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The gut-associated lymphoid tissue lies throughout the intestine, covering an area of approximately 260–300 m 2. [5] In order to increase the surface area for absorption, the intestinal mucosa is made up of finger-like projections (), covered by a monolayer of epithelial cells, which separates the GALT from the lumen intestine and its contents.
The intestinal trunk receives the lymph from the stomach and intestine, from the pancreas and spleen, and from the lower and front part of the liver, and empties lymph into the cisterna chyli, which in turn drains into the thoracic duct.
The ileocolic lymph nodes, from ten to twenty in number, form a chain around the ileocolic artery, but tend to subdivide into two groups, one near the duodenum and the other on the lower part of the trunk of the artery. Where the vessel divides into its terminal branches the chain is broken up into several groups:
Colorectal cancer may metastasise to the inferior mesenteric lymph nodes. For this reason, the inferior mesenteric artery may be removed in people with lymph node-positive cancer. [3] This has been proposed since at least 1908, by surgeon William Ernest Miles. [4]
The solitary lymphatic nodules are found scattered throughout the mucous membrane of the small intestine, but are most numerous in the lower part of the ileum.. Their free surfaces are covered with rudimentary villi, except at the summits, and each gland is surrounded by the openings of the intestinal glands.
Peyer's patches are observable as elongated thickenings of the intestinal mucosa measuring a few centimeters in length. About 100 are found in humans. Microscopically, Peyer's patches appear as oval or round lymphoid follicles (similar to lymph nodes) located in the mucosa layer of the ileum and extend into the submucosa layer.
The mucosa-associated lymphoid tissue (MALT), also called mucosa-associated lymphatic tissue, is a diffuse system of small concentrations of lymphoid tissue found in various submucosal membrane sites of the body, such as the gastrointestinal tract, nasopharynx, thyroid, breast, lung, salivary glands, eye, and skin.
Lymph nodes are particularly numerous in the mediastinum in the chest, neck, pelvis, axilla, inguinal region, and in association with the blood vessels of the intestines. [ 8 ] The substance of a lymph node consists of lymphoid follicles in an outer portion called the cortex .