Spleen lymphoma: cov tsos mob, kev kuaj mob ntxov, txoj kev kho mob, oncologists 'prognosis

Cov txheej txheem:

Spleen lymphoma: cov tsos mob, kev kuaj mob ntxov, txoj kev kho mob, oncologists 'prognosis
Spleen lymphoma: cov tsos mob, kev kuaj mob ntxov, txoj kev kho mob, oncologists 'prognosis

Video: Spleen lymphoma: cov tsos mob, kev kuaj mob ntxov, txoj kev kho mob, oncologists 'prognosis

Video: Spleen lymphoma: cov tsos mob, kev kuaj mob ntxov, txoj kev kho mob, oncologists 'prognosis
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Anonim

Spleen lymphoma yog ib yam kab mob oncological txaus ntshai. Xws li kev kuaj mob qhia pom cov qog nqaij hlav hauv cov ntaub so ntswg ntawm tus po. Qhov tshwm sim ntawm no pathology yog suav hais tias tsawg. Cov cim tseem ceeb ntawm tus kab mob no yog qhov qeeb ntawm txoj kev loj hlob thiab qhov nyuaj ntawm kev kho mob, uas tau piav qhia los ntawm qhov tsis muaj cov tsos mob thaum ntxov ntawm tus kab mob. Koj yuav tsum paub dab tsi txog tus kab mob no thiab koj puas tuaj yeem tshem nws mus ib txhis?

Lymphoma txhais

Lo lus kho mob "lymphoma" feem ntau nkag siab tias yog kab mob hnyav uas cov txheej txheem pathological tshwm sim hauv cov kab mob ntawm cov kab mob lymphatic (lymph nodes, spleen). Yuav kom nkag siab txog cov ntsiab lus ntawm tus kab mob, ib tus yuav tsum kawm kom ntxaws txog kev ua haujlwm ntawm lub cev ntawm tib neeg lub cev.

Cov kab mob lymphatic yog sawv cev los ntawm cov hlab ntsha lymphatic, cov qog ntshav qab zib thiab tus po. Cov kabmob no tsim thiab thauj cov qog ntshav (cov kua tsis muaj xim) thoob plaws hauv lub cev.

Spleen lymphoma cov tsos mob thiab kev kho mob
Spleen lymphoma cov tsos mob thiab kev kho mob

Qhov system no ua lub luag haujlwm tseem ceeb heev.

  1. Txoj kev. Nrog cov kua dej ntws los ntawm lub cevCov kab mob pathogenic, kab mob thiab lwm yam kab mob pathogenic uas tau nkag mus rau tib neeg lub cev raug tshem tawm.
  2. Khoom noj khoom haus. Cov khoom siv tau zoo uas nqus tau hauv cov hnyuv tau faib los ntawm cov qog ntshav mus rau txhua lub cev thiab cov ntaub so ntswg.
  3. Immune. Cov kab mob pathogenic los ntawm sab nraud raug tshem tawm sai sai los ntawm lymphocytes thiab tawm hauv lub cev.

Lymphoma tau hais tias yog thaum sib sau ntawm cov qog ntshav hloov pauv tshwm sim hauv cov kabmob ntawm cov kab mob lymphatic. Lawv sib faib sai sai thiab tsis ua lawv tej dej num, vim lub cev tag nrho ua tsis tau.

hom kab mob qog nqaij hlav lymphoma

Hauv tshuaj, nws yog ib txwm ua kom paub qhov txawv ntawm ntau hom kab mob no. Ntawm lawv yog cov ntawv hauv qab no:

  • follicular;
  • B-cell;
  • T-cell;
  • diffuse loj cell.

Differentiate tus kab mob raws li cov hlwb koom nrog cov txheej txheem pathological.

Xyoo 1994, cov kws tshawb fawb tau qhia lwm lo lus "lymphoma ntawm thaj chaw marginal ntawm tus po". Yuav kom nkag siab lub ntsiab lus ntawm daim ntawv no ntawm tus kab mob, ib tug yuav tsum kawm cov qauv ntawm lub cev kom ntxaws.

70-80% ntawm tus po muaj cov tawv nqaij liab - nws lub hauv paus yog cov ntaub so ntswg tshwj xeeb, cov leeg thiab lwm cov qauv anatomical. Qhov seem 20-30% ntawm tus po yog dawb pulp. Nws muaj ntau cov lymphocytes. Qhov chaw sib cais cov chav haujlwm no yog hu ua marginal zone. Yog tias cov qog nqaij hlav cancer cuam tshuam rau thaj chaw no, tus kab mob no hu ua marginal splenic lymphoma.

spleen lymphoma cov tsos mob
spleen lymphoma cov tsos mob

Yog vim li caskab mob kev loj hlob

Kev tshawb fawb hauv cheeb tsam no tau txais kev saib xyuas tshwj xeeb. Txawm li cas los xij, qhov tseeb ua rau kev loj hlob ntawm lymphomas tseem tsis tau pom. Nyob rau tib lub sijhawm, muaj ib txoj kev xav raws li cov kab mob oncological ntawm tus po tshwm sim los ntawm qhov tsis muaj zog ntawm lub cev tiv thaiv kab mob.

Ntau zaus, cov neeg mob spleen lymphoma tsim tawm tsam keeb kwm ntawm cov kab mob hauv qab no:

  • Epstein-Barr tus kab mob;
  • human immunodeficiency virus (HIV);
  • kab mob siab.

Qee zaum, lymphoma ntawm lymphatic system ua raws li mob qog noj ntshav thib ob. Hauv lwm lo lus, cov no yog metastases ntawm cov qog ntawm lwm lub cev.

Symptoms

Qhov phom sij tseem ceeb ntawm hom mob qog noj ntshav no yog qhov tsis muaj cov tsos mob thaum ntxov. Ib tug neeg tuaj yeem nyob tau ntau xyoo yam tsis paub txog tus mob hnyav. Ntawm thawj cov tsos mob ntawm tus kab mob spleen lymphoma yog:

  • faus;
  • txo qis hauv kev ua haujlwm;
  • lub cev tawm hws ntau;
  • xeev ntawm apathy thiab kev nyuaj siab;
  • kev qaug zog.
  • spleen lymphoma prognosis
    spleen lymphoma prognosis

Tib neeg feem ntau tsis tshua xyuam xim rau cov tsos mob zoo li no. Cov xwm txheej no cuam tshuam nrog kev nrawm nrawm ntawm lub neej, tsis muaj cov vitamins, thiab kev ntxhov siab ntau zaus.

Nrog rau kev txhim kho ntxiv ntawm tus kab mob, muaj:

  • xav hnyav hauv plab thiab hnyuv;
  • muaj peev xwm quav quav;
  • nce lub cev kub;
  • pw tsis tsaug zog (drowsiness lossis insomnia);
  • kev chim tsis tu ncua;
  • tsis muajqab los;
  • poob ceeb thawj.

Lab kuaj rau kev kuaj mob

Thaum xub mus ntsib kws kho mob, tus kws kho mob tshuaj xyuas tus neeg mob cov lus tsis txaus siab thiab ua qhov kev kuaj mob. Thaum lub sij hawm nws, kev saib xyuas yog them rau cov qog nqaij hlav thiab cov xwm txheej ntawm tus neeg mob. Nyob rau tib lub sijhawm, tus kws kho mob yam tsis tau ua tsis tiav muab xa mus rau kev kuaj ntshav dav dav.

Ntawm cov ntsuas tseem ceeb:

  • hemoglobin - nws qib yuav tsum nyob hauv thaj tsam ntawm 120-160 g / l;
  • leukocytes - cov ntsiab lus ib txwm muaj txij li 4 txhiab / µl txog 9 txhiab / µl;
  • platelets - tus nqi tso cai yog 180-320 txhiab /µl.

Kev nce qib ntawm leukocytes thiab txo qis hauv lwm qhov ntsuas qhia txog kev hloov pauv hauv lub cev. Txawm li cas los xij, kev kuaj mob tsis tuaj yeem ua los ntawm kev kuaj ntshav ib leeg. Yuav tsum tau tshawb nrhiav kho vajtse.

Ultrasound txhawm rau kuaj mob qog noj ntshav

Ultrasound rau spleen lymphoma yog suav hais tias yog ib txoj hauv kev qhia paub ntau tshaj plaws. Nrog nws cov kev pab, cov kws kho mob tau txais cov ntaub ntawv hais txog tus mob ntawm tus po, nws qhov loj me, muaj lossis tsis muaj qog nyob hauv nws.

Qhov kom zoo dua yog tias pathology tuaj yeem kuaj pom txawm tias qhov neoplasm me me. Tsis tas li ntawd, yog tias muaj metastases rau lwm lub cev, lawv yuav raug kuaj pom. Yog tias kuaj pom tus kab mob pathology, tus neeg mob tau txais kev kuaj ntxiv.

qog lymphoma
qog lymphoma

CT and MRI

Yog tias xav tias qog nqaij hlav, tus neeg mob tau sau ntawv suav thiab ua cov duab sib nqus resonance. Ua tsaug rau cov kev tshawb fawb kho vajtse, nws muaj peev xwm tau txaisdaim duab peb-dimensional ntawm tus po thiab cov qog hauv nws (yog tias muaj). Nyob rau tib lub sijhawm, cov kws kho mob tau txais cov ntaub ntawv ntawm qhov chaw nyob ntawm cov neoplasm, nws qhov loj thiab cov duab. Cov ntsuas no yuav tseem ceeb heev rau kev kho mob ntxiv (nrog rau kev phais).

Thaum CT thiab MRI, tag nrho cov metastases hauv tib neeg lub cev, nyob hauv cov nqaij mos thiab pob txha, raug kuaj pom.

marginal lymphoma ntawm tus po
marginal lymphoma ntawm tus po

Biopsy

Qhov kev kuaj pom tseeb tshaj plaws tuaj yeem tau txais tom qab kuaj pom. Lo lus no yog hais txog cov txheej txheem rau kev rho tawm cov qauv ntawm cov qog nqaij hlav. Nws yog nqa nrog rab koob ntev.

Tom qab cov ntaub so ntswg raug tshem tawm, lawv raug xa mus rau qhov chaw kuaj mob histological. Raws li qhov tshwm sim ntawm kev kuaj mob, qhov xwm txheej ntawm cov qog (txawm nws yog malignant) thiab nws hom tau tshwm sim.

Cov ntsiab cai tseem ceeb ntawm kev kho mob

Rau txhua kis, cov txheej txheem thiab kev kho mob raug xaiv tus kheej. Hauv qhov no, tus kws kho mob yuav tsum coj mus rau hauv tus account cov yam ntxwv hauv qab no:

  • a daim ntawv ntawm lymphoma;
  • kab mob theem;
  • hnub nyoog ntawm tus neeg mob;
  • kev sib hlub.

Feem ntau, kev tsom mus rau txoj kev kho mob nyuaj, uas yuav suav nrog kev phais, tshuaj khomob lossis kev kho hluav taws xob.

Saib xyuas

Kev kho mob splenic lymphoma tsis tas yuav tsum tau ua. Yog li, thaum kuaj pom cov qog ntawm thaj chaw marginal, oncologists pom zoo kom saib xyuas tas li. Qhov no tau piav qhia los ntawm kev txhim kho qeeb ntawm neoplasm thiab tsis muaj cov tsos mob tshwm sim.

Nyob hauv rooj plaublub degeneration ntawm daim ntawv no ntawm cov qog mus rau hauv ib tug txhoj puab heev, lawv pib kho nrog kev phais, chemotherapy thiab hluav taws xob kho. Qhov tseem ceeb yuav tsum tau thaum xaiv txoj hauj lwm no yog nruj me ntsis raws li cov lus pom zoo ntawm tus kws kho mob oncologist thiab tsis tu ncua ntawm cov txheej txheem kuaj mob.

Surgery

Txoj hauv kev no yog hais txog cov kev kho mob radical. Txawm hais tias kev txhim kho tshuaj thiab kev txhim kho ntau txoj hauv kev los kho mob qog noj ntshav, kev phais tseem ua tau zoo tshaj plaws. Txoj kev tshem tus po yog hu ua splenectomy.

Lub ntsiab ntawm nws yog tshem tawm tus po nrog cov qog nyob rau hauv nws. Cov ntaub so ntswg nyob ze kuj yuav raug tshem tawm. Qhov no yog qhov tsim nyog yog tias cov qog tau dhau mus dhau ntawm lub cev thiab kis mus rau cov ntaub so ntswg nyob sib ze.

Kev tshem tawm tag nrho ntawm lub cev thaiv kev txhim kho ntxiv ntawm tus kab mob. Hauv qhov no, ib qho tseem ceeb yuav tsum tau yog tshem tawm tag nrho cov kab mob pathological. Lub xub ntiag ntawm txawm tias ib qho qog me me ua rau muaj kev pheej hmoo rov qab los (rov tsim kho tus kab mob).

Kev kho mob spleen lymphoma
Kev kho mob spleen lymphoma

Feem ntau, kev phais yog ua ke nrog tshuaj khomob lossis kev kho hluav taws xob.

Tshuaj khomob

Tshuaj kho mob yog kev kho mob splenic lymphoma nrog tshuaj. Txoj kev no feem ntau ua ke nrog kev phais kom sib sau ua ke cov nyhuv thiab txo qhov kev pheej hmoo ntawm kev rov qab los. Lub hauv paus ntsiab lus ntawm kev ua haujlwm ntawm cov tshuaj no yog rhuav tshem cov qauv ntawm cov kab mob pathological. Vim li ntawd, cov qog nqaij hlav cancer poob lawv lub peev xwm los faib.

Tshuaj haum rau tus neeg mob raug xaiv los ntawm tus kws kho mob. Lawv yogtej zaum yuav yog nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj los yog kev daws rau intravenous tshuaj. Tsis ntev los no, cov tshuaj tiam tshiab uas muaj cov kev mob tshwm sim tsawg heev tau txais kev nrov nrov. Txawm li cas los xij, lawv muab qhov feem pua ntawm kev kho mob siab.

splenic marginal cheeb tsam lymphoma
splenic marginal cheeb tsam lymphoma

Huab cua

Kev kuaj mob no yog kab mob qog noj ntshav, yog li ntawd, nrog tus kab mob spleen lymphoma, cov kws kho mob sim txwv tsis pub kwv yees kev kho mob. Txhua rooj plaub muaj tej yam ntxwv.

Qhov muaj feem ntau tshaj plaws rau kev kho kom tiav yog cov neeg mob uas nws tau kuaj pom oncology thaum ntxov. Ntawm no, qhov ciaj sia taus ntawm cov neeg mob mus txog 90%. Nws yog vim li no qhov kev kuaj mob ntxov ntawm splenic lymphoma yog qhov tseem ceeb.

Lwm yam tseem ceeb hauv kev kwv yees - daim ntawv ntawm tus kab mob. Cov neeg mob uas muaj qog nqaij hlav ntawm thaj chaw marginal muaj qhov siab tshaj plaws rau kev kho. Nws muaj qhov ua phem tshaj plaws thiab qeeb qeeb ntawm kev txhim kho.

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