lymphoma yog dab tsi? Qhov no yog kab mob oncological ntawm cov ntaub so ntswg lymphoid. Ib qho tshwj xeeb ntawm tus kab mob no yog qhov nce hauv lymphoid nodes, kev puas tsuaj ntawm ntau yam hauv nruab nrog cev, nyob rau hauv uas muaj ib qho tseem ceeb tsub zuj zuj ntawm lymphocytes nrog qog hlwb. Cov qe ntshav dawb (lymphocyte) yog lub hauv paus tseem ceeb ntawm lub cev tiv thaiv kab mob. Hauv ICD-10, lymphoma yog teev nyob rau hauv code C 85.
Yog vim li cas
Qhov tseeb ua rau lymphomas hauv cov menyuam yaus tseem tsis tau nkag siab. Pathology nyob rau hauv lymphocytes predispose rau cov tsos ntawm tus kab mob. Cells tuaj yeem cuam tshuam tsis tau tsuas yog cov qog nqaij hlav xwb, tab sis kuj tseem muaj lwm yam hauv nruab nrog cev. Tab sis cov kws kho mob txheeb xyuas qee qhov ua rau Hodgkin's lymphoma hauv cov menyuam yaus, qhov kev tshwm sim uas tsis zoo:
- kab mob siab;
- kab mob HIV;
- malignant hloov pauv hauv B-lymphocytes;
- kab mob autoimmune (lupus erythematosus, rheumatoid mob caj dab);
- hluav taws xob hluav taws xob tsis yog ntawm tus menyuam nkaus xwb, tab sis kuj rau tus poj niam thaum cev xeeb tub;
- siv tshuaj tiv thaiv kab mob;
- txo qiskev tiv thaiv;
- muaj leukemia hauv niam txiv lossis lwm tus txheeb ze;
- cuam tshuam los ntawm cov kab mob sib kis thiab tus kab mob herpes;
- xws li cov carcinogens;
- khomob khomob, khomob hluav taws xob;
- caj ces thiab haiv neeg predisposition (Klinefelter thiab Down syndrome);
- lymphoid depletion;
- ua rau muaj qee tus kab mob - Epstein-Barr, Louis Bar, Wiskott-Aldrich, T-lymphocytic.
Yog tias kev kho tshuaj khomob tau siv los tshem tawm lwm cov qog nqaij hlav hauv menyuam yaus, yuav muaj kev pheej hmoo ntau ntxiv ntawm cov qog ntshav qog ntshav, vim tias cov tshuaj no muaj tshuaj lom heev thiab tuaj yeem ua rau cov cuab yeej caj ces ntawm cov qog nqaij hlav cancer thiab noj qab nyob zoo.
Lymphoma tshwm sim li cas?
Raws li tus kws kho mob oncologist, lymphoma tshwm sim tsis tshua muaj ua ntej hnub nyoog 3 xyoos, tab sis qhov kev pheej hmoo ntawm nws txoj kev loj hlob nce nrog lub hnub nyoog. Yog li ntawd, yog hais tias tsev neeg muaj los yog yav tas los malignant oncopathologies, nws yog ib qhov tsim nyog yuav tau ua tib zoo saib xyuas kev noj qab haus huv ntawm tus me nyuam, tsis tu ncua mus kuaj uas yuav tsis cia koj nco lub sij hawm ntawm qhov pib ntawm kev loj hlob ntawm tus kab mob. Feem ntau nyob rau hauv thaum yau, Hodgkin's lymphoma tshwm sim, uas muaj kev pom zoo tshaj qhov uas tsis yog Hodgkin's lymphoma. Feem ntau, txog niaj hnub no, kev cuam tshuam ntawm qhov tshwm sim ntawm lymphomas tau raug tshawb fawb.
Symptoms
Kev tshawb pom ntxov ntawm cov tsos mob ntawm lymphoma hauv cov menyuam yaus ua rau muaj kev pheej hmoo ntawm kev pom zoo thiab kev kho tau zoo. Feem ntau, cov tsos mobraug kuaj pom thaum kuaj mob rau lwm yam kab mob, tab sis lub luag haujlwm tseem ceeb yog muab rau cov niam txiv, uas yuav tsum ua tib zoo saib xyuas kev hloov pauv ntawm lub cev thiab tus cwj pwm ntawm cov menyuam yaus.
Cov tsos mob tseem ceeb ntawm cov qog ntshav qog ntshav hauv cov menyuam yaus yog qhov nce hauv ib lossis ntau cov qog ntshav qog ntshav. Kev loj hlob ntawm qhov loj yog feem ntau pom nyob rau hauv cov qog nqaij hlav nyob rau hauv caj dab, nyob rau hauv lub clavicular thiab occipital qhov chaw, nyob rau hauv armpits, nyob rau hauv lub inguinal cheeb tsam, raws li zoo raws li nyob rau hauv zais lymph nodes (nyob rau hauv lub plab mog, plab mog, qaum). Nws yuav tsum raug sau tseg tias qhov nce hauv cov qog ntshav qab zib tsis mob thiab tsis ua rau tus menyuam tsis xis nyob, yog li txoj haujlwm ntawm niam txiv tsis txhob nco cov kev hloov pauv ntawm lub cev ntawm tus menyuam lub cev.
Thaum cov qog nqaij hlav loj pib ua rau lub cev nyob ib sab ntawm lawv, nrog cov tsos mob tshwm sim:
- ua tsis taus pa lossis hnoos tuaj yeem qhia tau tias muaj cov qog ntshav loj hauv lub ntsws lossis lub ntsws;
- mob plab, plab zom mov tuaj yeem yog vim qhov nce ntawm cov qog ntshav qog ntshav hauv plab;
- thaum cov qog ntshav nkag mus rau hauv daim siab lossis tus po, cov kabmob no loj tuaj.
Qhov muaj cov qog ntshav qog ntshav hauv tus menyuam kuj tseem nrog qee cov tsos mob uas yog tus yam ntxwv ntawm ntau yam kab mob. Cov tsos mob no yuav tsum raug coj mus rau hauv tus account thaum sau cov keeb kwm dav dav. Cov no suav nrog:
- Tus menyuam yaus nkees sai - thaum pib nws tshwm sim tom qab ua haujlwm, tab sis ntxiv mustus kab mob no tshwm sim, tus me nyuam passive ntau dua? thiab lub sijhawm ua haujlwm raug txo.
- Nyob tsaug zog, apathy.
- Me nyuam tawm hws ntau thaum hmo ntuj, ua ke nrog kev poob phaus thiab kub taub hau.
- khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus pim
Nws tsis tuaj yeem hais meej tias nws yuav siv sijhawm ntev npaum li cas rau cov menyuam yaus los tsim cov qog ntshav qog ntshav. Qee cov tsos mob tshwm sim tom qab peb lub lis piam, lwm tus tom qab plaub lub hlis.
Views
Nyob rau hauv peb lub sijhawm, muaj ntau hom lymphomas, tab sis tsis ntev dhau los lawv tau muab faib ua Hodgkin's disease thiab non-Hodgkin's lymphoma, txawm li cas los xij, qhov sib txawv ntawm tus kab mob no tsis muaj kev cuam tshuam tag nrho cov ntsiab lus ntawm lymphoma thiab tsis tso cai rau txiav txim siab txog kev kho mob zoo tshaj plaws thiab nws qhov kev cia siab.
Non-Hodgkin's lymphomas tau muab faib ua cov neoplasms uas muaj qib siab thiab qis ntawm malignancy. Hauv txhua pab pawg, ntau hom lymphomas tau txheeb xyuas, suav nrog cov yam ntxwv morphological ntawm cov qog hlwb. Qhov kev faib tawm no tau lees txais, tab sis tam sim no cov kab ke no tau dhau los, txij li cov qog ntshav qog ntshav tsis yog Hodgkin muaj txog 16 hom subtypes.
Hodgkin's Lymphoma
Hodgkin's lymphoma yog dab tsi? Qhov tseeb, hom lymphoma no tsis yog lymphoma li no, vim cov neoplasm muaj monocytic thiab macrophage hlwb, thiab tsis lymphocytes. Yog li, tus kab mob no tau txiav txim siab cais los ntawm cov qog nqaij hlav uas tsis yog Hodgkin, tab sis nws tseem yog ib qho kev tsim tsis zoo uas tshwm sim hauv cov ntaub so ntswg ntawm cov qog ntshav.
Non-Hodgkin's lymphoma
Qhov no yog ib lub tswv yim dav, kom paub meejKev kuaj mob, nws yog ib qho tsim nyog yuav tsum paub meej qhov ua rau nws tsim, nrog rau qib ntawm malignancy. Lymphoid cov ntaub so ntswg muaj ob pawg ntawm lymphocytes: B-lymphocytes thiab T-lymphocytes. Cov tom kawg yog xav tau rau kev tiv thaiv kab mob ntawm cov hlwb uas ua rau inactivation ntawm txawv teb chaws hais. Rau kev tsim cov proteins tshwj xeeb uas khi rau cov kab mob fungus, kab mob thiab kab mob, ua rau lawv tsis zoo, muaj B-lymphocytes. Cov hlwb no yog pawg nyob rau hauv cov follicles, uas lub periphery yog feem ntau T-cell, thiab qhov chaw yog B-lymphocyte. Yog tias cov xwm txheej tsim nyog, kev sib kis tsis txaus ntawm cov hlwb hauv ib cheeb tsam yuav tshwm sim, uas txiav txim siab hom neoplasm.
Mature cell lymphomas
Cov no yog cov qog ntshav qog ntshav uas tshwm sim los ntawm cov lymphocytes paub tab, tus cwj pwm los ntawm yuav luag asymptomatic chav kawm. Tib thiab qhov tseeb cov tsos mob ntawm lymphoma yog hu ua ntau dhau ntawm cov qog nqaij hlav. Qee cov cell lymphomas paub tab tsim mus rau lymphosarcoma dhau sijhawm.
Burkitt's lymphoma
Hom kab mob qog no muaj qhov mob hnyav heev, nws kis mus rau cov ntshav, cov kab mob hauv nruab nrog cev thiab cov pob txha pob txha, dhau ntawm ciam teb ntawm cov kab mob lymphatic. Tus kab mob pib maj mam thiab mam li nco dheev, uas cuam tshuam los ntawm qhov chaw ntawm cov qog.
Loj cell diffuse lymphoma
hom kab mob qog ntshav no mob hnyav heev. Qhov tseem ceeb tshaj plaws nyob rau hauv feem ntau yog nyob rau hauv extradontally los yog nyob rau hauv lub lymph nodes. Cais, nws tsim nyog sau cia thawj qhov loj B-cell lymphoma ntawm mediastinum, uas tshwm sim hauv thymus,maj mam loj hlob mus rau hauv mediastinum.
Diagnosis
Thaum ua cov txheej txheem kuaj mob qog ntshav qog ntshav hauv menyuam yaus, kev kuaj mob sab nraud ntawm tus neeg mob tau ua tib zoo ua thawj zaug. Tom qab ntawd, txhawm rau txheeb xyuas qhov kev kuaj mob, tus menyuam yuav tsum xeem dhau qhov kev xeem tsim nyog hauv qab no:
- ntshav;
- ua ultrasound lossis x-ray.
Ntxiv rau, txhawm rau paub meej tias muaj cov qog ntshav qog ntshav, nws yog ib qho tsim nyog yuav tsum tau ua ntau qhov kev sib txuas lus tseem ceeb, ua tsaug uas nws yuav tuaj yeem txiav txim siab qhov txawv ntawm tus kab mob tam sim no thiab nyob rau theem twg tam sim no. Cov kws kho mob, thaum txheeb xyuas cov neeg mob cov ntaub so ntswg, siv txoj kev biopsy. Txhawm rau ua nws siv txoj kev no, tus kab mob qog noj ntshav tau raug coj mus kuaj thiab ua tib zoo tshuaj xyuas los ntawm tus kws tshaj lij hauv lub tshuab tsom.
Txhawm rau txiav txim siab theem ntawm tus kab mob uas twb muaj lawm, ntxiv rau cov txheej txheem teev saum toj no, koj tuaj yeem siv cov duab sib nqus resonance, ob-photon emission tomography, xam tomography, lossis scintigraphy ntawm lub pob txha. Kom tau txais cov ntaub ntawv ntau npaum li sai tau txog cov qog nqaij hlav ntawm cov pob txha thiab txiav txim seb muaj pes tsawg lub hlwb muaj kev cuam tshuam, nyob rau theem tseem ceeb tshaj plaws ntawm tus kab mob, lawv mus rau trepanobiopsy.
Ua ntej pib qhov kev kho mob uas tsim nyog, nws yog qhov nyuaj rau kev kuaj xyuas tus menyuam lub plawv los ntawm kev ua daim cardiogram lossis hloov nws nrog ultrasound ntawm lub plawv, nrog rau ntau ntxiv.efficiency, ob txoj kev tuaj yeem ua tiav ib txhij. Tsis tas li ntawd, nws yuav tsim nyog los kuaj xyuas qhov muaj qhov txawv txav hauv lub cev metabolism.
Txhua txoj kev kuaj mob saum toj no yuav tsis siv tau rau txhua kis. Txoj kev kawm twg lossis cov kev kawm twg los muab rau tus neeg mob, tsuas yog tus kws kho mob tuaj yeem txiav txim siab.
Kev kho mob
Yog tias tus menyuam muaj tus mob qog nqaij hlav qog noj ntshav, lawv yuav tsum tau mus rau lub chaw kho mob oncology ntawm lub tsev kho mob sai, thiab lub chaw kho mob hematology kuj tseem tsim nyog.
Feem ntau yog kho nrog kws khomob. Nyob rau hauv rooj plaub no, tus me nyuam raug kho nrog cytostatic, tsom rau kev txwv tsis pub ntawm tes los yog tshem tawm tag nrho (cov cell uas muaj qog nqaij hlav). Siv ib txoj hauv kev tsuas yog tsis txaus los tshem tawm tag nrho cov hlwb cuam tshuam, vim li ntawd, cov kws kho mob tau tsim kev sib xyaw ntawm cytostatics, txwv tsis pub lawv tseem hu ua polychemical therapy. Txoj kev no suav hais tias yog qhov zoo tshaj plaws vim nws qhov ua tau zoo tshaj plaws.
Tom qab cov txheej txheem tshuaj kho mob, qee zaum, kev siv hluav taws xob kuj tseem siv - kev kho hluav taws xob. Yog tias kev kho tshuaj lom neeg thiab radial tsis muab cov txiaj ntsig xav tau lossis tus kab mob rov zoo dua, lawv hloov mus rau kev kho mob nrog cov koob tshuaj ntau. Ib qho tsis zoo hauv hom kev kho no yog nws cov txiaj ntsig tsis zoo rau cov ntshav ntawm cov pob txha. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tau hloov cov qia cell - feem ntau mus rau autologous pob txha pob txha hloov.
Nyob zoolymphocyte-dominated Hodgkin tus kab mob
Nyob rau theem pib ntawm tus kab mob no, ib tus kab mob qog nqaij hlav raug tshem tawm (yog tias tsis muaj lwm yam cuam tshuam), yog tias tsis muaj teeb meem tom qab ntawd. Qee qhov ntau tshaj li ib nrab ntawm cov neeg mob nyob rau hauv cov ntaub ntawv no yog kho tsis tau mus rau radial thiab tshuaj kho mob. Lawv yuav tsum tau mus rau qhov kev tshuaj ntsuam xyuas kom tas li saib xyuas lawv tus mob. Cov txheej txheem no hu ua expectant study strategy. Yog tias cov tsos mob ntawm lymphoma tshwm sim, lub tswv yim no xaus.
Tshuaj Khomob Qhia
Nyob hauv ib txwm muaj Hodgkin's kab mob, ntau cov tshuaj kho mob tau ua tiav. Tus naj npawb ntawm cov voj voog, lawv lub sijhawm thiab kev siv zog yog pib raws li theem ntawm tus kab mob hauv tus menyuam, thiab nyob ntawm seb cov pab pawg kho mob twg yog siv los kho tus neeg mob. Ib qho thaiv kev kho mob yuav kav tsis ntev tshaj li ob lub hlis. Cov tshuaj hauv qab no suav nrog hauv ib qho kev kho mob:
- "Prednisolone";
- "Vincristine";
- "Nws yog qhov zoo";
- "Doxorubicin".
Nyob rau lub sijhawm nruab nrab ntawm kev kho mob, nws yuav tsum tau ua ob lub lis piam. Qhov nruab nrab, cov kev kho mob rau lymphoma yuav kav tsawg kawg yog ob thiab tsis pub ntau tshaj rau lub hlis, nyob rau hauv cov ntaub ntawv uas tsis muaj rov tshwm sim ntawm tus kab mob.
Kev kho hluav taws xob
Tam sim no, proctologists pom zoo rau ib nrab ntawm cov neeg mob ua hluav taws xob kho mob ntawm tus kab mob tom qab siv tshuaj. Tom qab soj ntsuam qhov ntawdYuav ua li cas tus neeg mob lub cev teb rau chemotherapy, tsa cov lus nug ntawm qhov ua tau ntawm kev kho hluav taws xob.
Yog tias ob qhov kev kho mob PET tau ua tiav thiab muaj kev txhim kho, ces tsis tas yuav muaj qhov kev kho no (qhov no siv tau rau txhua hom kab mob). Cov lus teb zoo rau qhov kev kho mob no txhais tau hais tias lymphoma yog halved, thiab yog li ntawd tsis muaj cov qog nqaij hlav hauv nws cov seem.
Feem ntau, kev kho hluav taws xob yog siv ob lub lis piam tom qab ua tiav cov tshuaj kho mob. Qhov nruab nrab, ib koob tshuaj hluav taws xob sib npaug rau nees nkaum greys tau muab. Yog tias qhov ntim ntawm lymphoma raug txo los ntawm kwv yees li 75% tom qab thawj ob ntu ntawm cov tshuaj khomob, cov koob tshuaj hluav taws xob nce mus rau peb caug greys.
Yuav kom tsis txhob rhuav tshem cov hlwb noj qab haus huv nyob ib sab ntawm cov qog, qhov ntim yuav tsum tau muab tsis yog nyob rau ib zaug, tab sis dhau ob peb txheej txheem. Kho qhov chaw cuam tshuam hauv qhov me me. Kev kho hluav taws xob yuav kav ntev li ob lossis peb lub lis piam. Hnub so yog muab rau lub cev kom so thiab rov qab los ntawm txoj kev.
Punctures rau Hodgkin's disease
Kev kho mob qog ntshav qog ntshav hauv cov menyuam yaus hauv cov chaw kho mob pej xeem hauv Moscow yog ua tau, tab sis yuav tsis coj cov txiaj ntsig zoo ib yam li txawv teb chaws. Nyob rau hauv lub teb chaws Yelemees, rau cov menyuam yaus cuam tshuam los ntawm lymphoma, tsuas yog cov kev pab cuam hu ua therapy optimization kev tshawb fawb yog siv rau kev kho mob. Lawv feem ntau lees txais kev kawm hauv tsev kho mob, teeb tsa lawv tus kheejtxoj hauj lwm ntawm kev kho cov neeg mob uas muaj kev vam meej cov kev pab cuam thiab nyob rau tib lub sij hawm nce cov nyhuv ntawm kev kho mob.
Txoj kev rov qab los
Ua tsaug rau cov txheej txheem kuaj mob niaj hnub thiab raug thiab cov txheej txheem punctures ntawm kev kho mob, txoj hauv kev ntawm kev rov qab los thiab kev kho kom tiav ntawm cov qog yog siab heev. Ua ntej kev kho mob, txhua tus neeg mob tau muab faib ua cov pab pawg kho mob sib txawv, rau txhua tus ntawm lawv tus kheej txoj kev kho mob tau muab. Raws li kev tshawb fawb tsis tu ncua, tus kab mob feem ntau rov tshwm sim, tab sis tom qab ntawd nws tuaj yeem kho tau zoo.
