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The lymphatic system is part of the circulatory system, comprising a network of conduits [1] called lymphatic vessels that

carry a clear fluid called lymph (from Latinlympha "water goddess" ) directionally towards the heart. The lymphatic system was first described in the seventeenth century independently by Olaus Rudbeck and Thomas Bartholin. The lymph system is not a closed system. The circulatory system processes an average of 20 liters of blood per day through capillary filtration which removes plasmawhile leaving the blood cells. Roughly 17 liters of the filtered plasma actually get reabsorbed directly into the blood vessels, while the remaining 3 liters are left behind in the interstitial fluid. The primary function of the lymph system is to provide an accessory route for these excess 3 liters [2] per day to get returned to the blood. Lymph is essentially recycled blood plasma. Lymphatic organs play an important part in the immune system, having a considerable overlap with the lymphoid system. Lymphoid tissue is found in many organs, particularly the lymph nodes, and in the lymphoid follicles associated with the digestive system such as the tonsils. Lymphoid tissues contain [3] lymphocytes, but they also contain other types of cells for support. The system also includes all the structures dedicated to the circulation and production of lymphocytes (the primary cellular component of lymph), which includes the spleen, thymus, bone marrow, and the lymphoid tissue associated with the [4] digestive system.

the main function of the lymphatic system is to collect and transport tissue fluids from the intercellular spaces in all the tissues of the body, back to the veins in the blood system; it plays an important role in returning plasma proteins to the bloodstream; digested fats are absorbed and then transported from the villi in the small intestine to the bloodstream via the lacteals and lymph vessels. new lymphocytes are manufactured in the lymph nodes; antibodies and anti (manufactures in the lymph nodes) assist the body to build up an effective immunity to infectious diseases; lymph nodes play an important role in the defence mechanism of the body. They filter out micro-organisms (such as bacteria) and foreign substances such as toxins, etc. it transports large molecular compounds (such as enzymes and hormones) from their manufactured sites to the bloodstream.

SPLEEN The spleen (from Greek spln ) is an organ found in virtually all vertebrateanimals. Similar in structure to a large lymph node, the spleen acts primarily as a blood filter. As such, it is a non-vital organ, with life possible after removal. The spleen plays important roles in regard to red blood cells (also referred [2] to as erythrocytes) and theimmune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shockwhile also recycling iron. As a part of the mononuclear phagocyte system, it metabolizes hemoglobin removed from senescent erythrocytes. The globin portion of hemoglobin is degraded to its constitutive amino acids, and the heme portion is metabolized to bilirubin, which is subsequently shuttled to the liver for [3] removal. It synthesizes antibodies in its white pulp and removes antibody-coated bacteria along with antibody-coated blood cells by way of blood and lymph node circulation. The spleen is brownish in [3][4] color. A study published in 2009 using mice showed it has been found to contain in its reserve half of [5] the body's monocytes within the red pulp. These monocytes, upon moving to injured tissue (such as the [5][6][7] heart), turn into dendritic cellsand macrophages while promoting tissue healing. It is one of the
[1]

centers of activity of the reticuloendothelial system and can be considered analogous to a large lymph [8] node, as its absence leads to a predisposition toward certain infections.
LYMPH NODES

A lymph node is an organized collection of lymphoid tissue, through which the lymph passes on its way to returning to the blood. Lymph nodes are located at intervals along the lymphatic system. Severalafferent lymph vessels bring in lymph, which percolates through the substance of the lymph node, and is drained out by an efferent lymph vessel. The substance of a lymph node consists of lymphoid follicles in the outer portion called the "cortex," which contains the lymphoid follicles, and an inner portion called "medulla," which is surrounded by the cortex on all sides except for a portion known as the "hilum." The hilum presents as a depression on the surface of the lymph node, which makes the otherwise spherical or ovoid lymph node bean-shaped. The efferent lymph vessel directly emerges from the lymph node here. The arteries and veins supplying the lymph node with blood enter and exit through the hilum. Lymph follicles are 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 upon encountering a foreign antigen. The selection of B cells occurs in the germinal center of the lymph nodes. Lymph nodes are particularly numerous in the mediastinum in the chest, neck, pelvis, axilla (armpit), [4] inguinal (groin) region, and in association with the blood vessels of the intestines. [edit]Lymphatics

Immune system The immune system is a system of biological structures and processes within anorganism that protects against disease. To function properly, an immune system must detect a wide variety of agents, from viruses to parasitic worms, and distinguish them from the organism's own healthy tissue. Pathogens can rapidly evolve and adapt to avoid detection and neutralization by the immune system. As a result, multiple defense mechanisms have also evolved to recognize and neutralize pathogens. Even simple unicellular organisms such asbacteria possess a rudimentary immune system, in the form of enzymes that protect against bacteriophage infections. Other basic immune mechanisms evolved in ancienteukaryotes and remain in their modern descendants, such as plants and insects. These mechanisms include phagocytosis, antimicrobial peptides called defensins, and the complement system. Jawed vertebrates, including humans, have even more sophisticated defense [1] mechanisms, including the ability to adapt over time to recognize specific pathogens more efficiently. Adaptive (or acquired) immunity createsimmunological memory after an initial response to a specific pathogen, leading to an enhanced response to subsequent encounters with that same pathogen. This process of acquired immunity is the basis of vaccination. Role of lymph nodes The role of lymph node dissection (LND) in patients with locally advanced non-metastatic renal cell 1 carcinoma (RCC) is controversial. Employing an all or none practice will either expose a majority of

patients to an unnecessary and potentially morbid procedure or will deny a small proportion of patients an opportunity for a therapeutic procedure leading to a cure. In the absence of a clinical trial assessing the role of LND in patients at high risk for lymph node metastases, a reasonable approach is to use available retrospective data to guide clinical decision making. Recent additions to the literature have attempted to provide guidance on many of the challenging issues surrounding LND in high-risk RCC including: 2,3 identification of the patients at the highest risk of harboring nodal metastasis, definition of the extent of lymphadenectomy and application of this consistently regardless of 4 surgical approach, and demonstration that a reasonable proportion of patients will derive a durable therapeutic benefit 5,6 from the procedure.

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