淋巴造血系统结构

nullnullDISEASES OF LYMPHOID AND HEMATOPOIETIC TISSUES / SYSTEM 淋巴造血组织／系统疾病 淋巴网状组织：结构和功能天津医科大学 病理学教研室nullORGANS 器 官 ⑴Reactive hyperplasia (benign) Thymus 胸腺 反应性增生(良性) Spleen 脾 Lymph nodes 淋巴结① ⑵Neoplastic hyperplasia (malignant：Lymphoma) Tonsils 扁桃体 肿瘤性增生(恶性：淋巴瘤) DISSEMINATED 散在性 Hodgkin lymphoma 霍奇金淋巴瘤(HL) all over the body Non-Hodgkin lymphoma 非霍奇金淋巴瘤(NHL) Skin 皮肤 B-cell neoplsms B细胞淋巴瘤 GI 消化道 T/NK-cell neoplsms T/NK细胞淋巴瘤 RS 呼吸系统 Lymphocytic leukemia 淋巴细胞性白血病② US 泌尿系统 Histiocytic & Dendritic cell neoplasms CNS 中枢神经系统 组织细胞和树状突细胞肿瘤 Others ① usually Lymphadenopathy 淋巴结病(淋巴结肿大) ②arising from BM LYMPHOID TISSUE 淋巴组织null周身淋巴组织的分布nullTransformation of lymphocytes 淋巴细胞转化 淋巴细胞转化：B细胞淋巴细胞转化：B细胞培养中的淋巴细胞， 受植物血凝素作用后： A.0小时 B.1小时 C-F.24小时淋巴细胞转化淋巴细胞转化依Lennert(1975)淋巴细胞系：一些细胞类型的光镜形态淋巴细胞系：一些细胞类型的光镜形态nullMucosa-associated lymphoid tissues (MALT) 黏膜相关淋巴组织恶 性 淋 巴 瘤：概 述恶 性 淋 巴 瘤：概 述黏膜相关淋巴组织FCMZMAR黏膜相关淋巴组织黏膜相关淋巴组织null黏膜相关淋巴组织淋巴瘤[MALToma]胃MALToma ：淋巴上皮病变腮腺MALToma ：淋巴上皮病变乳腺MALToma ：淋巴上皮病变子宫内膜MALToma：淋巴上皮病变nullLymph Nodes 淋 巴 结null1. Fibrous frame 纤维性网架 Capsule 包膜 Trabeculum 小梁 Reticular fibers 网状纤维 2. Lymphoid parenchyma 淋巴组织实质 3. Lymph drainage 淋巴引流路径 4. Blood circulation 血液循环nullnullnull (1)CORTEX 皮质 Follicles 滤泡[B cell zone B细胞区] : Primary F 初级滤泡: · Virgin B cells 童真性B细胞 · Mature B cells 成熟B细胞 · Follicular dendritic cells 滤泡性树状突细胞(FDC)* (CD21+) Secondary F 次级滤泡: Mantle zone 套层 ·Mantle cells 套细胞(Small lymphocytes 小淋巴细胞, IgM+D) Germinal center 生发中心 ·Centroblasts 中心母细胞 ·Centrocytes 中心细胞(CD10+，IgM＋, Ig＋, IgA＋ or IgE＋, IgD－) ·Follicular dendritic cells 滤泡性树状突细胞(FDC)* (CD21+) ·T lymphocytes T淋巴细胞(CD10 strongly +; usually CD4+/helper and CD57+) ·Histiocytes 组织细胞 ·Tingible body macrophages 可染小体巨噬细胞(CD68+) Marginal zone 边缘区 ·Marginal zone cells 边缘区细胞 / ·Monocytoid B cells 单核细胞样B细胞(IgM＋) Interfollicular zone滤泡间区 [T cell zone T细胞区] ·T lymphocytes T淋巴细胞(CD4>CD8) ·Interdigitating dendritic cells (2)PARACORTEX 副皮质(Deep cortex 深皮质) 交指样树状突细胞(IDC)*(S-100+) ·Transformed B cells 转化性B淋巴细胞 (3)MEDULLA PCV＃ 毛细血管后小静脉 Medullary cords 髓索 [B cell zone B细胞区] : ·Plasmacytoid lymphocytes 淋巴浆细胞样淋巴细胞 (CD20 ＋,IgM+) ·Plasma cells 浆细胞(CD38+,CD138+,IgG+,κ+/λ+) *FCD,ICD and LC(Langerhans cells): Accessary cells of immunity 免疫辅佐细胞 ＃PCV=Postcappillary venules (High endothelial venules,HEV 高内皮小静脉 )Lymphoid parenchyma 淋巴组织实质nullCortex 皮质：Primary Follicles 初级滤泡nullThe evolution of follicles 淋巴滤泡的演化nullDirection of antigen influxMantle zone thicker at the top ("corona")Light zone of germinal centerDark zone of germinal center (more large cells)nullLight zoneDark zoneStary skyStary skyCentrocytesCentroblastsTingible body cellsnullFDCFDCCD21(FDC)中心母细胞／中心细胞浆母细胞CD20(B cdlls)CD45RO(T cells)Organization of secondary lymphoid follicleOrganization of secondary lymphoid follicleMarginal zone cells (IgM)Mantle zone cells (IgM+D)Follicle center cells (IgM, IgG, IgA or IgE, not IgD)nullMentle zone/Mentle cells 淋巴滤泡：套层/套细胞Marginal zone / Marginal cells (Monocytoid B cells) 淋巴滤泡：边缘区/边缘区细胞 (单核细胞样B细胞)****nullMaCMCaS MaCMCaS nullMantle zone／Mantle cellsnullMantle zoneMarginal zonenullParacortexnullParacortexnullIDCParacortexnullCD3nullCD20nullSinus histiocytesMedullary cords/Plasma cellsnullAfferent lympatics → Sinuses → Efferent lympatic 输入淋巴管 淋巴窦 输出淋巴管 SINUSES: Supcapsular/Peripheral S 包膜下窦/边缘窦 ↓ Paratrabecular/Intermediate S 小梁旁窦/中间窦 Sinus ↓ histiocytes Medullary S 髓窦 ↓ Hilar S 门窦 Artery → Capillaryies→ Postcapillary venules(PCV *) → Vein 动脉 毛细血管 毛细血管后小静脉 静脉 *PCV=Postcappillary venules (High endothelial venules,HEV 高内皮小静脉 / Epithelioid venules,EV上皮样小静脉 ) in the paracortex: permitting lymphocytes to traffic through them/ recirculation passage of lymphocytesLymph drainage 淋巴引流/ Blood circulation血液循环nullSinusnullMarginal sinusSnullSinus histiocytesnullnullPCV