HISTOLOGI SEL & ORGAN PADA SISTEM LIMFOID

Nur Signa Aini Gumilas Bagian Histologi Kedokteran FKIK Unsoed

Lymphoid tissue: primary and secondary sites

Primary lymphoid tissue - Bone marrow - Thymus Secondary lymphoid tissue (SLT) - Spleen - Lymph nodes (LN) - Mucosa-associated lymphoid tissues (MALT) : Bronchial associated lymphoid tissue (BALT), Nasopharyngeal-associated lymphoid tissue (NALT), Gut associated lymphoid tissue (GALT), Peyers patches (PP)

 Sistem imun t.a. struktur & sel yg didistribusikan ke seluruh tbh, dimana fxnya adlh : melindungi organisme (tbh) thdp invasi dan perusakan oleh mikroorganisme & zat asing.

 Sistem imun ini meliputi baik struktur tunggal (nodus limfatikus, limfa) dan sel bebas (sel limfosit, sel fagosit mononukleus & jaringan penyambung).

 Suatu sistem yg berperan utama dalam sistem imun ini adalah sistem limfatik. Sistem limfatik meliputi : 1. Cairan limfe 2. Jaringan pembuluh limfe 3. Sel limfosit 4. Jaringan & organ limfatik 5. Sumsum tulang

The lymphoid organs and lymphatic vessels are widely distributed in the body. The lymphatic vessels collect lymph from most parts of the body and deliver it to the blood circulation primarily through the thoracic duct.

Cells and organs of the immune system

Lymphocytes mature in the bone marrow of the thymus
(primary lymphoid organs)

and then congregate in lymphoid tissues throughout the body

(secondary/ peripheral lymphoid organs)
The distribution of lymphoid tissues in the body

Primary lymphoid organs

Secondary lymphoid organs

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Cells and organs of the immune system

The cells of the immune system derive from precursors in the bone marrow

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Cells and organs of the immune system

The cells of the immune system derive from precursors in the bone marrow

Bome marrow Primary lymphoid organs

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Cells and organs of the immune system

Thymus Primary lymphoid organs

Development of T lymphocytes Chapter 7

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Cells and organs of the immune system

All the cellular elements of the blood including the cells of the immune system arise from pluripotent hematopoietic cells in the bone marrow

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Cells and organs of the immune system

The myeloid lineage comprises most of the innate immune system

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Cells and organs of the immune system

The myeloid lineage comprises most of the innate immune system

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Cells and organs of the immune system

The myeloid lineage comprises most of the innate immune system

Granulocytes or Polymorphonuclear (PMN) leukocytes

Chapter 2
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Cells and organs of the immune system

The myeloid lineage comprises most of the innate immune system

Granulocytes or Polymorphonuclear (PMN) leukocytes

Chapter 9 and 13
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Cells and organs of the immune system

The myeloid lineage comprises most of the innate immune system

Granulocytes or Polymorphonuclear (PMN) leukocytes

Chapter 9 and 13
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Cells and organs of the immune system

The myeloid lineage comprises most of the innate immune system

Chapter 13
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Cells and organs of the immune system

The lymphoid lineage comprises the lymphocytes of the adaptive immune system and the natural killer cells of innate immunity

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Cells and organs of the immune system

Lymphocytes are mostly small and inactive cells Stimulation induce lymphocyte to become active
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Sel Limfosit
Semua limfosit berasal dari sumsum tulang migrasi. Terdiri atas Limfosit T, Limfosit B & sel NK (Natural killer). Limfosit T (pematangan di timus) (sel imunokompeten) terutama berperan dalam imunitas selular, bereaksi melawan dan membunuh mikroorganisme. Ex : pd keadaan inflamasi. Limfosit B (pematangan di sumsum tulang) terutama berperan dalam imunitas humoral, saat terstimulasi dpt berdiferensiasi mjd. sel plasma dan dpt menghasilkan antibodi/imunoglobulin (Ig). Sel NK, dikenal sebagai sel besar bergranula, bereaksi melawan virus, kanker.

Origin of the main types of lymphocytes. B lymphocytes and natural killer lymphocytes are formed in the bone marrow and leave the bone marrow already mature, to seed the secondary lymphoid organs and transit through the blood, epithelia, and connective tissues. Immature CD4 and CD8 T lymphocyte precursors are transported by the blood circulation from the bone marrow to the thymus, where they complete their maturation and leave as either CD4+ or CD8+ cells.

Jaringan & Organ Limfatik

Jaringan & organ limfoid terbagi mjd :
Jaringan limfoid terkait mukosa (tidak berkapsul)
Contoh : tonsila, plak Peyeri dlm mukosa usus halus, jaringan limfoid di apendiks, jaringan limfoid di saluran pernafasan, dll.

Organ limfoid (berkapsul)

Contoh : limfonodus, timus, lien/limpa

TONSILA
Mrkpn jar. limfoid terkait mukosa, berkontak dgn epitel sal. cerna (ep. skuamus kompleks non keratin) atau epitel sal. pernafasan (ep. kolumner pseudokompleks bersilia), & pd lamina propria (jar. ikat) tersebar di antaranya kelompok2 nodulus limfatikus & limfosit. Kadang limfosit sampai menerobos epitel. 3 kelompok besar tonsila : tonsila palatina, tonsila faringeal, & tonsila lingualis

 Tonsila palatina : terletak pd dinding lateral faring bagian oral. jar. limfoid yg berupa nodulus2 dgn pusat germinal yg lebih pucat, terletak di bawah epitel skuamus kompleks berkeratin, & dipisahkan oleh jar ikat (lamina propria). Tonsil membentuk kripte, suatu invaginasi epitel ke dalam parenkim, dimana mengandung sel2 epitel yg terlepas, limfosit hidup/mati, & bakteri dlm lumennya.

TONSILA PALATINA

 Tonsila faringeal : mrpkn tonsila tunggal terletak pd supero-posterior faring. Ditutupi o. epitel kolumner pseudokompleks bersilia. T.a. lipatan2 mukosa dgn jar. limfoid difus & nodulus limfatikus. Tidak mempnyai kriptus.

TONSILA FARINGEAL

 Tonsila lingualis : terletak di pangkal lidah. Ditutupi oleh ep. skuamus kompleks non keratin, membentuk kriptus. Di bawahnya pd lamina propria tersebar nodulus limfatikus.

TONSILA LINGUALIS

Plak Payeri
Plak Payeri adlh kumpulan limfoid besar yg ditemukan dlm mukosa usus halus.

LIMFONODUS
Mrpkn. organ limfoid (bersimpai/berkapsul), btk mirip ginjal, tersebar di tubuh sepanjang jalannya pembuluh limfe. Sebagian besar tdpt. pd. lipatan aksila, lipatan paha, leher, di abdomen (mesenterium) & thorak. Nodus limfatikus mempnyai sisi konveks (tmpt masuk cairan limfe/pemb limfe aferen) & sisi konkaf (hilum). Hilum mrpkn tmpt aliran arteri masuk, tmpt aliran vena keluar & tmpt keluarnya cairan limfe/pemb limfe eferen.

Lanjutan Limfonodus
Jaringan ikat kapsul mengelilingi setiap nodus, membentuk trabekula yg masuk ke bagian dalam. Setiap nodus mengandung : korteks luar, korteks dalam & medula. Korteks :
Korteks luar : pd. permukaan korteks luar tdpt sinus subkapsularis yg dibentuk o. sel retikular, serat retikular, makrophag. Sinus subkapsularis berhub dengan sinus medularis melalui sinus intermedia. Pd korteks luar banyak tdpt sel limfosit B, & nodulus limfatikus. Korteks dalam (parakortikal) : Tdpt nodulus & mengandung limfosit T.

Lanjutan Limfonodus
Medula : t.a. korda medularis (yaitu su cab. perluasan dari korteks), dan korda medularis ini dipisahkan o/ sinus medularis. Sinus ini mengandung limfosit B & sel plasma, cairan limfe, & tersusun atas sel retikular, serat retikular & makrophag.

LIMFONODUS

LIMFONODUS

Sirkulasi
Aliran cairan limfe dibawa o. pemb. limfe aferen, masuk melalui sisi konveks nodus limfatikus sinus subkapsular nodus pd korteks luar nodus pd korteks dlm (parakortikal) sinus medula dikumpulkan o. pemb limfe eferen hilus.

Schematic representation of the structure of a lymph node. The left half of the figure shows the primary components of the organ and the circulation of lymph within a lymph node, entering through the convex side of the node and leaving through the hilum. The right half depicts part of the blood circulation.

Histopatologi
Fungsi nodus limfatikus :
Sebagai penyaring partikel asing (99%) sebelum kembali ke sistem sirkulasi darah. Sebagai sistem deteksi dini jika ada infeksi atau kelainan patologi pd jaringan/organ. Dilihat pd letaknya (perifer & organ2 yg kemungkinan besar mudah terkena infiltrasi partikel asing) deteksi dini.

Lanjutan Histopatologi
Infeksi & perangsangan antigenik menyebabkan nodus limfatikus membesar & membentuk pusat2 germinativum yg banyak dgn ploriferasi sel yg aktif.

Sistem Vaskular Limfatik

Pembuluh limfe membawa cairan limfe dari perifer ke sistem venosus. T.a. : pembuluh kapiler limfe, pembuluh kecil limfe & pembuluh besar limfe/duktus limfatikus (duktus torasikus). Pembuluh kapiler limfe : berasal dari jaringan perifer, t.a. selapis sel endotel yg pd tepiannya saling menumpuk, lamina basalnya terputus2 & adanya serabut penambat. Struktur tsb diatas menyebabkan kapiler limfe mudah menyerap cairan dan zat terlarut spt protein, virus, bakteri & debris, serta mencegahnya utk kembali ke jaringan/cairan ekstraseluler.

 Pembuluh kecil limfe : struktur serupa dgn vena, kecuali bhw dindingnya lebih tipis & tdk ada pemisahan jelas di antara ketiga lapis (intima, media & adventisia). Mempnyai bnyk katup intern. Aliran limfe ini jg dibantu o. kontraksi otot rangka pd dindingnya & kontraksi otot polos dlm dinding pembuluh limfe

 Struktur duktus limfatikus mirip dgn vena, hny ada penambahan otot polos pd lapisan media. Struktur otot memanjang & melingkar. Adventisia relatif tdk berkembang.

Pembuluh Limfe

This plate shows an afferent lymphatic vessel near a lymph node. The lymph vessel is lined with endothelium and has a valve that opens toward the node. The valve is a fold of that part of the vessel wall known as the intima. Valves, by preventing retrograde flow, are essential for the movement of lymph to major lymphatic trunks. Lymph is formed in part from materials and fluid that leave the capillaries and venules of the blood vascular system.

LIMPA
Mrpkn organ limfoid terbesar, bnyk m.) sel fagositik. Fx : pertahanan thdp mikroorganisme yg msk ke sistem sirkulasi, tmpt pembentukan & pengaktifan limfosit, tmpt destruksi bagi eritrosit. Struktur umum : limpa dibungkus o. kapsul jar. ikat yg menjulurkan trabekula yg membagi parenkim mjd kompartemen2. Terdiri atas pulpa putih & pulpa merah.

Sirkulasi Darah Limpa

Arteri lienalis msk melalui hilum arteri trabekula arteri sentralis/arteri pulpa putih meninggalkan pulpa putih, bercabang membentuk arteri penisili kapiler arteri sederhana yg mencurahkan darah ke dalam sinusoid (sinus pulpa merah), yg terletak di antara korda pulpa merah. Cara pengaliran :
Sirkulasi tertutup : kapiler lngsng mencurahkan isinya ke dlm sinusoid Sirkulasi terbuka : darah merembes melalui celah2 di antara sel2 korda pulpa merah & kemdn ditampung di dlm sinusoid.

Bukti2 terakhir menyatakan bhw sirkulasi limpa manusia adalah yg sirkulasi terbuka. Stlh dari sinusoid, darah menuju ke vena pulpa merah msk ke trabekula membentuk vena trabekularis hilum sebagai vena lienalis.

Schematic view of the blood circulation and the structure of the spleen. To understand the structure of the white and red pulp follow the flow of the blood from the trabecular artery to the trabecular vein. Theories of open and closed circulation are represented. Splenic sinuses (S) are indicated. PALS, periarterial lymphatic sheath. (Redrawn and reproduced, with permission, from Greep RO, Weiss L: Histology, 3rd ed. McGraw-Hill, 1973.)

Pulpa Putih
T.a. jar. limfoid yg menyelubungi arteri sentralis. Sel2 limfoid yg mengelilingi arteri sentralis (periarterial lymphatic sheath/PALS) terutama adlh limfosit T. Sedangkan pulpa putih perifer (peripheral white pulp) terutama tersusun oleh limfosit B.

Pulpa Merah
T.a. jaringan retikular membtk korda limpa(korda Billroth). Selain sel & serat retikular jg tdpt makrophag, limfosit, sel plasma & sel2 darah (eritrosit, trombosit, granulosit). Sinusoid yg berjalan memanjang tersusun o. sel endotel & diselubungi jar. ikat retikular.

SPLEEN; Capsule

Mesothelium: A single layer of mesothelial cells that covers the free surface of the spleen except at the hilum. Capsule: Dense fibroelastic tissue containing some smooth muscle fibers. Red pulp: Loosely textured lymphatic tissue. Formed of anastomosing cords of tissue (Billroth's* or splenic cords) rich in cells that separate the venous sinuses.

LIMPA

The spleen is the largest single accumulation of lymphoid tissue in the human body. it is also the most important in-line filter for the blood vascular system. Its primary function is to remove (1 X 10 6/second) wornout red blood cells and to store and recycle their component parts. Iron is removed from heme, conserved, and reused within the bone marrow to synthesize new hemoglobin. Hemoglobin (without the iron) is converted into bilirubin, which is excreted by the liver as a part of bile.

LIMPA
White pulp: Compact lymphatic tissue sheath surrounding the central arteriole. This sheath forms ovoid enlargements at intervals. The enlargements, known as lymphatic nodules, splenic nodules or Malpighian* corpuscles, may have germinal centers. Blends into the adjacent red pulp. Lymphocytes are the predominant cellular element, but plasma cells, macrophages, and other free cells are also found.

HISTOFISIOLOGI
Pembentukan & pengaktifan limfosit tjdnya proses metaplasia mieloid pd keadaan leukimia. Dekstruksi eritrosit menghasilkan bilirubin yg dikeluarkan dlm empedu o. sel2 hati. Pertahanan organisme : mengandung limfosit B dan T fagositik organisme asing.

TIMUS
Timus adlh organ limfoidepitelial yg terletak di mediastinum, mencapai puncak perkembangan selama usia muda dan mengalami involusi setelah pubertas. Memiliki suatu kapsul jar. ikat yg masuk ke dlm parenkim & membagi timus dlm lobulus2. Setiap lobulus memiliki korteks (zona perifer gelap) & medula (zona pusat terang).

 Korteks Timus : t.a. limfosit T, makrophag & sel retikuler epitel yg tersebar. Sel retikuler adlh sel stelata dgn inti oval yg berwrn pucat. Sel stelata saling bergandengan dgn sel stelata lain yg berdekatan melalui desmosom. Fungsi sel retikuler adlh sbg barier sawar darah & sekresi hormon. Selama masa embrionik & pubertas, tjd proliferasi limfosit yg aktif pd korteks stlh matur, limfosit meninggalkan korteks menuju medula.

 Medula Timus : me.) limfosit & sel retikular epitel. Sel2 dlm medula tidak berkumpul padat, memberikan rupa lebih terang pd daerah ini. Struktur khas : badan Hassal, yg mrpkn sel retikular epitel yg tersusun konsentris, yg berdegenerasi & penuh dgn granula keratohialin.

TIMUS
Human infant, 10% formalin, A. 35 x., B. 55 x., C. 87 x. The primary function of the thymus is to produce immunocompetent T lymphocytes.

TIMUS
In A, note the cortex of the thymic lobule, composed of densely packed lymphatic tissue, and the medulla, composed of looser lymphatic tissue containing Hassall's corpuscles. The latter are diagnostic for the thymus. They vary in size and are formed of concentrically arranged polygonal or flattened cells with a hyalinized degenerated core. In B, a Hassall's* corpuscle is seen at higher magnification. Note also the abundance of lymphocytes and the epithelial reticular cells. The latter are characterized by a large pale nucleus and are derived from embryonic entoderm rather than from

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