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Lymphokinetic motion (flow of the lymph) due to:

1) Lymph flows down the pressure gradient.
2) Muscular and respiratory pumps push lymph forward due to function of the semilunar valves.

Other lymphoid tissue:

1. Lymph nodes: Lymph nodes are small encapsulated organs located along the pathway of lymphatic vessels. They vary from about 1 mm to 1 to 2 cm in diameter and are widely distributed throughout the body, with large concentrations occurring in the areas of convergence of lymph vessels. They serve as filters through which lymph percolates on its way to the blood. Antigen-activated lymphocytes differentiate and proliferate by cloning in the lymph nodes.

2. Diffuse Lymphatic Tissue and Lymphatic nodules: The alimentary canal, respiratory passages, and genitourinary tract are guarded by accumulations of lymphatic tissue that are not enclosed by a capsule (i.e. they are diffuse) and are found in connective tissue beneath the epithelial mucosa. These cells intercept foreign antigens and then travel to lymph nodes to undergo differentiation and proliferation.

Local concentrations of lymphocytes in these systems and other areas are called lymphatic nodules. In general these are single and random but are more concentrated in the GI tract in the ileum, appendix, cecum, and tonsils. These are collectively called the Gut Associated Lymphatic Tissue (GALT). MALT (Mucosa Associated Lymphatic Tissue) includes these plus the diffuse lymph tissue in the respiratory tract.

3. The thymus: The thymus is where immature lymphocytes differentiate into T-lymphocytes. The thymus is fully formed and functional at birth. Characteristic features of thymic structure persist until about puberty, when lymphocyte processing and proliferation are dramatically reduced and eventually eliminated and the thymic tissue is largely replaced by adipose tissue.

The lymphocytes released by the thymus are carried to lymph nodes, spleen, and other lymphatic tissue where they form colonies. These colonies form the basis of T-lymphocyte proliferation in the specific immune response. T-lymphocytes survive for long periods and recirculate through lymphatic tissues.

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Lymphatic System Cleansing

As all patients who have had lymph nodes removed know, circulation is generally worse after the loss of nodes: swelling, serious edema, and the need for medical procedures to remove fluids are all part of the aftermath of these procedures.

I am not in a position to evaluate the merits of the surgical measures. I merely sympathize with the suffering of the patients. They often have reddish swelling, intense itching, rashes, and loss of motion.
There are specialists in manual lymphatic drainage, a very delicate massage technique taught in Austria (called the Vodder method) who are trained to help reroute lymph flow so as to by-pass the normal channels, the ones that have been removed.

Though people who are specialists in this method are reluctant to state opinions, many have theorized that when malignancy is found in the lymph that the lymph nodes are doing exactly what they are supposed to be doing. In other words, it is not 100% clear to them that the cancer has metastasized, merely that it has accumulated in the lymph.

Given that we do not understand these fine points well enough to be certain, it would seem appropriate that patients who have not yet had surgery try to move as much lymph through the body as possible to see if the swelling subsides. For those who feel they are at risk for cancer, periodic lymphatic stimulation and/or drainage may be a healthy preventative measure. Once, however, the nodes are gone, it is more uphill.

One very simple but probably only minimally helpful exercise is to hold the affected (swollen) area upwards to see if gravity will permit some of the lymph to descend into areas that still have adequate drainage.

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