Department of Histology Medical Faculty Tarumanagara University Jakarta, 2008 Introduction The body has a system of cells that has the ability to distinguish self (the organisms own molecules) from nonself (foreign substance) the immune system. Has the ability to neutralize / inactivate foreign molecules and destroy microorganisms or other cells. Autoimmune disease the immune system of individual reacts against its own normal body tissues or molecules. The cells of immune system, Are distributed throughtout the body in the blood, lymph and epithelial and connective tissues; Are arranged in small spherical nodules called lymphoid nodules found in connective tissues and inside several organs; And are organized as differently sized organs called lymphoid organs. The wide distribution of immune system cells and the constant traffic of lymphocytes through the blood, lymph, connective tissues and lymphoid organs provide the body with an elaborate and efficient system of surveillance and defense. The lymph system is made up of the following: Lymph: Colorless, watery fluid that travels through the lymph system and carries white blood cells called lymphocytes. Lymphocytes protect the body against infections and the growth of tumors. Lymph vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream. Lymph nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin. Spleen: An organ that makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. The spleen is on the left side of the abdomen near the stomach. Thymus: An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. Tonsils: Two small masses of lymph tissue at the back of the throat. The tonsils make lymphocytes. Bone marrow: The soft, spongy tissue in the center of large bones. Bone marrow makes white blood cells, red blood cells, and platelets. From: www.meb.uni- bonn.de/cancer.gov/CDR0 000257993.html Lymphatic System
Lymphatic Organs Lymph vessels
Lymphatic Tissues
Reticular tissue Free cells
Reticular fibers Reticular cells
The form of lymphatic tissue:
Diffuse lymphoid tissue
Lymphatic nodulus Diffuse lymphoid tissues The alimentary and respiratory tracts. The simplest form of lymphoid tissues. Infiltration of the lamina propria of mucous membranes. Not packed closely together and do not show any special organization. The reticular cells Close relation The reticular fibers Free cells: Small lymphocytes (the most) Hemocytoblast (lymphoblast) Monocytes Plasma cells (between the reticular cells and fibers) Lymphatic nodulus Vary in diameter (m mm or more). The formation / structure: Solitarius. Nonencapsulated aggregations. Encapsulated aggregations. Primary nodules: Unclear circumstance outline Small lymphocytes Cortex : Closely packed small lymphocytes. It may have an outer peripheral darker zone. Medulla : Germinal center / secondary nodule. Develop in response to an antigenic. Lymphoblast. Large, medium and small sized lymphocytes. Zona of rapid proliferation The size of the center is an indication of level of the immunological response. THE LYMPH NODES / LYMPHONODUS Location : Feature: Prevertebral region. Bean-shaped body. Axillary regions. Ranging from 1 25 mm. Inguinal regions. Convex contour. Mesentery. Except at an indented region the hilum/hilus (blood vessels enter and leave the node, and efferent vessels) Afferent lymphatic vessel penetrate the capsule at multiple point on the convex surface. The capsular material trabeculae. Lymphatic sinuses. An outer / cortical: An inner / medullary: Lypmh nodules Trabeculae branch Anastomose to form irregular, anastomosing cords.
The connective tissue of the capsule also
penetrates the gland at the hilum. Framework Capsule consists: Collagenous fibers with scattered elastic fibers. The capsule, hilum and trabeculae constitute the collagenous framework. Within the framework, there is a delicate meshwork of reticular connective tissue, comprising reticular fibers, reticular cells and fixed macrophages. From: Junqueira & Carneiro, 2005. CORTEX Development of the trabeculae and separation of the cortex into compartments vary in nodes of the body. The nodules are separated from the capsule and trabeculae by space lymph sinuses, throught which the lymph circulates. Surrounding the medulla except at the hilum. The cortical nodules often contain germinal centers (medium-sized lymphocytes; lymphoblast; plasma cells) Active phase the cells are produced and pushed outward into a peripheral zone. After a time, mitotic activity diminished. inactive phase the nodule returns to its homogeneous, resting appearance. Region where B lymphocytes are concentrated. Stimulation antigen proliferation of small lymphocytes & cell plasma concerned specific humoral antibodies Paracortex Small lymphocytes / T lymphocytes specific sellular antibodies. Venula Medulla Medullary cords. Medullary sinuses. B lymphocytes & plasma cells. Lymph circulation AFFERENT LYMPHATIC VESSELS
(MOSTLY) MIGRATION OF T LYMPHOCYTES Lymphocytes that leave the venules penetrate the paracortical zone (intercellular or intracellular/transcellular route) medullary sinuses efferent vessels the thoracic duct the blood vascular system. FUNCTIONS OF LYMPH NODES Production of lymphocytes (lymphopoiesis). Filter lymph. Formation of antibodies. Memory cells. THE TONSILS The tonsil are aggregates of unencapsulated lymphoid tissue that lie in close assosiation with a wet epithelial membrane. There are tonsillar groups: The palatine tonsils. Pharyngeal lymphoid The lingual tonsil. ring of Waldeyer
The pharyngeal tonsil.
Fourth tonsillar group: Tubal tonsils. PALATINE TONSILS (faucial) Features: Paired Ovoid masses Location: beetwen the glossopalatine and pharyngopalatine arches. Lie in the connective tissue of the mucosa and covered on their free surface by a stratified squamous epithelium. Tonsillar crypts Primary crypt. Secondary crypts. Lymphoid tissue surrounds the crypts as a diffuse mass. The nodules may contain germinal centers. Small mucous glands From: Junqueira & Carneiro, 2005. From: Lesson & Lesson, 1988. LINGUAL TONSIL Located in the root of the tongue, behind the circumvallate papillae. Simple pit / crypt. Stratified squamous epithelium. Infiltrations of the epithelium with lymphocytes. Lymph nodules (lymphonodulus) with germinal centers. Mucous glands. PHARYNGEAL TONSIL Accumulation of lymphoid tissue in the median posterior wall of the nasopharynx. The lymphatic tissue is similar with the palatine tonsils. The epithelium over the free surface is folded, but no true crypts occur. Pseudostratified epithelium with cilia and goblet cells. In the Adult stratified squamous epithelium. The epithelium is extensively infiltrated with lymphocytes. Mixed seromucous glands. Hypertrophy of the pharyngeal tonsil, with consequent obstruction of the nasal opening, is common and is known clinically as adenoids. TUBAL TONSIL Lies around the pharyngeal orifice of the pharyngotympanic (auditory) tube, And constitues a lateral extension of the pharyngeal tonsil. Columnar epithelium with ciliated. FUNCTIONS Participate in lymphocyte production Aid in the protection of the body against invading bacteria, viruses, and other foreign protein. Foreign protein (antigens) stimulate the production of antibodies. On the other hand, epithelial erosion would seem to enhance an invasion by microorganisms and the tonsils are known to be frequent portal of infection. THE THYMUS Lymphoepithelial organ. Varies in size and development with the age of the individual. Maximum around puberty, after which it become insconspicuous. It has neither lymph nodules nor sinuses. Two large lobes. Extends from the root of neck into upper part of the thorax, behind the sternum. Composed of thousands of lobules. Peripheral cortical and a central medullary component. A capsule is composed mainly of collagenous fibers and some elastic fibers. The inward extensions from the capsule (septa) delineate the lobules. The reticular cells, which support the parenchyma, arise from entoderm. From: Netter, 2006. CORTEX Thymocytes. The epithelial reticular cells. Retikular tissue (rare). True macrophage in perivascular regions. MEDULLA Thymocytes. The epithelial reticular cells. Small and large lymphocytes. Thymic corpuscles (of Hassal) (20 100 m). It is acidophil and spherical or ovoid structures composed of consentrically arranged epithelial reticular cells. The central cells are large and often show evidence of hyalinization and degeneration into a formless mass that may even undergo calcification. The corpuscle become increasingly. From: Junqueira & Carneiro, 2005. From: Junqueira & Carneiro, 2005. BLOOD VESSELS From the internal thoracic and the inferior thyroid arteries. THE SPLEEN The largest of the lymphoid organs. Collagenous framework within which is suspended a reticular network. Surrounded by the peritoneum. Trabeculae Sinuses. Hilus. FUNCTION OF THE SPLEEN They are not understood completely. Hemopoietic organ. Producing lymphocytes. Produce myeloid element. Separates plasma from the blood cells. Great phagocytic capacity. Production of antibodies. WHITE PULP Central artery, eccentric in position. Small, medium and large size lymphocytes, monocytes and plasma cells. Between the white and red pulp are poorly delineated marginal zone of diffuse lymphatic tissue containing few lymphocytes and numerous macrophages. T Lymphocytes populated the periarteial sheath B Lymphocytes are concentrated in the marginal zones and in the nodules. RED PULP Infiltrated with all element of circulating blood. Numerous venous sinuses. Between the sinuses, the pulp appears as cellular cords (splenic, or Billroths cords). Small, medium and large size lymphocytes. Monocytes also are fairly numerous. Contains numerous plasma cells, granular leukocytes and erythrocytes. Megakaryocytes, myelocytes and erythroblasts. These myeloid element are absent from the spleen in adult humans, except in certain pathological conditions when the spleen undergo myeloid metaplasia. From: Junqueira & Carneiro, 2005. From: Junqueira & Carneiro, 2005. BLOOD VESSELS The arteries enter the spleen at the hilum Terminal arterial capillaries trabeculae (trabeculae/interlobular arteries) the splenic parenchyma (central arteries/arterioles) Red Pulp Penicilli vessels venous sinuses pulp veins
trabecular/interlobular veins Hilus the splenic vein. References Copenhaver, Kelly & Wood. (1971). Baileys textbook of histology. USA: William & Wilkins. Junqueira & Carneiro. (2003). Basic histology text & atlas. NY: McGraw Hill. Lesson, Lesson & Paparo. (1998). Text/atlas of histology. Philadelphia: Saunders. Netter. (2006). Atlas of human anatomy. Philadelphia: Saunders. Putz & Pabst. (2006). Sobotta. Atlas der anatomie des menschen. Munchen: Elsevier. Quade, G. (2008). AIDS-Related Lymphoma Treatment Retrieved: 3 April 2008. From: www.meb.uni- bonn.de/cancer.gov/CDR0000257993.html