Waldemar Olszewski">Waldemar Olszewski</a> – discovered fundamental processes in human tissues connected with function of the lymphatic system</li>

<li><a href="Trogocytosis" title="Trogocytosis">Trogocytosis</a></li></ul>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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</ol></div>

<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>

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<div class="side-box-text plainlist">Wikimedia Commons has media related to <a href="https://commons.wikimedia.org/wiki/Category:Lymphatic_system" class="extiw external" title="commons:Category:Lymphatic system">Lymphatic system</a>.</div></div>

</div>

<div class="side-box-text plainlist">The Wikibook <a href="https://en.wikibooks.org/wiki/Anatomy_and_Physiology_of_Animals" class="extiw external" title="wikibooks:Anatomy and Physiology of Animals">Anatomy and Physiology of Animals</a> has a page on the topic of: <a href="https://en.wikibooks.org/wiki/Anatomy_and_Physiology_of_Animals/Lymphatic_System" class="extiw external" title="wikibooks:Anatomy and Physiology of Animals/Lymphatic System">Lymphatic System</a></div></div>

</div>

<ul><li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20060815143239/http://www.emc.maricopa.edu/faculty/farabee/BIOBK/BioBookIMMUN.html">Lymphatic System</a></li>

<li><a rel="nofollow" class="external text" href="https://www.innerbody.com/image/lympov.html">Lymphatic System Overview</a> (innerbody.com)</li></ul>

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</style><div id="Organs_of_the_lymphatic_system122" style="font-size:114%;margin:0 4em">Organs of the </div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Primary_lymphoid_organs" class="mw-redirect" title="Primary lymphoid organs">Primary organs</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Bone_marrow" title="Bone marrow">Bone marrow</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Hematopoietic_stem_cell" title="Hematopoietic stem cell">Hematopoietic stem cell</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Thymus" title="Thymus">Thymus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Hassall's_corpuscles" title="Hassall's corpuscles">Hassall's corpuscles</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Secondary_lymphoid_organs" class="mw-redirect" title="Secondary lymphoid organs">Secondary organs</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Spleen" title="Spleen">Spleen</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li>Parts

<ul><li><a href="Splenic_hilum" class="mw-redirect" title="Splenic hilum">Hilum</a></li>

<li><a href="Trabeculae_of_spleen" title="Trabeculae of spleen">Trabeculae</a></li></ul></li>

<ul><li><a href="Cords_of_Billroth" title="Cords of Billroth">Cords of Billroth</a></li>

<li><a href="Marginal_zone" title="Marginal zone">Marginal zone</a></li></ul></li>

<li><a href="White_pulp" title="White pulp">White pulp</a>

<ul><li><a href="Periarteriolar_lymphoid_sheaths" title="Periarteriolar lymphoid sheaths">Periarteriolar lymphoid sheaths</a></li>

<li><a href="Germinal_center" title="Germinal center">Germinal center</a></li></ul></li>

<li>Blood vessels

<ul><li><a href="Trabecular_arteries" title="Trabecular arteries">Trabecular arteries</a></li>

<li><a href="Trabecular_veins" title="Trabecular veins">Trabecular veins</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Tonsil" title="Tonsil">Tonsils</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Palatine_tonsil" title="Palatine tonsil">Palatine</a></li>

<li><a href="Lingual_tonsils" title="Lingual tonsils">Lingual</a></li>

<li><a href="Pharyngeal_tonsil" class="mw-redirect" title="Pharyngeal tonsil">Pharyngeal</a></li>

<li><a href="Tubal_tonsil" title="Tubal tonsil">Tubal</a></li>

<li><a href="Tonsillar_crypts" title="Tonsillar crypts">Tonsillar crypts</a></li>

<li><a href="Waldeyer's_tonsillar_ring" title="Waldeyer's tonsillar ring">Waldeyer's tonsillar ring</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Lymph_node" title="Lymph node">Lymph nodes</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Lymphatic_vessel" title="Lymphatic vessel">Lymphatic vessel</a></li>

<li><a href="T_cell" title="T cell">T cells</a>

<ul><li><a href="High_endothelial_venules" title="High endothelial venules">High endothelial venules</a></li></ul></li>

<li><a href="B_cell" title="B cell">B cells</a>

<ul><li><a href="Germinal_center" title="Germinal center">Germinal center</a></li>

<li><a href="Mantle_zone" title="Mantle zone">Mantle zone</a></li>

<li><a href="Marginal_zone" title="Marginal zone">Marginal zone</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Mucosa-associated_lymphoid_tissue" title="Mucosa-associated lymphoid tissue">MALT</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<li><a href="Peyer's_patch" title="Peyer's patch">Peyer's patch</a></li>

<li><a href="Germinal_center" title="Germinal center">Germinal center</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Lymphatic_vessels63" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Lymphatic_vessels63" style="font-size:114%;margin:0 4em"> vessels</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Lymph_node" title="Lymph node">Nodal</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Lymph_capillary" title="Lymph capillary">Lymph capillary</a></li>

<li><a href="Lymphatic_vessel" title="Lymphatic vessel">Lymphatic vessel</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Lymph_trunk" title="Lymph trunk">Lymph trunk</a></li>

<li><a href="Lymph" title="Lymph">Lymph</a></li>

<li><a href="Lymphangion" title="Lymphangion">Lymphangion</a></li></ul>

</div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Anatomy_of_the_lymphatic_system77" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Anatomy_of_the_lymphatic_system77" style="font-size:114%;margin:0 4em">Anatomy of the </div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Head and neck</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Head</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Back</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Occipital_lymph_nodes" title="Occipital lymph nodes">Occipital</a></li>

<li><a href="Mastoid_lymph_nodes" title="Mastoid lymph nodes">Mastoid/retroauricular</a></li>

<li><a href="Parotid_lymph_nodes" title="Parotid lymph nodes">Parotid</a>

<ul><li><a href="Superficial_parotid_lymph_nodes" title="Superficial parotid lymph nodes">Superficial</a></li>

<ul><li><a href="Preauricular_deep_parotid_lymph_nodes" title="Preauricular deep parotid lymph nodes">preauricular</a></li>

<li><a href="Infraauricular_deep_parotid_lymph_nodes" title="Infraauricular deep parotid lymph nodes">infra-auricular</a></li>

<li><a href="Intraglandular_deep_parotid_lymph_nodes" title="Intraglandular deep parotid lymph nodes">intraglandular</a></li></ul></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Front</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Facial_lymph_nodes" title="Facial lymph nodes">Facial</a>

<ul><li><a href="Buccinator_lymph_node" title="Buccinator lymph node">buccinator</a></li>

<li><a href="Nasolabial_lymph_node" title="Nasolabial lymph node">nasolabial</a></li></ul></li>

<li><a href="Mandibular_lymph_node" title="Mandibular lymph node">Mandibular</a>

<ul><li><a href="Submandibular_lymph_nodes" title="Submandibular lymph nodes">Submandibular</a></li></ul></li>

<li><a href="Submental_lymph_nodes" title="Submental lymph nodes">Submental</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cervical_lymph_nodes" title="Cervical lymph nodes">Cervical</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Superficial_cervical_lymph_nodes" title="Superficial cervical lymph nodes">Superficial</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Superficial_anterior_cervical_lymph_nodes" title="Superficial anterior cervical lymph nodes">anterior</a></li>

<li><a href="Superficial_lateral_cervical_lymph_nodes" title="Superficial lateral cervical lymph nodes">lateral</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Deep_cervical_lymph_nodes" title="Deep cervical lymph nodes">Deep</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Deep_anterior_cervical_lymph_nodes" title="Deep anterior cervical lymph nodes">Deep anterior cervical</a>

<ul><li><a href="Pretracheal_lymph_nodes" title="Pretracheal lymph nodes">pretracheal</a></li>

<li><a href="Paratracheal_lymph_nodes" title="Paratracheal lymph nodes">paratracheal</a></li>

<li><a href="Prelaryngeal_lymph_nodes" title="Prelaryngeal lymph nodes">prelaryngeal</a></li>

<li><a href="Thyroid_lymph_nodes" title="Thyroid lymph nodes">thyroid</a></li></ul></li>

<li><a href="Deep_lateral_cervical_lymph_nodes" title="Deep lateral cervical lymph nodes">Deep lateral cervical</a>

<ul><li><a href="Superior_deep_cervical_lymph_nodes" title="Superior deep cervical lymph nodes">superior deep cervical</a></li>

<li><a href="Inferior_deep_cervical_lymph_nodes" title="Inferior deep cervical lymph nodes">inferior deep cervical</a></li>

<li><a href="Retropharyngeal_lymph_nodes" title="Retropharyngeal lymph nodes">retropharyngeal</a></li>

<li><a href="Jugulodigastric_lymph_node" title="Jugulodigastric lymph node">jugulodigastric</a></li>

<li><a href="Jugulo-omohyoid_lymph_node" title="Jugulo-omohyoid lymph node">jugulo-omohyoid</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Anterior_cervical_lymph_nodes" title="Anterior cervical lymph nodes">Anterior cervical</a></li>

<li><a href="Lateral_cervical_lymph_nodes" title="Lateral cervical lymph nodes">Lateral cervical</a></li>

<li><a href="Supraclavicular_lymph_nodes" title="Supraclavicular lymph nodes">Supraclavicular</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Vessels</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Jugular_lymph_trunk" title="Jugular lymph trunk">Jugular trunk</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Arm and axilla</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Nodes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Axillary_lymph_nodes" title="Axillary lymph nodes">Axillary</a>

<ul><li><a href="Brachial_lymph_nodes" title="Brachial lymph nodes">Brachial</a></li>

<li><a href="Pectoral_axillary_lymph_nodes" title="Pectoral axillary lymph nodes">Pectoral</a></li>

<li><a href="Subscapular_axillary_lymph_nodes" title="Subscapular axillary lymph nodes">Subscapular</a></li>

<li><a href="Central_lymph_nodes" title="Central lymph nodes">Central</a></li>

<li><a href="Apical_lymph_nodes" title="Apical lymph nodes">Apical</a></li></ul></li>

<li>Arm

<ul><li><a href="Supratrochlear_lymph_nodes" title="Supratrochlear lymph nodes">Supratrochlear</a></li>

<li><a href="Deltopectoral_lymph_nodes" title="Deltopectoral lymph nodes">Deltopectoral</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Vessels</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Subclavian_lymph_trunk" title="Subclavian lymph trunk">Subclavian lymph trunk</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Chest</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Nodes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Parasternal_lymph_nodes" title="Parasternal lymph nodes">Parasternal</a></li>

<li><a href="Intercostal_lymph_nodes" title="Intercostal lymph nodes">Intercostal</a></li>

<li><a href="Superior_diaphragmatic_lymph_nodes" title="Superior diaphragmatic lymph nodes">Superior diaphragmatic</a></li>

<li><a href="Tracheobronchial_lymph_nodes" title="Tracheobronchial lymph nodes">Trachea and bronchi</a>

<ul><li><a href="Tracheobronchial_lymph_nodes" title="Tracheobronchial lymph nodes">superior</a></li>

<li><a href="Tracheobronchial_lymph_nodes" title="Tracheobronchial lymph nodes">inferior</a></li>

<li><a href="Tracheobronchial_lymph_nodes" title="Tracheobronchial lymph nodes">bronchopulmonary</a></li>

<li><a href="Paratracheal_lymph_nodes" title="Paratracheal lymph nodes">paratracheal</a></li>

<li><a href="Intrapulmonary_nodes" title="Intrapulmonary nodes">intrapulmonary</a></li></ul></li></ul>

<ul><li><a href="Thoracic_duct" title="Thoracic duct">Thoracic duct</a></li>

<li><a href="Right_lymphatic_duct" title="Right lymphatic duct">Right lymphatic duct</a></li>

<li><a href="Bronchomediastinal_lymph_trunk" title="Bronchomediastinal lymph trunk">Bronchomediastinal lymph trunk</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Abdomen</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Nodes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Retroaortic_lymph_nodes" title="Retroaortic lymph nodes">Retroaortic</a></li>

<li><a href="Paraaortic_lymph_nodes" class="mw-redirect" title="Paraaortic lymph nodes">Paraaortic</a></li>

<li><a href="Preaortic_lymph_node" class="mw-redirect" title="Preaortic lymph node">Preaortic</a></li>

<li><a href="Celiac_lymph_nodes" title="Celiac lymph nodes">Celiac</a>

<ul><li><a href="Gastric_lymph_nodes" title="Gastric lymph nodes">gastric</a></li>

<li><a href="Hepatic_lymph_nodes" title="Hepatic lymph nodes">hepatic</a></li>

<li><a href="Splenic_lymph_nodes" class="mw-redirect" title="Splenic lymph nodes">splenic</a></li></ul></li>

<li><a href="Superior_mesenteric_lymph_nodes" title="Superior mesenteric lymph nodes">Superior mesenteric</a>

<ul><li>mesenteric</li>

<li>ileocolic</li>

<li>mesocolic</li></ul></li>

<li><a href="Inferior_mesenteric_lymph_nodes" title="Inferior mesenteric lymph nodes">Inferior mesenteric</a>

<ul><li><a href="Pararectal_lymph_nodes" title="Pararectal lymph nodes">pararectal</a></li></ul></li>

<li>Iliac

<ul><li><a href="Common_iliac_lymph_nodes" title="Common iliac lymph nodes">Common</a></li>

<li><a href="External_iliac_lymph_nodes" title="External iliac lymph nodes">external</a></li>

<li><a href="Internal_iliac_lymph_nodes" title="Internal iliac lymph nodes">internal</a></li></ul></li>

<li><a href="Sacral_lymph_nodes" title="Sacral lymph nodes">Sacral</a></li>

<li><a href="Retroperitoneal_lymph_nodes" class="mw-redirect" title="Retroperitoneal lymph nodes">Retroperitoneal</a></li></ul>

<ul><li><a href="Lumbar_lymph_trunk" title="Lumbar lymph trunk">Lumbar lymph trunk</a></li>

<li><a href="Intestinal_lymph_trunk" title="Intestinal lymph trunk">Intestinal trunk</a></li>

<li><a href="Cisterna_chyli" title="Cisterna chyli">Cisterna chyli</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Leg</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Inguinal_lymph_nodes" title="Inguinal lymph nodes">Inguinal</a>

<ul><li><a href="Cloquet's_node" class="mw-redirect" title="Cloquet's node">Cloquet's node</a></li></ul></li>

<li><a href="Superficial_inguinal_lymph_nodes" class="mw-redirect" title="Superficial inguinal lymph nodes">superficial</a></li></ul></li>

<li><a href="Popliteal_lymph_nodes" title="Popliteal lymph nodes">Popliteal</a></li></ul>

</div></td></tr></tbody></table></div>

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