When the Flow Gets Blocked: Enlarged Lymph Nodes, Lymphoma and Drainage Problems in the Lymphatic System.

This is the second post in a two part series on the lymphatic system. Check out Part 1 (The Lymphatic System’s Hidden Talents) for background on how this system functions.

Your lymphatic system plays three main roles in your body. It clears out a fluid called lymph, it plays a big role in your body’s immunity, and it transports fat to allow it to be used by your body. Did you realize that the lymphatic system did so much? It is really amazing. This also means that when it is not working properly it can affect our body in numerous ways. Now let’s jump in and discuss some of the more common impairments that occur in the Lymphatic System.

Lymphadenopathy (Enlarged Lymph Nodes)

This is probably the most common thing that comes to mind when we talk about the lymphatic system. This is something that your doctor will frequently feel for under your chin, in your neck and around your collarbone when you have a checkup. You have approximately 800 lymph nodes within your body. Many are concentrated around your neck, under your arms and in your groin area. This means that if there is an enlarged node in this area your healthcare team may be able to find it by touch. An enlarged lymph node often means that your body is doing it’s job of recognizing an invading bacteria and attacking and removing it as we discussed in the Lymphatic System post. However, this can be a signal to your doctor to look closer at what is causing the lymph node to be enlarged.

The location of the swollen lymph node can help to clue your doctor in to where an infection has occurred. For instance, when your body is fighting off an infection in your upper respiratory tract the lymph nodes in your neck will often be swollen. This is caused by your white blood cells traveling to that area to help fight off the infection. This again, means that your body is working as it should and the lymph node should only be swollen for a short period of time.

When swollen lymph nodes are found in different parts of a person’s body simultaneously this is a higher cause for concern. This can indicate a disease that is throughout their entire body. Some examples include human immunodeficiency virus, autoimmune diseases (such as lupus), and cancer.

Lymphedema (Fluid Accumulation)

When we understand that a main function of the Lymphatic System is to return fluid to the vascular system so that it is not just hanging out in the tissues, it makes sense that if the system was not working right we would see an increase of fluid volume in the tissues. This is most commonly seen in the extremities (your arm or leg). As more and more fluid leaves your capillaries without being able to return to your blood supply your extremity will begin to swell due to the fluid volume in your tissues.

Lymphedema (swelling caused by lymph fluid) happens when something causes the lymphatic system to be unable to drain the lymph fluid from the tissues and return it back to your bloodstream. This can happen for many different reasons. For instance, some surgeries for breast cancer can affect the lymphatic system. Other causes could be infected lymphatic vessels, scar tissue, or obstructive lesions. Cancer of the lymphatic system itself (lymphoma) can cause lymph nodes to need to be removed. This can cause blockages to the system and lead to lymphedema as fluid is no longer able to drain as it is intended to.

Lymphoma (Lymphatic System Cancer)

Your immune system utilizes a white blood cell called a lymphocyte to make antibodies and destroy infected cells. Lymphoma causes abnormal lymphocytes. These abnormal cells continue to replicate within a person’s lymphatic system at an uncontrolled rate. They can build up within a person’s lymph nodes and cause a tumor. There are many different types of lymphoma depending on which type of lymphocyte is impacted (B cell or T cell) and how it affects the lymphatic system. For example lymphoma that causes your B cells to create and replicate a specific abnormally large cell are considered Hodgkin Lymphomas. Lymphoma that affects B or T cells to mutate and change are considered Non-Hodgkin Lymphomas. There are many subtypes of lymphoma and these vary on how quickly they spread and what part of the lymphatic system that they are located in.

Intestinal Lymphangiectasia

We saw above that a blocked lymph node and vessels can lead to fluid accumulation in an extremity. But what happens when the vessels that drain the lymph fluid from the lacteals of your small intestine become blocked? These lacteals are what allow fat and fat-soluble vitamins to be absorbed into your body. When these are unable to function properly, you will see a decrease in the absorption of fat and fat-soluble vitamins, a loss of protein, and lymph leaking into the small intestine.

As we have seen, the lymphatic system plays a major role in keeping our body healthy and functioning. It is always a good idea to get any concerning symptoms or “lumps” checked out by your healthcare team.