Disorders of the lymphatic system represent a complex and heterogeneous group of conditions that range from congenital lymphatic dysplasias to acquired inflammatory and infectious lymph node diseases. Despite its central role in tissue fluid balance, immune surveillance, and lipid transport, the lymphatic system has historically received less investigative attention than the blood vascular system. This imbalance has contributed to diagnostic delays, incomplete classification frameworks, and suboptimal clinical management of lymphatic disorders. The present review integrates anatomical, developmental, molecular, and pathological perspectives to provide a comprehensive understanding of primary lymphatic disorders and peripheral lymph node pathology, with particular emphasis on cervical and peripheral lymphadenopathy.

Drawing on classical anatomical descriptions, contemporary molecular insights into lymphangiogenesis, and clinicopathological correlations from cytological and histopathological studies, this article synthesizes evidence across disciplines. The discussion highlights advances in the classification of primary lymphatic dysplasias, evolving concepts of lymphangiogenic signaling pathways, and the diagnostic value of fine-needle aspiration cytology in infectious and non-infectious lymphadenopathies. Tubercular lymphadenitis, a major contributor to peripheral lymph node enlargement in developing regions, is examined in detail to illustrate the intersection between lymphatic biology and infectious disease pathology.

By emphasizing structure–function relationships and integrating traditional pathology with emerging molecular frameworks, this review aims to bridge existing gaps between basic science and clinical practice. A clearer conceptualization of lymphatic disorders is essential for improving diagnostic accuracy, guiding therapeutic decision-making, and informing future research directions in lymphatic biology and disease.

Lymphatic system, primary lymphatic dysplasia, lymphangiogenesis, peripheral lymphadenopathy, tubercular lymphadenitis, fine-needle aspiration cytology

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