Degowin's Diagnostic Examination by Richard F. LeBlond MD MACP & Richard L. DeGowin MD FACP & Donald D. Brown MD FACP

Author:Richard F. LeBlond, MD, MACP & Richard L. DeGowin, MD, FACP & Donald D. Brown, MD, FACP
Language: eng
Format: epub
Publisher: McGraw-Hill
Published: 2009-06-16T16:00:00+00:00

Spleen and Lymphatics

See Chapter 5, page 92ff for a discussion of the lymph nodes.

The spleen is the largest lymphatic organ. It has a complex sinusoidal structure that serves several functions. Arterial blood is distributed into sinusoids where senescent red blood cells, intracellular inclusions, and membrane abnormalities are removed. The spleen is important in the generation of specific humoral immune responses to encapsulated bacteria and their removal from the blood. The abdominal organs are rich in lymphatics. The lymphatic capillaries drain into regional lymph nodes located at the hila of solid organs and in the mesentery of the bowel. These drain into the periaortic nodes, which also receive lymph from the lower extremities and pelvis. The periaortic nodes drain cephalad toward the thoracic duct. Few specific symptoms arise from alterations in these organs. Enlargement of the spleen will be felt as upper abdominal fullness, and retroperitoneal lymph node enlargement can present as flank and back pressure or pain. Fever, weight loss, and sweats may be the only symptoms of intraabdominal lymphoma. Moderate splenomegaly can be detected by physical examination, but intraabdominal lymph nodes are rarely palpable.

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