Panina Hodgkin lymphoma: nodular sclerosis

Nodular sclerosis - he histologicalʻano o Hodgkin ka maʻi, ua wehewehe aku ma ke anuanu ulu o connective'aʻaʻa, māheleʻana i ka nui o irregularly hoʻokino keena a me lobules. Ka mea, aia no iloko olaila ulu lymphoid mea me ka nui helu o Berezovsky-Sternberg keena. Ka maʻi hoʻomaka me ka mahuahua o ka aka wahi. Kēia pathology o kekahi o na Lolina o panina Hodgkin ka lymphoma.

Hodgkin ka maʻi ua noʻonoʻo i ka nui maʻi e loli ai i ka lymphatic nenoaiu. I ka maʻi i hana anywhere i loko o ke kino, i loaʻa lymphoid nā'aʻaʻa (thymus, tonsils, spleen a me adenoids AL.).

Nodular sclerosis symptoms

Hodgkin ka lymphoma hiki e ke kanaka, ina ia he mea e like symptoms like:

• ke kaupaona poho;
• Pehu lymph aka wahi (pinepine ia i loko o ka ciia o ka'ā'ī);
• kahe o ka ikaika loa ka makemake;
• pokole o ka hanu;
• po kaheʻana a me ka wela;
• umauma eha;
• hoonee aku i ake (5% o nā mea maʻi) ole spleen (30% o nā mea maʻi);
• ehaeha a me kaʻeha i loko o ka'ōpū (i loko o na keiki);
• itchy ili (wale 1/3 o kanaka e loaa ana maʻi);
• paakiki hanu;
• cough.

kumu

Hodgkin ka maʻi hiki ke ano, ma kekahi mau makahiki, akā, loa pinepine ia ia lŘlŘ ma opiopio kāne a pau i loko o ka makahiki waeʻano o 16 a hiki i 30 makahiki o ka makahiki a me ka poʻe kūpuna no 50 makahiki. Children i ka 5 makahiki, kokoke mai e maʻi. He aha kēia nui triggers keia maʻi mea nō IKE OLE IA. Eia naʻe, he mea he mea mahuʻi i ke kumu - nā mea hoʻomaʻi. Ua Ua manaoio aku i ke kumu o keia maʻi hiki hoʻomaka:

• immunodeficiency;
• infectious mononucleosis (malia e Epstein-Barr mea hoʻomaʻi).

Nodular sclerosis Hodgkin ka lymphoma hiki ke hele koke, hope mai ka 3 a hiki i 6 mahina, a me ka hope no 20 makahiki.

He aha ke kahua i ka maʻi?

Ka papahelu hodzhinskoy lymphoma manao mai keʻena hoʻokolohua haʻawina, a ma luna o ke kumu o ka kēia nā hoailona:

• i ka helu o ka loli lymph aka wahi, e like me kā lākou wahi;
• loaʻa nui o kaʻikepili aka wahi i loko o kekahi mau mea o ka diaphragm;
• hikoko i loko o nā nā loko (e laʻa me, ake ole spleen).

Ka mua ke kahua. Ma keia hihia loli wale kekahi lymph wahi a lymphoid hui (spleen, ke komo lima o Pirogov-Valdera).

Ka lua o ke kahua. Aia i IeAUPIIe, IAa IO iho la lakou lymph aka wahi ma na aoao a elua o ka pahu, diaphragm, a me nā loko lymphoid.

Ke kolu o ke kahua. Kēia degere Hodgkin aneane oko a mai ka lua o ke kahua. Naʻe, ka mea, he mau ano o nodular sclerosis kolu o ke kahua.

• ma ka hihia mua i loli nā loko aia ma lalo o ka diaphragm (celiac lymph aka wahi, spleen);
• i hou i na wahi i heluʻia ma ka likeʻole ma mua, nō pihoihoi, a me nā wahi me ka lymph aka wahi kahi kokoke i ka diaphragm.

I ka ha o ke kahua. Ua loli aiʻAʻole wale na eiiiiiaiou, akā, i 'ole-lymphoid nā loko - iwi ka lolo, akepaa, iwi, ia maʻiʻaʻai a me ka ili.

Designations degere Hodgkin ka lymphoma

Index ka lapaʻau pilikia a me ka oolea o ka maʻi papa o nā nā'aʻaʻa a me nā loko ua hoailono aku la me ka palapala.

A - loa mau symptoms o ka maʻi ole.

B - i ke alo o kekahi a oi symptoms (unfounded loa wela, po kaheʻana, kokololio kaumaha poho).

E - foci pili i nā'aʻaʻa a me nā loko kahi kokoke i ka loli ana o lymph aka wahi.

S - Ua splenic lesion.

X - aia no he nani nui o, alahula nui.

Histological ano o ka maʻi

E pili ana i ka ke kelepona hele 'ole o ko Hodgkin ka maʻi, he 4 ano o ka maʻi puʻuwai.

1. Nodular sclerosis Hodgkin ka lymphoma - ka loa e like me ka ano o ka maʻi, ma kahi o 40-50% o na hihia a pau. Ka mea, e maʻi oi pinepine ma mua o na kaikamahine, ka mea iʻano nui e pili mai lymph aka wahi o ka mediastinum. Ke biopsy mea, ma ka hou ana i Berezovsky-Sternberg aeee mea i nui lacunar keena me ka foamy cytoplasm, a he pāʻumi nuclei. Ka olelo wanana a ma keia maʻi mea IeAUPIIe, IAa IO maikai.
2. Lymphohistiocytic lymphoma i hanaʻia, ke 15% o na examples. Ka hapanui o pinepine ka mea, hiki ke loaʻa i loko o na kanaka ui ma lalo o 35 makahiki. Ua loaʻa he maikaʻiʻelima-makahiki ola ana o ke keena, a mai ka oʻo limfaitov a me Shtrenberga. Kēiaʻano o ka maʻi me ka uuku malignant, a leki ia i loko o ka loiloi mua kahua o ka hoʻonaʻauao.
3. Hui? Ueo ua ana diagnosed ma ka kūpuna a me nā keiki. Kekahi mau ano typical lapaʻau kiʻi, a me ka ka welelau o e generalize i ka hana. Histological ninaninau hoike okoa wale nō o ka halepaahao i pili ai, me Sternberg. I loaʻa i loko o 30% o nā mea maʻi me ka lymphoma. Nodular sclerosis i keia hihia i kekahi prognosis kŘpa a maikai, a ina i ka manawa lapaʻau ua kuhikuhi, ka mea paʻa e kalaia mai ia lŘlŘ me ka pilikia.
4. Hoʻopōʻino granuloma ka lukuia'na o lymphoid'aʻaʻa kaulana infrequently, wale 5% o ka examples (ka hapanui i waena o nā kūpuna). A ano hiʻonaʻaneʻi mea i loaʻa nā ole keena, a ua Kīwala'ō ma lalo Sternberg keena. Keia ano o ka lymphoma wehewehe aku ma ka haahaa pakeneka o elima-makahiki ola.

lapaʻau '

I kaʻike, o "lymphoma" ua ho'ākāka 'ia wale nō ma histological ninaninau o ka lymph aka wahi, a e mokomoko wale i loko o ka hihia ma ka hana nunui-Sternberg aeee i ua ike i ka hopena o keia ao. I loa nui e pono ai immunophenotyping. Cytological Ka Ikepili o ka lymph wahi a puʻupaʻa pele uuku puncture e hōʻoia nodular sclerosis, type 1. He aha pono ia e hanaia mai, e hookupaa aku i kaʻike, o ka mea maʻi.

• mau a me ka biochemical koko hoʻokolohua;
• X-na kukuna o ka ia maʻiʻaʻai (OAXA i loko o kaʻaoʻao a me ka frontal wānana);
• lymph wahi biopsy;
• kani ultrasonic nana o kela ano keia ano o kaʻike ākea, a intraabdominal lymph aka wahi, thyroid, ake, a me ka spleen;
• HI scan NineManga.com e hoʻopau imperceptible mediastinal lymph aka wahi iʻike mau radiography;
• trephine biopsy o ka iliac iwi , e pale aku iwi ka lolo;
• scan a me ka X-kukuna o ka iwi.

Inc

Ua he pāhawewe Inc,ʻoki kino a me ka chemotherapy. Koho i ke ala, e hoʻonoho i ke kahua o ka maʻi a me ke alo o ka maikaʻi 'ole io prognostic aʻe. Ke ano aʻe nā:

• 'enehana hou ma histological ninaninau nodular sclerosis, a me ka lymphohistiocytic type;
• kona mau makahiki malalo o ka 40 makahiki;
• puke lymph aka wahi mea e ole oi 6 knm i loko o ke anawaena;
• ka nele o na hoike ana mai o ka liluwelo laulā (Aey? acaeoey biochemical indices o ke koko);
• i ke alo o ole hou aku 3 lesion wahi.

Inā e hana ole ma ka liʻiliʻi loa i kekahi o kēia mau kumu, alaila, ua haawiia keia i ka pae o ka hoʻomanawanui me ka poe ilihune prognosis.

pāhawewe Inc

Full radiotherapy me he kanaka iaoia ua hoʻohana no nā mea maʻi me ka kahua IA a me ka iia,, hookupaa iho la ia ma laparotomy, a me ka ua i ka maikai prognostic aʻe. Ua ua i noa mahinaʻai me ka waiū i nāʻano o nā iʻa lymph aka wahi a lymph nōkahea ala.

Hapa o ka heluna hoʻokemuʻia ma ka metastases lesion mea 40-45 g. No 4-6 pule i loko o ka mahinaʻai o prophylactic irradiation - 30-40 g. No 1-4 pule. No hoi me ka widefield i kūpono ka hoʻohana nunui-kahua irradiation o kekahi lesions, e pale aku nodular sclerosis ns1.

Ka pāhawewe ke Inc hiki i na complications me subcutaneous'aʻaʻa fibrosis, pāhawewe pneumonitis a me ka pericarditis. Mea hōʻemi i hoʻomaka ai i kekahi manawa - mai ka 3 mahina a hiki i 5 makahiki ma hope lapaau. Lākou ka manaʻo pohihihi hilinaʻi nui ma luna o ka waiwai o ka mahele lāʻau.

ana

ʻoki lāʻau lapaʻau lapaʻau ua kākaʻikahi hoʻohana wale onoobychno mea māhele o ka luna 'Inc. Hana splenectomy, e like me ana ma luna o ka trachea, ka esophagus, i ka'ōpū a me nā nā loko (me ka pilikia o ka asphyxia, leʻa hoʻi o ka hooholo ia ana o ka ai). Wehe ae ia i ka wa e kahe ana chlamydia hāpai keiki e maopopo leʻa e keʻakeʻa.

chemotherapy

Kēia palapala Ua hoʻohana 'ia i kekahi ke keʻena o luna' lapaau. E hana nodular sclerosis, hoʻohanaʻokoʻa hoomakaukau:

• alkaloids ( "Vinblastine" a me "rozevin", "Etoposide" a me "Vincristine," Oncovin ");
• Alkire läÿau, ( "Mustargen", "Cyclophosphamide" a me "embihina", "nitrosomethylurea" a me "hlorbutin");
• kemikala konohiki ( "Natulan" a me "procarbazine," "Dacarbazine" a "Imidazole-carboxamide");
• antitumor antibiotics ( "Bleomycin", "adriablastin").

monochemotherapy

Ua Ua hoʻohana 'ia wale nō i loko o kūikawā hihia me ka manao ikaika o ka hōʻikeʻana i. Nō kāu hou medicaments koi Inc me ka okoaʻano papa hana o ka 'ana (chemotherapy). I ka ha o ke kahua i nā mea maʻi me ka eiei? Ake maʻi a me ka iwi ka lolo i ka lapaau o ka wale ala - keia mea i ka panina Hodgkin lymphoma. Nodular sclerosis ia me ia manaʻo:

• ABVD ( "Bleomycin", "Dacarbazine", "adriablastin" "Vinblastine");
• MOTAPMs ( "Oncovin", "prednisolone", "Mustargen", "procarbazine");
• TSVPP ( "Vinblastine", "prednisolone", "Cyclophosphamide", "procarbazine").

Inc ka pokole (2, 7, 14 lā) papa me ka mau-puleʻanuʻu. Ka helu o nā pōʻaiapuni loli aʻe ma muli o ka nui o ka loiloi mua lesion a me ka susceptibility i ka lapaau. I hookuu i ka a pau ke kala ana i loaʻa me ka kuhikuhi 2-6 papa. Ma hope o ia, ka mea, ua? Aeiiaiaoaony e hana i ka hou 2 pōʻaiapuni o ka Inc. Inā ka hopena ua hapa ke kala, mea hoʻololi i ka iapaau ana regimen ua, a me ka helu o nā papa, piʻi pū.

? Eaia mea pressurized ka lapaʻauʻia hematopoiesis, alopecia, dyspeptic symptoms, a waiho ma ka hope o ka lapaau. Nodular sclerosis nōʻo ia i ka hopena o complications, e like me infertility, leukaemias a me nā malignancies (kiʻekiʻe hikoko).

Outlook

Hodgkin ka maʻi ua kauoha ae la ia e ka pele ano, lapaʻau ke kahua o ka maʻi, makahiki o ke ahonui, a me nā histological type. Me ka pahikaua a me ka subacute papa o ka maʻi mea,ʻaʻole he prognosis maikai: hoʻomanawanui iki mai pele make i loko o ke au o ka 1-3 mahina i 1 makahiki. Akā, i ka maʻi chlamydia kēla conditionally maikaʻi. I ka maʻi ke mau no ka lōʻihi loa ka manawa, mai ka 15 makahiki (i loko o kekahi hihia nui hou).

I ka 40% o nā mea a pau mailoko o kanaka, o ka oi aku i loko o ka 1st a me ka 2nd ke kahua, e like me ka maikaʻi prognostic kumu, no ka mea, ma luna o ka 10 makahiki a oi recurrences i kaulana. Hana, e hana i ka hopena o ka lōʻihi like 'ole o ke kala ana i mea e haki.

Kāohi

E like me ka rula, ka mea, ua kauoha ia ka Kāohiʻana o relapses. Hoʻomanawanui iki mai me Hodgkin e nānā 'ia ai dispensary oncologist. Ma ke ao, i mea ka mua 3 makahiki o ka hana koi 'ia a pau i na malama eono, a laila koke ka makahiki, e pono e kālele ana ma luna o ka laulā o liluwelo nā hoailona pinepine i ka loiloi mua hoailona o ka recurrence (mea ulu i loko o ka nui o ka fibrinogen a me globulins, POP hoomahuahua). Hoʻomanawanui iki mai me Hodgkin ka maʻi nā palapala thermal physiotherapy, overheating a me ka pololei insolation. Kauia mea ulu i loko o ka helu ana o relapses aie i ka hāpai keiki.

Ano, he oiaio no, na kanaka ike i Hodgkin ka lymphoma - he Lolina nodular sclerosis, i mea he loa kaʻawaʻawa loa, a hiki ole i ka pono maʻi.