Yuav ua li cas hauv lub cev yog kuaj pom lymphogranulomatosis? Hauv cov qog nqaij hlav yog "cov hlwb tiv thaiv", uas yog, lymphocytes. Yog hais tias ib tug neeg mob nrog tus kab mob no, cov qe ntshav dawb nce zuj zus, thiab cov qog nqaij hlav hauv lub caj dab thiab caj dab nce hauv ntim.
Medic (pathologist) ntawm British keeb kwm Thomas Hodgkin tau piav qhia txog tus kab mob no thawj zaug. Tam sim no nws hu ua Hodgkin's lymphoma. Tus kab mob no yog dab tsi? Cov kab mob ciaj sia yog dab tsi, thiab qhov lymphoma kho li cas?
Lub ntsiab lus ntawm Hodgkin tus kab mob yog qhov muaj lub npe hu ua Reed-Sternberg hlwb. Lub xub ntiag ntawm cov hlwb txawv txav qhia tau hais tias nws yog mob qog noj ntshav, tab sis puas yog tus kab mob tau muab cais ua mob qog noj ntshav?
Hodgkin's lymphoma. Qhov txawv ntawm lwm yam lymphomas
Lymphomas yog cov qog nqaij hlav qog nqaij hlav. Lymphogranulomatosis, lossis Hodgkin's disease, yog hom qog ntshav qog ntshav. Yog tias cov kab mob pathological pom thaum kuaj,Tom qab ntawd lawv tau kuaj pom tias tsis yog Hodgkin's lymphoma.
Knots maj mam nce thiab pom ntau dua. Txhawm rau kuaj mob raws sijhawm, koj yuav tsum tau hu rau tus kws kho mob oncologist raws sijhawm.
YLymphogranulomatosis. Puas yog mob qog noj ntshav?
Lymphogranulomatosis yog ib qho mob hnyav heev. Nws yog feem ntau hu ua mob qog noj ntshav ntawm lymphoid cov ntaub so ntswg. Tab sis, qhov tseeb, lymphogranulomatosis - puas yog mob qog noj ntshav? Epidemiologically thiab kho mob, qhov lymphoma no txawv ntawm ntau txoj hauv kev los ntawm kev mob qog noj ntshav tiag tiag.
Dab tsi yog qhov txawv?
- Kev ntsuas kev kho mob ntawm Hodgkin tus kab mob yog qhov zoo. Yog tias pom pathology nyob rau theem 1, thiab tsis muaj lwm yam kab mob sib kis, ces lymphoma yog kho tau.
- No localized qog yam ntxwv ntawm cancer.
- Cov qog nqaij hlav cancer "noj" cov hlwb noj qab haus huv. Nyob rau hauv cov ntaub ntawv ntawm lymphogranulomatosis, qhov no tsis yog.
- mob qog noj ntshav pib nrog kev hloov pauv ntawm cov ntaub so ntswg sib txuas. Hauv lymphoma, kev loj hlob ntawm lwm cov ntaub so ntswg (lymphoid cov ntaub so ntswg) cuam tshuam.
Txawm li cas los xij, ib yam li mob qog noj ntshav, Hodgkin tus kab mob ua rau tuag yog tias tsis kho. Lymphoma kis thoob plaws lub cev thiab tuaj yeem ua rau muaj kev puas tsuaj rau lwm yam kabmob. Nyob rau theem 3 thiab 4, cov qog twb loj lawm thiab tag nrho cov qog nqaij hlav hauv lub cev raug cuam tshuam: hauv qab caj npab, hauv siab, hauv puab tais. Thiab kev kho mob kuj muaj hluav taws xob.
YLymphogranulomatosis. Yog vim li cas
Muaj ntau qhov kev xav piav qhia txog kev txhim kho ntawm lymphomas feem ntau thiab Hodgkin's lymphoma tshwj xeeb. Tseem yog daim duab tseeb ntawm qhov laj thawj thiab qhov cuam tshuam hauv kev cuam tshuam rau kev loj hloblymphogranulomatosis hauv kev kho mob science tseem tsis tau muaj. Txawm hais tias tag nrho cov kws kho mob oncologists xa mus rau cov caj ces predisposition rau tus kab mob no. Txawm li cas los xij, tsis paub txog lub tshuab ua haujlwm.
Lub ntsiab tseem ceeb txhawb kev loj hlob ntawm tus kab mob tseem suav tias yog tus kab mob Epstein-Barr, uas, raws li kev txheeb cais, muaj nyob rau hauv cov neeg mob feem ntau. Txawm hais tias nws zoo li cov no yog teeb meem autoimmune lossis mononucleosis. Ntau tus ntseeg hais tias Hodgkin tus kab mob (lymphogranulomatosis) yog provoked los ntawm ib tug muaj zog thiab ntev raug rau cov tshuaj lom thiab tsis zoo ecology.
Ntau lub sijhawm thiab nyiaj txiag tseem yuav tau siv rau qhov teebmeem no, tab sis txog tam sim no, cov kws tshawb fawb tau mob siab rau kev kho mob ntau dua.
Cov tsos mob ntawm lymphogranulomatosis
Nws tsis tuaj yeem txheeb xyuas Hodgkin tus kab mob (lymphogranulomatosis) yam tsis muaj kev tshawb fawb. Tab sis koj yuav tsum tau ceev faj thiab saib xyuas cov tsos mob ntawm tus kab mob.
Cov tsos mob muaj raws li hauv qab no:
- Tsis muaj laj thawj tshwj xeeb (tsis muaj kab mob, tsis muaj qhov kub thiab txias), cov qog ntshav nce ntxiv. Tsis muaj mob ntawm palpation.
- Dyspnea vim kis tus kab mob mus rau mediastinum. Cov qog nqaij hlav loj hauv lub hauv siab ua rau lub ntsws.
- Hav hmo ntuj sweats.
- poob phaus sai. Ib tug neeg " ploj mus" ua ntej peb ob lub qhov muag.
- Pab mob plab.
- Qee tus neeg mob (30–35%) yws ntawm qhov khaus khaus khaus heev.
- qaug zog thiab kub taub hau. Feem ntau mus txog 380 C.
- Thaum tus poov loj zuj zus mus, tus neeg mobxav tias hnyav hauv hypochondrium sab laug.
Cov neeg mob feem ntau tsis saib xyuas lawv tus kab mob li cas, tab sis lawv mob siab txog kev muaj sia nyob. Cov lus nug ntawm seb lymphogranulomatosis puas yog mob qog noj ntshav lossis tsis yog ntau qhov kev kho mob. Nws yog ib qho tseem ceeb rau cov tib neeg uas tsis muaj feem xyuam nrog cov tshuaj kom paub cov cim tseem ceeb ntawm lymphogranulomatosis thiab nkag siab tias tus kab mob no hnyav heev thiab tuaj yeem ua rau tuag taus.
Hodgkin's lymphoma ntau npaum li cas?
Hodgkin's lymphoma - tus kab mob no yog dab tsi? Nws loj hlob li cas thiab ntau npaum li cas hauv ntiaj teb? Raws li kev tshawb fawb, cov neeg dawb yuav raug mob qog nqaij hlav ntau dua li cov neeg dub.
Cov qog ntshav qog no pom hauv 3 ntawm 1 lab tus tib neeg hauv ib xyoos. Ntawm lwm cov qog ntshav, Hodgkin tshwm sim hauv 15% ntawm cov neeg mob. Daim ntawv txaus ntshai tshaj plaws yog suav tias yog lymphoid depletion.
Yav dhau los, txawm tias nyob hauv Tebchaws Meskas, qhov chaw tshuaj tau tsim kho, ntau dua 1,100 tus neeg tuag txhua xyoo los ntawm Hodgkin tus kab mob. Tab sis tom qab xyoo 1975, cov txheeb cais pib hloov pauv, cov kws kho mob tau kawm yuav ua li cas kho cov qog ntshav qog ntshav thiab nws qhov tshwm sim.
Risk group
Pab pawg pheej hmoo suav nrog cov neeg muaj hnub nyoog tshaj 50 thiab cov hluas hnub nyoog 16-20. Cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo - pawg no yog 5% ntawm tag nrho cov neeg mob. Thiab qhov no yog 150 tus neeg hauv ib xyoos. Cov ntaub ntawv no yog muab los ntawm kev txheeb cais ntawm cov kws tshawb fawb German. Nws ntseeg tau tias pawg pheej hmoo tseem suav nrog cov pawg ntawm cov pej xeem:
- poj niam cev xeeb tub tom qab 30;
- neeg raug rau lub sijhawm ntev ultraviolet hluav taws xob;
- neeg laus;
- leej twg muaj teeb meem tiv thaiv kab mob.
Txawm li cas los xij, tom qab kev saib xyuas hnyav, tib neeg rov zoo tag nrho, lossis nyob twj ywm hauv kev zam txim rau lub sijhawm ntev yog tias pom cov qog ntshav qog ntshav nyob rau theem lig. Kev mob siab tshaj plaws yuav tsum yog ib tus neeg uas muaj kev pheej hmoo thiab tuaj yeem tau txais kev kuaj mob ntawm "lymphogranulomatosis"; Cov tsos mob, kuaj ntshav thiab x-rays - txhua qhov no yuav tsum tau kuaj xyuas tas li, ceeb toom thiab saib xyuas koj tus mob.
Kev nyuaj siab
Cov teeb meem dab tsi tuaj yeem tos tus neeg mob? Nws paub tias lymphoma kis mus rau cov qog nqaij hlav thiab cuam tshuam kev ua haujlwm ntawm ntau lub cev. Kev ua haujlwm ntawm daim siab raug cuam tshuam, tus po thiab thymus tau loj tuaj.
Lub hlwb puas lawm. Tab sis lwm yam kab mob dab tsi tuaj yeem nrog lymphoma?
- nephrotic syndrome;
- neurological teeb meem;
- mediastinal jaundice;
- lymph edema;
- plab hnyuv occlusion;
- kab mob;
- kab mob fungal tawm tsam keeb kwm ntawm kev tiv thaiv tsis muaj zog.
Tus kab mob no yog qhov txaus ntshai tshwj xeeb rau cov poj niam cev xeeb tub. Raws li cov txiv neej, tom qab kho tus kab mob no, lawv tsis pom zoo kom muaj menyuam tau 1 xyoos.
Diagnosis
Yuav ua li cas thiaj kuaj tau kom raug? Lymphogranulomatosis tsis yog txiav txim siab los ntawm cov tsos mob sab nraud. Nws yog ib qho tseem ceeb rau cov kws kho mob kom paub txog theem ntawm tus kab mob thiab hom lymphoma. Txhawm rau kuaj xyuas daim ntawv kom raug, koj yuav tsum ua ntau qhov kev xeem.
Tau kawg, tus kws kho mob paub txog yuav tsis yuam kev, nws yuav raug ceeb toom tias tus neeg mob muaj lymphogranulomatosis, cov tsos mob. Kev kuaj ntshav kuj tseem ceeb. Ntxiv nrog rau kev kuaj ntshav, cov txheej txheem hauv qab no tau ua:
- MRI.
- Biopsy.
- Trepanobiopsy tau pom zoo nyob rau theem 4.
- Nco ntsoov palpate cov qog nqaij hlav ntawm caj dab thiab ib sab ntawm cov pob txha. Yog tias muaj lymphoma, lawv yuav loj tuaj. Txawm li cas los xij, ib tug neeg feem ntau tsis mob.
- X-ray tso cai rau koj pom qhov nce hauv cov qog ntshav hauv cov hlab ntsha mediastinum. Qhov no kuj yog ib qho cim tshwj xeeb ntawm lymphoma.
Cov qog nqaij hlav loj zuj zus tuaj yeem ua rau cov leeg thiab cov hlab ntsha, vim qhov no, qhov o tau pom meej meej hauv ntau tus neeg mob. Metabolism yuav tsum tau kawm. hnoos, nrog rau ua tsis taus pa luv thiab mob hnyav nyob rau hauv lub armpits - tag nrho cov no indirectly qhia Hodgkin tus kab mob.
Kev kuaj mob yuav tsum tseem nyob ntawm cov ntaub ntawv biopsy thiab kuaj ntshav ntawm tus neeg mob. Kev kuaj ntshav biochemical feem ntau qhia txog qib siab ntawm bilirubin, siab enzymes, thiab globulins. Tus neeg mob yuav muaj anemia thiab thrombocytopenia siab heev.
Huab cua
Tiam sis Hodgkin's lymphoma yog mob qog noj ntshav uas yooj yim kho. Ntau tshaj 95% ntawm cov neeg mob uas tau ua tiav cov kev kawm tsim nyog ntawm hluav taws xob rov zoo. Thiab nws teeb tsa cov neeg mob hauv txoj kev zoo. Tom qab tag nrho, tsis muaj dab tsi ua rau poob siab yog tias pom cov qog ntshav qog no.
Qhov kev cia siab phem tshaj plaws muaj xws li kev kuaj mob li lymphoid depletion. Nrog rau qhov kev kuaj mob no, ntau cov hlwb atypical thiab ntau cov ntaub so ntswg pom. Nws muaj peev xwm txheeb xyuas cov lymphoid depletion tsuas yog nrog kev pab ntawm biopsy, txij li kev kuaj histological tsis muaj txiaj ntsig ntawm no. Tab sis daim ntawv no tshwm simTsuas yog 5% ntawm cov neeg mob lymphogranulomatosis.
Hodgkin's lymphogranulomatosis yog qhov zoo, qhov kev cia siab ntawm kev ciaj sia yog qhov siab tshaj. Xws li kev kwv yees tau muab thaum kuaj pom lymphogranulomatosis nyob rau hauv daim ntawv me me - nrog rau feem ntau ntawm lymphocytes. Hauv qhov no, tus kab mob no tshwm sim yam tsis muaj sclerosis, necrosis thiab kho tau sai.
Forms of Hodgkin's disease
Yuav kom paub meej daim ntawv ntawm tus kab mob, nws yog ib qho tseem ceeb uas yuav tsum tau ua kom paub meej txog cov ntshav muaj pes tsawg leeg. Muaj ntau hom lymphogranulomatosis. Multinucleated pathological hlwb yog cov substrate ntawm cov qog, thiab yog tias lawv raug kuaj pom, lymphogranulomatosis (Hodgkin's disease) yuav luag 100% paub tseeb.
Yog li, cov ntawv sib txawv raws li hauv qab no:
1) Classic duab. Nws suav nrog cov subtypes hauv qab no:
- knot shape;
- mixed cell;
- nrog cov lymphocyte tsawg (lymphoid depletion).
2) Ib daim ntawv ntawm lymphogranulomatosis ua rau muaj cov lymphocytes.
Nyob ntawm seb hom lymphogranulomatosis li cas, tus kws kho mob yuav npaj kho thiab ua kev kwv yees. Qhov txaus ntshai tshaj plaws yog daim ntawv uas muaj cov lymphocytes tsawg.
theem kab mob
Raws li rau theem ntawm lymphogranulomatosis, muaj 4 theem, xws li mob qog noj ntshav. Ib zaug ntxiv cov lus nug tshwm sim: "Lymphogranulomatosis - puas yog mob qog noj ntshav?". Yeej, nws yog ib qho mob qog noj ntshav ntawm cov qog nqaij hlav lymphoid, thiab ntau tus kws kho mob tsuas tsis quav ntsej qhov sib txawv.
Hodgkin tus kab mob yog dab tsi? Cov theem yog raws li nram no:
- Local stage thaumtsuas yog ib pawg ntawm cov nodes (los yog ob pawg) tau nce.
- Regional - ob peb lub qog ntshav mus txog rau lub diaphragm koom nrog.
- Generalized - cov nodes cuam tshuam rau ob sab ntawm lub diaphragm.
- Disseminated. Cov theem kawg thiab nyuaj tshaj plaws, thaum lwm yam kabmob thiab cov kab ke koom nrog cov txheej txheem pathological: tus po, daim siab.
theem ntawm lymphoma yog txiav txim siab tom qab ultrasound thiab xam tomography.
Pathological Reed-Sternberg hlwb sai sai kis nrog cov ntshav mus rau lwm pab pawg ntawm cov qog ntshav qab zib. Nws yog ib qho tseem ceeb heev kom paub txog lymphoma nyob rau theem 1 lossis 2 thiab ua cov tshuaj khomob tam sim ntawd, thiab tom qab ntawd siv xov tooj cua. Qhov no ua rau qeeb qhov kev loj hlob thiab kis ntawm cov hlwb txawv txav.
Kev kho mob nrog cov txheej txheem niaj hnub
Lymphogranulomatosis kho li cas? Kev kho mob tau zoo dua. Piv nrog rau xyoo dhau los ntawm lub xyoo pua 20th, kev nce qib hauv kev kho tus kab mob no yog pom tseeb: 90% ntawm cov neeg mob lossis ntau dua nyob rau hnub nyoog 5 xyoos thiab, nyob hauv tsev kho mob, tau kho tag nrho. Niaj hnub no, cov kev kho mob hauv qab no tau siv hauv ntiaj teb kev xyaum:
- tshuaj tiv thaiv kab mob;
- biological therapy;
- splenectomy;
- stem cell hloov;
- xov tooj cua;
- surgery;
- kho mob steroid.
Ntawm cov cytostatics, kws kho mob tuaj yeem sau: "Embikhin", "Cyclophosphan", "Natulan", "Prednisolone". Cov tshuaj no siv tau ntevlub sij hawm.
Thiab kev kho hluav taws xob yuav luag txhua zaus txhim kho tus neeg mob tus mob. Yuav luag txhua tus neeg mob mus dhau qhov txheej txheem no.
Txawm li cas los xij, tsis yog txhua txoj hauv kev no tau siv los kho. Tus kws kho mob tus kheej yuav tsum tsim nws txoj kev npaj. Qee qhov tsuas yog siv rau kev kho mob thiab tshuaj xwb. Lwm tus nyiam kev kho mob steroid. Txhua yam nyob ntawm lub hnub nyoog ntawm tus neeg mob thiab nws tus mob tam sim no.
Kev kho mob nrog pej xeem tshuaj
Ntxiv rau cov tshuaj, koj tuaj yeem noj cov tshuaj ntuj. Qee cov nroj tsuag yeej muaj txiaj ntsig zoo heev, piv txwv li, aloe. Ntawm no yog ib qho ntawm cov zaub mov uas muaj kua txiv aloe: 500 gr. kua txiv ntawm cov nroj tsuag no, 700 gr. zib mu thiab tsuas yog 20 gr. niam. Tiv thaiv tau peb hnub.
Ib haus dej los ntawm cov nroj tsuag xws li cov cag liab lossis periwinkle kuj yog kev kho mob.
Tab sis koj yuav tsum nkag siab tias kev noj tshuaj ntsuab tsis tuaj yeem yog kev kho mob tseem ceeb rau cov kab mob loj xws li Hodgkin's disease. Kev kho mob nrog pej xeem tshuaj yog qhov thib ob; feem ntau yog hluav taws xob thiab tshuaj.
Yuav ua li cas tiv thaiv koj tus kheej los ntawm Hodgkin's lymphoma?
Vim qhov tseeb ntawm tus kab mob no tseem tsis tau pom, nws nyuaj rau txiav txim siab tiv thaiv. Txawm li cas los xij, nws yog ib qho tseem ceeb rau cov tub ntxhais hluas kom saib xyuas lawv txoj kev noj qab haus huv ntau dua, kom lub cev tsis zoo rau cov tshuaj lom xws li cawv thiab luam yeeb. Kev mus ntsib solariums tas li tuaj yeem ua rau muaj kev phom sij.
