Ntau tus neeg tsis paub txog qhov xwm txheej ntawm moles thiab vim tias cov txheej txheem no tsis cuam tshuam rau lawv lub neej, lawv tsis nco qab txog lawv lub neej. Dab tsi yog ib qho nevus los ntawm kev saib xyuas kev kho mob? Qhov no yog ib qho tsub zuj zuj ntawm pigment hlwb nyob rau saum npoo los yog nyob rau hauv ib txheej ntawm daim tawv nqaij, uas yuav congenital los yog kis tau. Cov pob no tuaj yeem muaj qhov sib txawv - los ntawm 0.5 mus rau 10 cm inch. Qhov chaw ntawm lub cev, qhov luaj li cas ntawm cov formations yog Ameslikas embedded nyob rau hauv tib neeg DNA thiab twb muaj nyob rau hauv cov me nyuam mos, tab sis tsis pom mus txog rau thaum ib tug tej lub hnub nyoog.
Nevuses ntawm daim tawv nqaij yog kis los yog congenital formations ntawm ib tug benign xwm thiab muaj tsub zuj zuj ntawm melanocytes. Ntawd yog, qhov no suav nrog cov cim yug lossis moles uas ib tus neeg muaj thiab yog qhov tsis zoo ntawm cov hlwb dermal. Ordinary nevi yog ib qho tshwm sim heev uas tsis tas yuav muaj kev kho mob thiab tsis ua rau muaj kev hem thawj rau tib neeg kev noj qab haus huv. Txawm li cas los xij, lawv tuaj ntawm ntau hom, qee qhov ntawm lawv zoo li degenerate mus rau hauv cov qog nqaij hlav malignant.
Ntxiv rau, daim tawv nqaij nevi tsis tas licongenital pathology, feem ntau lawv tshwm sim thaum lub neej. Raws li txoj cai, kom txog rau thaum muaj hnub nyoog ntawm feem coob ntawm ib tug neeg, lawv qhov loj thiab tus naj npawb tuaj yeem nce ntxiv, thiab tom qab ntawd txo qis me ntsis. Qhov tseeb no yog vim kev loj hlob ib txhij ntawm nevi nrog rau lub cev. Tom qab kawg ntawm lub sijhawm loj hlob, qhov nce ntawm moles kuj nres.
Raws li International Classification of Diseases (ICD), daim tawv nqaij nevi muaj tus lej D22.
Kev tshwm sim
Qhov ua rau moles yog ua txhaum ntawm cov txheej txheem ntawm kev tsiv teb tsaws ntawm melanoblasts, uas yog cov precursors ntawm melanocytes. Raws li qhov tshwm sim ntawm qhov kev ua txhaum cai, thaj tsam ntawm lawv qhov tseem ceeb concentration yog tsim, qhov twg nevus ntawm daim tawv nqaij tom qab tshwm sim. Cov kws tshaj lij faib lawv mus rau hauv congenital thiab tau txais, tab sis qee cov kws tshaj lij tau xav tias qhov kev faib tawm no yog qhov xwm txheej. Qhov kev xav no txuas nrog lub fact tias moles uas tshwm sim nyob rau hauv cov neeg laus tsis yog tsim tshiab cheeb tsam ntawm melanoblast concentration, tab sis congenital, tab sis manifested tsuas yog tom qab ib pliag.
Qhov laj thawj tseem ceeb uas ua rau muaj cov moles thaum lub sij hawm kev loj hlob ntawm fetal suav nrog:
- Hereditary factor.
- Pathologies uas nrog cev xeeb tub (toxicosis, hem nchuav menyuam).
- raug hluav taws xob thiab hluav taws xob ionizing.
- raug rau tshuaj tsis haum thiab tshuaj lom.
- Cov kab mob kis tau zoo ntawm cov kab mob genitourinary hauv cov poj niam cev xeeb tub.
Txhob Cia Siab
Ua kom muaj kev txhim khotau txais moles tuaj yeem yog cov hauv qab no:
- raug rau daim tawv nqaij ntawm hluav taws xob ultraviolet.
- Kev cev xeeb tub nrog hormonal surges.
- kab mob ntawm daim tawv nqaij ntawm ib qho xwm txheej.
- kab mob ntawm daim tawv nqaij.
- Mechanical trauma rau daim tawv nqaij.
- Kev siv tshuaj tiv thaiv kab mob.
- Hormonal surges thaum lub sij hawm puberty.
Hauv qab no, xav txog yam tseem ceeb ntawm moles.
Ntau yam, kev faib tawm
Tau txais thiab congenital daim tawv nqaij nevi tej zaum yuav muaj cov qauv zoo sib xws. Qhov laj thawj no ua rau nws tsim nyog los faib lawv raws li lawv cov qauv histological. Qhov no tso cai rau koj coj mus rau hauv tus account lub ntsiab nta ntawm txhua mole thiab, nrog ib tug siab probability, kwv yees lawv cov kev loj hlob tom ntej. Cov kws tshaj lij paub qhov txawv ntawm 50 ntau yam ntawm nevi, tab sis txog 10 ntawm lawv feem ntau. Ua ntej tshaj plaws, tag nrho cov moles feem ntau muab faib ua ob hom:
- Melanoma txaus ntshai (melanomoform).
- Melanomaniac.
Kev tsim ntawm hom thib ob yuav luag tsis tuaj yeem ua rau tsis zoo. Yog li ntawd, kev pom zoo kom tshem tawm lawv feem ntau yog tshuaj pleev ib ce.
Melanoform daim tawv nqaij nevi yog tus cwj pwm los ntawm qhov muaj feem ntau ntawm degeneration rau hauv cov qog nqaij hlav malignant. Cov qauv zoo li no yuav luag ib txwm pom zoo kom tshem tawm.
Ntawm cov melanomaniacs, cov hauv qab no yog qhov txawv:
- Intradermal pigment.
- Halonevus.
- YFibroepithelial.
- papillomatous.
- Mongolian chaw.
Mongolian chaw
Nws yog pigmented nevus ntawm daim tawv nqaij ntawm ib hom congenital, feem ntau pom nyob rau hauv cov me nyuam mos uas yog haiv neeg Mongoloid. Qhov no ntau yam yog inherently ib tug genetic variant ntawm ib tug ua txhaum ntawm cov txheej txheem ntawm pigmentation ntawm lub dermis. Rau cov neeg feem coob, qhov chaw Mongolian ploj mus thaum muaj hnub nyoog tsib xyoos. Lawv nyob hauv zos, raws li txoj cai, ntawm sacrum thiab pob tw. Qee lub sij hawm Mongolian qhov chaw nyob mus ib txhis es tsis ploj mus. Tab sis txawm nyob rau hauv xws li mob, nws tsis degenerate mus rau hauv ib tug malignant tsim thiab tsis xav tau kev kho mob.
papillomatous tsos
Papillomatous nevus ntawm daim tawv nqaij muaj qhov tsis pom kev, uas feem ntau ntshai nws cov neeg nqa khoom. Tias yog vim li cas tib neeg feem ntau sab laj nrog oncologists, xav tias qhov xwm txheej phem tshaj plaws. Papillomatous intradermal nevi ntawm daim tawv nqaij yog tus cwj pwm los ntawm kev nce siab, qhov sib txawv ntawm qhov seem ntawm cov dermis hauv cov xim thiab cov duab. Qhov saum npoo yog lobular, xim av. Xws li ib tug nevus tsis ua rau cov kev xav, tshwj tsis yog rau kev puas siab puas ntsws tsis xis nyob, yog tias qhov chaw ntawm nws txoj hauj lwm yog ob txhais tes, caj dab, ntsej muag. Ib qho chaw nyiam ntawm localization yog tawv taub hau, ceg ceg, lub cev. Thaum lub neej, papillomatous nevi hloov lawv cov yam ntxwv. Lawv tuaj yeem dhau los ua xim sib txawv, nce qhov loj, tab sis tsis tshua muaj degenerate rau hauv cov qog nqaij hlav.
Fibroepithelial nevi
hom mole feem ntau yog fibroepithelial. Nws tuaj yeem yog ob qho tib si congenital thiab tau txais. Feem ntau xws linevi tshwm sim tawm tsam keeb kwm ntawm kev hloov hormonal hauv lub cev. Txawm li cas los xij, cov tshuaj muaj cov ntaub ntawv hais txog qhov tshwm sim ntawm moles ntawm hom no hauv cov neeg laus. Feem ntau, fibroepithelial nevus muaj cov duab sib npaug, xim liab, elastic sib xws. Rau qee lub sijhawm, mole loj hlob, tom qab ntawd cov txheej txheem no qeeb, thiab nws qhov kev vam meej nres. Cov xwm txheej ntawm degeneration ntawm fibroepithelial nevi yog qhov tsawg heev.
Setton's nevus
Qee zaum nws hu ua halonevus. Nws yog tsuas yog kis tau, tsim nyob rau hauv tib neeg, nrog malfunctions ntawm hormonal system, autoimmune pathologies, txo kev tiv thaiv. Cov tshuaj tiv thaiv pib txoj kev loj hlob ntawm halonevus, nyob rau hauv uas lub cev fights nrog nws cov hlwb. Nws yog characterized los ntawm ib tug oval duab, nws nce me ntsis saum daim tawv nqaij. Lub npe ntawm nevus yog consonant nrog nws cov duab. Qhov nruab nrab ntawm lub mole yog xim xim ntau dua li cov npoo. Cov xim no pom qhov zoo ib yam li lub halo - qhov tshwm sim kho qhov muag uas tshwm sim nyob ib puag ncig lub hli lossis hnub. Lub hauv paus (qhov tseem ceeb) ntawm lub nevus yog nyob rau hauv thaj tsam daj ntseg. Nws tsis pom zoo kom tshem tawm xws li formations, raws li lawv yuav qhia tau hais tias muaj lwm yam, loj pathologies nyob rau hauv lub cev. Halonevus yuav luag tsis degenerate rau hauv cov qog nqaij hlav.
Lwm yam ntau yam
Intradermal pigmented daim tawv nqaij nevi feem ntau tshwm sim thaum puberty. Nyob rau hauv thawj theem ntawm lawv txoj kev loj hlob, lawv nyob rau hauv lub hau, lawv tsis protrude ntawm nws nto. Feem ntau nevi ntawm nohom me me, tab sis dhau sij hawm lawv tuaj yeem hloov pauv - hloov lawv tus kheej cov duab, xim. Lawv tsis yooj yim rau kev loj hlob hauv cov laus, uas tsis tuaj yeem hais txog moles ntawm lwm hom. Tsuas yog qee zaus lawv degenerate mus rau hauv cov qog malignant.
Ntau tus neeg xav tias qhov no yog melanocytic nevus ntawm daim tawv nqaij. Nws yog kev cai suav nrog ntau yam hauv qab no hauv pawg no:
- Blue.
- Pigment loj.
- Nevus Ota.
- Dysplastic.
- Border pigment.
Cov xim ciam teb mole feem ntau yog ib qho neoplasm congenital, tab sis qee zaum nws tuaj yeem tshwm sim thawj xyoo ntawm tus menyuam lub neej. Raws li txoj cai, nevi ntawm hom no loj hlob hauv kev faib ua feem rau kev loj hlob ntawm lub cev. Yog hais tias ib tug neeg loj hlob intensive, qhov loj ntawm kev tsim kuj nce ntau heev. Sab saum toj ntawm daim tawv nqaij, xws li nevi nce me ntsis thiab yog tus cwj pwm los ntawm kev sib sau ua ke ntawm melanin, uas ua rau cov xim tsaus nti ntawm mole, uas tuaj yeem ua xim liab, tsaus xim av, txawm tias dub. Hom moles no tsis muaj qhov chaw pom meej meej; nws tuaj yeem tshwm sim ntawm txhua qhov ntawm lub cev. Ib tug yam ntxwv feature yog tias tsuas yog borderline pigmented nevi tuaj yeem tshwm sim ntawm ob txhais taw thiab xib teg. Nws qhov ntom ntom ntom nti tuaj yeem qhia tau tias muaj mob.
Dysplastic nevi
Dysplastic daim tawv nqaij nevi yog ob qho tib si congenital thiab kis tau. Moles ntawm hom no nyob rau hauv ntau tus neeg mob tshwm sim thaum puberty, yog tsev neeg nyob rau hauv cov xwm (feem ntau pom nyob rau hauv ob peb tsev neeg). nyobLawv feem ntau yog nyob rau hauv armpits, inguinal folds, ntawm lub duav, ob txhais ceg, thiab sab nraub qaum. Daim tawv nqaij nevi tshwm sim, raws li txoj cai, hauv ib pab pawg, tab sis muaj cov xwm txheej ntawm ib qho tshwm sim. Cov xim ntawm cov pob no tuaj yeem sib txawv - los ntawm lub teeb xim av mus rau dub. Heev feem ntau muaj ib tug peculiar pigmentation ntawm lub periphery thiab nyob rau hauv nruab nrab ntawm qhov chaw. Kev kuaj mob kom raug suav nrog kev kuaj mob biopsy uas tso cai rau koj los txheeb xyuas qhov sib txuam ntawm cov hlwb rau qhov tsim. Hauv 90% ntawm cov neeg mob, dysplastic nevi degenerate mus rau hauv malignant formations - melanomas. Hauv qhov no, qhov tsos ntawm cov mole yuav tsum tau tshem tawm radical thiab kho kom tsim nyog.
Nevus of Ota
Nevus Ota yog tus cwj pwm los ntawm kev sib sau loj ntawm melanin. Raws li txoj cai, cov ntsiab lus no yog ib qho xwm txheej, txawm li cas los xij, kuj tseem muaj ntau qhov xwm txheej, nws yooj yim rau kev sib koom ua ke. Nws yog ib tug neurocutaneous nevus. Nyob rau hauv cov ntaub ntawv no, tsim ntawm moles tshwm sim nyob rau hauv lub cuam tshuam ntawm neurological yam. Nws yog suav hais tias yog ib tug nevus ntawm daim tawv nqaij ntawm lub ntsej muag - nws yog feem ntau nyob rau ntawm ntug ntawm lub orbit los yog ntawm lub cheekbones. Nws tshwm sim raws li qhov chaw xiav-dub nyob rau hauv lub cornea los yog ntawm lub qhov muag dawb. Ib tug yam ntxwv feature ntawm lub nevus ntawm Ota yog hais tias nws muaj peev xwm hloov lub mucous daim nyias nyias ntawm lub qhov muag, tshwj xeeb tshaj yog yog hais tias nws muaj ib tug loj loj.
Kev kawm zoo li no yog qhov tshwm sim hauv lub cev thiab caj ces etiology. Nws feem ntau tshwm sim hauv Mongolians thiab Nyij Pooj, tsawg dua hauv lwm cov neeg Esxias thiab Suav. Nyob rau hauv ib tug malignant nevus ntawm Otatransforms infrequently, tab sis xws li ib tug muaj peev xwm tseem nyob. Ultraviolet plays lub luag haujlwm tseem ceeb hauv kev yug dua tshiab.
Giant nevi
Giant pigmented nevi yog congenital formations thiab, tsis zoo li lwm yam congenital birthmarks, yog pom thaum yug los. Kev nce qib thaum lub cev loj hlob thiab nce mus txog qhov loj me. Feem ntau, xws li ib tug tsim tsis yog nyob rau hauv ib cheeb tsam loj ntawm lub dermis, tab sis occupies tag nrho cov anatomical cheeb tsam, piv txwv li, lub cev, caj dab, ib nrab ntawm lub ntsej muag. Cov tshuaj tau sau tseg thaum qhov loj ntawm cov pigmented nevi loj heev mus txog 40 cm. Nyob rau hauv cov xwm txheej zoo li no, peb tuaj yeem tham txog qhov tsis xws luag ntawm cov tshuaj pleev ib ce, txij li cov mole tau nthuav tawm saum npoo ntawm lub dermis thiab suav tias yog cov qog loj heev uas ua rau lub cev tsis zoo. tsos ntawm ib tug neeg. Cov xim ntawm qhov chaw nyob rau hauv feem ntau nws txawv ntawm grey mus rau xim av. Nws cov qauv tuaj yeem sib txawv, piv txwv li, me me warts, furrows, kab nrib pleb tuaj yeem nyob ntawm nws qhov chaw, nce plaub hau tuaj yeem pom. Nws yog cov yam ntxwv uas paub qhov txawv loj pigmented nevi los ntawm lwm hom.
Kev kho ntawm cov txheej txheem no yog ua los txhawm rau tshem tawm qhov tsis xws luag. Tsuas yog nyob rau hauv tsawg zaus yog nws malignancy pom. Feem ntau qhov no tshwm sim tom qab nws raug tshem tawm. Txawm li cas los xij, cov kws kho mob hais tias lub nevus ntawm qhov loj me no feem ntau raug mob, thiab qhov no, tig mus, ua rau nws rov yug dua tshiab. Nws raug tshem tawm los ntawm kev phais excision ntawm cov qog thiab tom qab ntawm daim tawv nqaij grafting.
Blue nevus
Nws yog ib qho kev tsim kho zoo, txawm hais tias nws qhia tau tias muaj mob ua ntej. Lawv lub npe yog vim xim. Txawm li cas los xij, moles tuaj yeem ua tsis tau tsuas yog xiav, tab sis kuj dub, tsaus ntshav, grey, tsaus xiav, xiav. Blue nevi muaj ib qho tseem ceeb tsub zuj zuj ntawm melanocytes uas nquag tsim melatonin. Raws li txoj cai, lawv yog ib leeg, tab sis kuj muaj ntau yam pob liab liab. Sab saum toj ntawm daim tawv nqaij, xws li moles protrude me ntsis, thiab palpation ntawm lub tsim ua rau nws muaj peev xwm mus ntes ib tug intradermal node ntawm ib tug ntom qauv. Xws li ib tug nevus tsis muaj ib tug meej localization, nws muaj peev xwm tshwm sim nyob rau hauv tej cheeb tsam. Nws cov ciam teb yog qhov tseeb, txoj kab uas hla tsis tshaj ib centimeter, tsis muaj plaub hau loj hlob ntawm nws. Lub degeneration ntawm xiav nevus tshwm sim, raws li txoj cai, raws li ib tug tshwm sim ntawm kev raug mob tas li los yog tom qab tshem tawm tsis tiav. Nws yog tsim nyog sau cia tias qhov kev hloov pauv nws tus kheej yog qhov tsawg heev.
Kev kuaj mob ntawm moles
Lub luag haujlwm tseem ceeb ntawm cov txheej txheem ntawm kev kuaj mob ntawm daim tawv nqaij nevi (raws li ICD code D22) yog kev sib txawv ntawm kev kawm nrog melanoma thiab lwm yam kab mob ntawm lub dermis ntawm ib tug malignant xwm. Hauv qhov no, tus kws kho mob dermatologist-oncologist yuav ua ntej ntawm tag nrho cov yuav tsum tau tshem tawm cov malignant daim ntawv ntawm pathology, thiab tom qab ntawd txiav txim seb hom thiab kev kho mob tsim nyog.
Rau lub hom phiaj no, siv cov kev kuaj mob hauv qab no:
- Echography.
- Histological xeem.
- Biopsy.
- Termometry.
- YPhosphorus isotope diagnostics.
- Dermatoscopy.
Dermatoscopy yog ua nrogsiv lub cuab yeej tshwj xeeb uas nthuav cov duab kaum npaug thiab tso cai rau koj kom pom qhov hloov me ntsis ntawm qhov chaw ntawm nevus. Tam sim no, cov txheej txheem no yog qhov zoo tshaj plaws hauv kev kuaj mob ntxov ntawm melanoma. Txawm li cas los xij, dermatoscopy tsis tso cai tsis lees paub lossis lees paub qhov kev kuaj mob nrog kev ntseeg siab, tab sis tsuas yog tuaj yeem hais qhia tus kws kho mob rau cov kev kuaj mob tom ntej. Txoj kev kuaj mob no tsis mob kiag li, vim nws tsis yog kev sib cuag thiab tsis cuam tshuam rau tus neeg mob daim tawv nqaij.
Phosphorus isotope kuaj mob cuam tshuam nrog kev sib sau ntawm cov xov tooj cua phosphorus los ntawm malignancy. Nyob rau hauv melanoma, cov tshuaj no accumulates nyob rau hauv nevi, uas qhia tau hais tias muaj zog cell faib nyob rau hauv nws cov qauv thiab qhia tias muaj mob cancer.
Thermometry suav nrog kev ntsuas hauv zos ntawm qhov ntsuas kub ntawm lub dermis. Cov txheej txheem yog nqa tawm siv ib tug tshwj xeeb apparatus. Thaum lub sij hawm txoj kev tshawb no, qhov kub ntawm qhov chaw ntawm ib tug noj qab nyob zoo dermis yog muab piv nrog rau qhov kub thiab txias ntawm daim tawv nqaij nevus (raws li ICD 10 code - D22). Yog tias qhov tsim tau zoo, ces qhov sib txawv ntawm cov ntsuas yuav yog ib qho degree, thiab yog tias nws yog malignant, nws yuav yog li 2-2.5 degrees.
Txoj kev kuaj mob txhim khu kev qha tshaj plaws yog kev kuaj ntshav biopsy, uas suav nrog kev kuaj ntshav biopsy thiab nws cov kev kuaj mob tom ntej. Biopsy tuaj yeem raug txiav thiab txiav tawm. Cov txheej txheem kawg kuj tseem kho tau, thaum lub mole raug tshem tawm thiab nws tom qabkuaj histological. Cov txheej txheem no tso cai rau koj los txhim kho qhov kev kuaj mob kom raug, tab sis nws tsuas yog siv nyob rau hauv cov ntaub ntawv ntawm superficial nevi.
Kev kho mob
Kev kho rau daim tawv nqaij nevi (ICD code - D22) cuam tshuam nrog lawv cov kev phais tshem tawm. Qhov no tuaj yeem ua rau kev zoo nkauj lossis kev kho mob. Kev tshem tawm zoo nkauj yog qhov tsim nyog yog tias mole yog qhov ua kom zoo nkauj tsis zoo.
Hnub no, muaj ntau txoj hauv kev rau tshem tawm nevi:
- Kev phais mob.
- YElectrocoagulation.
- Cryosurgery.
- YLaser phais.
Txoj kev uas feem ntau yog tom kawg. Cov ntaub so ntswg ntawm kev tsim yog evaporated nrog cov pa roj carbon dioxide laser, vim tias cov hlwb hauv nws cov qauv tuag. Cov txheej txheem tsis mob, tus neeg mob tsuas hnov tsuas yog sov so thiab kub hnyiab me ntsis. Tsis muaj qhov caws pliav lossis nti tom qab laser tshem tawm. Lub luag haujlwm tseem ceeb yog ua los ntawm qhov chaw ntawm mole thiab nws qhov loj me. Yog tias nws nyob ntawm qhov chaw, qhov ua tsis tiav evaporation tuaj yeem tshwm sim, ua rau rov ua dua.
Cryodestruction tshem tawm cov mole los ntawm kev nthuav tawm cov kua nitrogen. Cov txheej txheem no yog siv yog tias qhov chaw ntawm qhov tsim yog superficial, thiab qhov loj me me.
Lub sijhawm electrocoagulation, cov ntaub so ntswg evaporation kuj tshwm sim, tab sis tsuas yog nrog kev pab ntawm hluav taws xob tam sim no. Txoj kev siv tau los tshem tawm cov moles me xwb.
Kev phais phais yog ua tiav nrog ib qho tshuaj scalpel. ATThaum lub sijhawm ua haujlwm, tsis tsuas yog tshem tawm nevus, tab sis kuj yog cov ntaub so ntswg uas nyob ib sab. Qhov chaw incision yog ces sutured. Kev ua haujlwm zoo sib xws yog ua los ntawm kev siv tshuaj loog hauv zos.
Peb tshuaj xyuas seb nws yog - daim tawv nqaij nevus.
