Lymph nodes function to remove debris and pathogens from the lymph, and are thus sometimes referred to as the “filters of the lymph” (Figure). Any bacteria that infect the interstitial fluid are taken up by the lymphatic capillaries and transported to a regional lymph node. Dendritic cells and macrophages within this organ internalize and kill many of the pathogens that pass through, thereby removing them from the body. The lymph node is also the site of adaptive immune responses mediated by T cells, B cells, and accessory cells of the adaptive immune system. Like the thymus, the bean-shaped lymph nodes are surrounded by a tough capsule of connective tissue and are separated into compartments by trabeculae, the extensions of the capsule. In addition to the structure provided by the capsule and trabeculae, the structural support of the lymph node is provided by a series of reticular fibers laid down by fibroblasts.

Lymph nodes are small bean-shaped structures that are usually less than 2.5 cm in length. They are widely distributed throughout the body along the lymphatic pathways where they filter the lymph before it is returned to the blood. Lymph nodes are not present in the central nervous system. There are three superficial regions on each side of the body where lymph nodes tend to cluster. These areas are the inguinal nodes in the groin, the axillary nodes in the armpit, and the cervical nodes in the neck.

The typical lymph node is surrounded by a connective tissue capsule and divided into compartments called lymph nodules. The lymph nodules are dense masses of lymphocytes and macrophages and are separated by spaces called lymph sinuses. The afferent lymphatics enter the node at different parts of its periphery, which carry lymph into the node; entering the node on the convex side. The lymph moves through the lymph sinuses and enters an efferent lymphatic vessel, which, located at an indented region called the hilum, carries the lymph away from the node.

The lymphatic system has three primary functions. First of all, it returns excess interstitial fluid to the blood. Of the fluid that leaves the capillary, about 90 percent is returned. The 10 percent that does not return becomes part of the interstitial fluid that surrounds the tissue cells. Small protein molecules may "leak" through the capillary wall and increase the osmotic pressure of the interstitial fluid. This further inhibits the return of fluid into the capillaries, and fluid tends to accumulate in the tissue spaces. If this continues, blood volume and blood pressure decrease significantly and the volume of tissue fluid increases, which results in edema (swelling). Lymph capillaries pick up the excess interstitial fluid and proteins and return them to the venous blood. After the fluid enters the lymph capillaries, it is called lymph.

The second function of the lymphatic system is the absorption of fats and fat-soluble vitamins from the digestive system and the subsequent transport of these substances to the venous circulation. The mucosa that lines the small intestine is covered with fingerlike projections called villi. There are blood capillaries and special lymph capillaries, called lacteals, in the center of each villus. The blood capillaries absorb most nutrients, but the fats and fat-soluble vitamins are absorbed by the lacteals. The lymph in the lacteals has a milky appearance due to its high fat content and is called chyle.

The third and probably most well known function of the lymphatic system is defense against invading microorganisms and disease. Lymph nodes and other lymphatic organs filter the lymph to remove microorganisms and other foreign particles. Lymphatic organs contain lymphocytes that destroy invading organisms.

The regional lymph nodes are the most common site of metastases.

*Bilateral or contralateral for the primary sites of head, neck and trunk

There are between 100 and 150 lymph nodes in the mesentery of the colon. Regional lymph nodes are the nodes along the colon, plus the nodes along the major arteries that supply blood to that particular colon segment.

Lymph nodes along a "named vascular trunk" (as defined by the fourth edition of the AJCC staging manual) are those along a vein or artery that carries blood to a specific part of the colon, for example, the inferior and superior mesenteric arteries, sigmoidal artery, left or right colic artery. In the fifth and sixth editions, the location of the nodes does not affect assignment of the N category.