Abdominal Lymph Nodes

Overview

• Major lymphatic vessels and nodal chains lie along major blood vessels (aorta, inferior vena cava, iliac)

• Lymph nodes carry same name as vessel they accompany

• Lymph from alimentary tract, liver, spleen, and pancreas passes along celiac, superior mesenteric chains to nodes

  • Efferent vessels from alimentary nodes form intestinal lymphatic trunks

  • Cisterna chyli (chyle cistern)

    • –

      Formed by confluence of intestinal lymphatic trunks and right and left lumbar lymphatic trunks, which receive lymph from nonalimentary viscera, abdominal wall, and lower extremities

    • –

      May be discrete sac or plexiform convergence

• Thoracic duct: Inferior extent is chyle cistern at L1-L2 level

  • Formed by convergence of main lymphatic ducts of abdomen

  • Ascends through aortic hiatus in diaphragm to enter posterior mediastinum

  • Ends by entering junction of left subclavian and internal jugular veins

• Lymphatic system drains surplus fluid from extracellular spaces and returns it to bloodstream

  • Important function in defense against infection, inflammation, and tumor via lymphoid tissue present in lymph nodes, gut wall, spleen, and thymus

  • Absorbs and transports dietary lipids from intestine to thoracic duct and bloodstream

• Lymph nodes

  • Composed of cortex and medulla

  • Invested in fibrous capsule, which extends into nodal parenchyma to form trabeculae

  • Internal honeycomb structure filled with lymphocytes that collect and destroy pathogens

  • Hilum: In concave side, with artery and vein, surrounded by fat