Kufotokozera mwachidule za cutaneous (khungu) lymphoma
Lymphoma ndi mtundu wa khansa yomwe imayambira m'maselo oyera a magazi otchedwa lymphocytes. Maselo a magaziwa nthawi zambiri amakhala mu lymphatic system yathu, koma amatha kupita ku gawo lililonse la thupi lathu. Ndi maselo ofunikira a chitetezo chathu cha mthupi, kumenyana ndi matenda ndi matenda, komanso kuthandiza maselo ena oteteza thupi kumagwira ntchito bwino.
Pafupi ndi Lymphocytes
Tili ndi mitundu yosiyanasiyana ya ma lymphocyte, ndipo magulu akuluakulu amakhala B-cell lymphocyte ndi T-cell lymphocytes. Ma lymphocyte a B ndi T-cell ali ndi ntchito yapadera, yokhala ndi "chikumbutso cha immunological". Izi zikutanthauza kuti tikakhala ndi matenda, matenda, kapena ngati ena mwa maselo athu awonongeka (kapena atasinthidwa), ma lymphocyte athu amawunika maselowa ndikupanga "memory B kapena T-cell" apadera.
Maselo okumbukirawa amasunga zidziwitso zonse za momwe angathanirane ndi matendawa, kapena kukonza ma cell owonongeka ngati matenda omwewo kapena kuwonongeka kwachitikanso. Mwanjira imeneyi amatha kuwononga kapena kukonza maselo mwachangu komanso mogwira mtima nthawi ina.
- B-cell lymphocyte imapanganso ma immunoglobulins kuti athe kulimbana ndi matenda.
- T-maselo amathandiza kuti chitetezo chathu cha mthupi chitetezeke kuti chitetezo chathu cha mthupi chigwire ntchito bwino polimbana ndi matenda, komanso kumathandiza kuti chitetezo cha mthupi chitetezeke matendawa atatha.
Ma lymphocyte amatha kukhala maselo a khansa ya lymphoma
Cutaneous lymphomas zimachitika pamene B-cell kapena T-cell omwe amapita pakhungu lanu amakhala ndi khansa. Maselo a khansa a lymphoma amagawanika ndikukula mosalamulirika, kapena samafa pamene ayenera.
Akuluakulu ndi ana amatha kutenga ma lymphomas ndipo anthu ambiri omwe ali ndi cutaneous lymphoma adzakhala ndi T-maselo a khansa. Pafupifupi anthu 5 mwa 20 aliwonse omwe ali ndi cutaneous lymphoma adzakhala ndi B-cell lymphoma.
Cutaneous lymphomas amagawidwa mu:
- Wosasamala - Ma Indolent lymphomas amakula pang'onopang'ono ndipo nthawi zambiri amadutsa magawo omwe "amagona" osakuvulazani. Simungafune chithandizo chilichonse ngati muli ndi indolent cutaneous lymphoma, ngakhale anthu ena adzatero. Ma lymphomas ambiri omwe ali ndi indolent samafalikira ku ziwalo zina za thupi lanu, ngakhale ena amatha kuphimba mbali zosiyanasiyana za khungu. M'kupita kwa nthawi, ma lymphoma ena osagwira ntchito amatha kupita patsogolo, kutanthauza kuti amafalikira kumadera ena a thupi lanu, koma izi ndizosowa ndi ma lymphoma ambiri opweteka.
- Wokwiya - Aggressive lymphomas ndi ma lymphoma omwe akukula mwachangu omwe amatha kukula mwachangu ndikufalikira kumadera ena a thupi lanu. Ngati muli ndi aggressive cutaneous lymphoma, muyenera kuyamba kulandira chithandizo mukangopezeka ndi matendawa.
Zizindikiro za Cutaneous Lymphoma
Indolent cutaneous lymphoma
Simungakhale ndi zizindikiro zowoneka ngati muli ndi indolent lymphoma. Chifukwa ma indolent lymphomas amakula pang'onopang'ono, amayamba zaka zambiri, kotero kuti zotupa kapena zotupa pakhungu lanu sizingawonekere. Ngati mupeza zizindikiro zingaphatikizepo:
- chiphuphu chomwe sichichoka
- kuyabwa kapena zowawa pakhungu lanu
- zopyapyala, zofiira, zotupa pakhungu
- zilonda zomwe zimatha kung'ambika ndikutuluka magazi osachira monga momwe amayembekezera
- kufiyira kwakukulu pakhungu lalikulu
- zotupa limodzi, kapena zingapo pakhungu lanu
- Ngati muli ndi khungu lakuda, mukhoza kukhala ndi malo opepuka kuposa ena (osati ofiira).
Zigamba, ma papules, zolembera ndi zotupa - pali kusiyana kotani?
Zilonda zomwe muli nazo ndi ma lymphomas a cutaneous amatha kukhala zotupa, kapena zitha kutchedwa zigamba, zotupa, zotupa kapena zotupa.
Mapazi - nthawi zambiri amakhala malo athyathyathya a khungu omwe amasiyana ndi khungu lozungulira. Zitha kukhala zosalala kapena zopindika ndipo zimatha kuwoneka ngati zotupa.
Magudumu - ndi malo ang'onoang'ono, olimba okwera pakhungu, ndipo amatha kuwoneka ngati pimple yolimba.
Mapilala - ndi malo olimba a khungu omwe nthawi zambiri amakwezedwa pang'ono, madera okhuthala omwe nthawi zambiri amakhala ndi mabala. Nthawi zambiri plaques amatha kuganiziridwa molakwika ndi eczema kapena psoriasis.
Zotupa - amakhala ndi ziphuphu, zotupa kapena tinatake tozungulira zomwe nthawi zina zimatha kukhala zilonda zomwe sizipola.
Aggressive and Advanced cutaneous lymphoma
Ngati muli ndi lymphoma yoopsa kapena yapamwamba, mukhoza kukhala ndi zizindikiro zomwe zili pamwambazi, koma mukhoza kukhala ndi zizindikiro zina. Izi zingaphatikizepo:
- Ma lymph nodes otupa omwe mutha kuwona kapena kumva ngati chotupa pansi pa khungu lanu - izi nthawi zambiri zimakhala m'khosi mwako, mkhwapa kapena ntchafu.
- Kutopa komwe ndi kutopa kwambiri sikumatheka ndi kupuma kapena kugona.
- Kutuluka magazi mwachilendo kapena mabala.
- Matenda omwe amabwereranso kapena osachoka.
- Kupuma pang'ono.
- B-zizindikiro.
Kodi cutaneous lymphoma imadziwika bwanji?
Mudzafunika biopsy kapena ma biopsy angapo kuti muzindikire cutaneous lymphoma. Mtundu wa biopsy womwe muli nawo umadalira mtundu wa zidzolo kapena zotupa zomwe muli nazo, komwe zili pathupi lanu komanso kukula kwake. Zidzadaliranso ngati khungu lanu lokha ndilomwe lakhudzidwa, kapena ngati lymphoma yafalikira ku ziwalo zina za thupi lanu monga ma lymph nodes, ziwalo, magazi kapena mafupa. Mitundu ina ya biopsies yomwe ingakulimbikitseni yalembedwa pansipa.
Khungu biopsy
Kupimidwa pakhungu ndi pamene chitsanzo cha zidzolo kapena zilonda zanu zimachotsedwa ndikutumizidwa ku matenda kuti akayesedwe. Nthawi zina, ngati muli ndi chotupa chimodzi, chotupa chonsecho chikhoza kuchotsedwa. Pali njira zingapo zopangira biopsy yapakhungu, ndipo adokotala azitha kukuwuzani za biopsy yoyenera pamikhalidwe yanu.
Matenda a mitsempha yambiri
Ngati muli ndi ma lymph node otupa omwe amatha kuwonedwa kapena kumveka, kapena omwe awonetsedwa pamasinthidwe, mutha kukhala ndi biopsy kuti muwone ngati lymphoma yafalikira kumatenda anu. Pali mitundu iwiri ikuluikulu ya ma lymph node biopsies omwe amagwiritsidwa ntchito pozindikira lymphoma.
Zikuphatikizapo:
Core singano biopsy - pamene singano imagwiritsidwa ntchito kuchotsa chitsanzo cha lymph node yomwe yakhudzidwa. Mudzapatsidwa mankhwala ochititsa dzanzi m'deralo kuti musamve kuwawa panthawiyi. Nthawi zina, dokotala kapena radiologist angagwiritse ntchito ultrasound kuti atsogolere singano pamalo oyenera kuti apange biopsy.
Excisional biopsy - ndi excisional biopsy mutha kukhala ndi mankhwala ogonetsa kuti mugone mwa njirayi. Ma lymph node kapena zilonda zonse zimachotsedwa panthawi ndi excisional biopsy kotero kuti node yonse kapena chotupa chikhoza kuyang'aniridwa ngati pali zizindikiro za lymphoma. Mukadzuka mudzakhala ndi zobvala zingapo ndi kuvala. Namwino wanu adzatha kukuwuzani momwe mungasamalire bala, komanso nthawi / ngati mukufunikira kuchotsedwa.
Ma subtypes a indolent cutaneous T-cell lymphomas
Mycosis Fungoides ndi mtundu wodziwika bwino wa T-cell lymphoma wa indolent cutaneous. Nthawi zambiri imakhudza achikulire, ndipo amuna nthawi zambiri kuposa akazi, komabe ana amathanso kukhala ndi MF. Kwa ana amakhudza anyamata ndi atsikana mofanana ndipo nthawi zambiri amapezeka ali ndi zaka 10.
MF nthawi zambiri imakhudza khungu lanu, koma pafupifupi munthu m'modzi mwa anthu khumi amatha kukhala ndi mtundu wankhanza kwambiri wa MF womwe ungafalikire ku ma lymph nodes, magazi ndi ziwalo zamkati. Ngati muli ndi matenda amtundu wa MF, mudzafunika chithandizo chofanana ndi chithandizo choperekedwa kwa T-cell lymphoma yoopsa.
Primary cutaneous ALCL ndi indolent (ikukula pang'onopang'ono) lymphoma yomwe imayambira mu T-maselo mu zigawo za khungu lanu.
Mtundu uwu wa lymphoma nthawi zina umatchedwa subtype ya cutaneous lymphoma ndipo nthawi zina amatchedwa subtype Anaplastic Large Cell Lymphoma (ALCL). Chifukwa cha magulu osiyanasiyana ndi chifukwa maselo a lymphoma ali ndi zofanana ndi mitundu ina ya ALCL monga kukhala maselo akuluakulu omwe amawoneka mosiyana kwambiri ndi T-maselo anu wamba. Komabe, nthawi zambiri zimakhudza khungu lanu ndipo limakula pang'onopang'ono.
Mosiyana ndi aggressive subtypes a cutaneous lymphoma ndi ALCL, simungafune chithandizo cha PCALCL. Mutha kukhala ndi PCALCL kwa moyo wanu wonse, koma ndikofunikira kudziwa, kuti mutha kukhala nawo bwino, ndipo sizingakhale ndi vuto lililonse pa thanzi lanu. Nthawi zambiri zimakhudza khungu lanu komanso kawirikawiri imafalikira kudutsa khungu lanu kupita ku ziwalo zina za thupi lanu.
PcALCL nthawi zambiri imayamba ndi zotupa kapena zotupa pakhungu zomwe zimatha kuyabwa kapena zowawa, koma sizingakubweretsereni vuto lililonse. Nthawi zina, zimatha kukhala ngati chilonda chomwe sichichira monga momwe mumayembekezera. Chithandizo chilichonse cha PCALCL chikhoza kukhala chothandizira kuyabwa kapena kupweteka kulikonse, kapena kusintha maonekedwe a lymphoma m'malo mochiza lymphoma yokha. Komabe, ngati PCALCL imakhudza kachigawo kakang'ono kwambiri ka khungu, ikhoza kuchotsedwa ndi opaleshoni kapena kudzera mu radiotherapy.
PcALCL imapezeka kwambiri mwa anthu azaka zapakati pa 50-60, koma imatha kugwira aliyense wazaka zilizonse, kuphatikiza ana.
SPTCL ikhoza kuchitika mwa ana ndi akuluakulu koma imapezeka kwambiri mwa akuluakulu, omwe ali ndi zaka zapakati pa matenda ndi zaka 36. Amatchedwa izi chifukwa amawoneka ngati vuto lina lotchedwa panniculitis, lomwe limachitika pamene minofu yamafuta pansi pa khungu ipsa, zomwe zimapangitsa kuti ziphuphu ziyambe. Pafupifupi munthu m'modzi mwa anthu asanu omwe ali ndi SPTCL adzakhalanso ndi matenda omwe alipo kale omwe amachititsa kuti chitetezo chanu cha mthupi chiwukire thupi lanu.
SPTCL imachitika pamene ma T-maselo a khansa amayenda ndikukhalabe m'miyendo yakuya ya khungu lanu ndi minofu yamafuta, zomwe zimapangitsa kuti zotupa zibwere pansi pa khungu lanu zomwe mungathe kuziwona kapena kuzimva. Mutha kuonanso zolembera pakhungu lanu. Zotupa zambiri zimakhala zozungulira 2cm kukula kapena kuchepera.
Zotsatira zina zomwe mungapeze ndi SPTCL ndi monga:
- magazi kuundana kapena magazi osadziwika bwino
- zovuta
- haemophagocytic lymphohistiocytosis - chikhalidwe chomwe mumakhala ndi maselo ambiri oteteza thupi omwe amawononga mafupa anu, maselo athanzi amagazi ndi ziwalo.
- Chiwindi chokulitsa ndi/kapena ndulu.
Lymphomatoid papulosis (LyP) imatha kukhudza ana ndi akulu. Si khansa choncho si mtundu wa lymphoma. Komabe, imawonedwa ngati kalambulabwalo wa T-cell lymphoma ya cutaneous monga Mycosis Fungoides kapena Primary Cutaneous Anaplastic Large Cell Lymphoma, ndipo kawirikawiri. Hodgkin Lymphoma. Ngati mwapezeka kuti muli ndi vutoli simungafune chithandizo chilichonse, koma muziyang'aniridwa mosamala ndi dokotala wanu chifukwa cha zizindikiro zilizonse za khansa ya LyP.
Ndi matenda omwe amakhudza khungu lanu pomwe mungakhale ndi zotupa zomwe zimabwera ndikupita pakhungu lanu. Zotupa zimatha kuyamba pang'ono ndikukulirakulira. Amatha kusweka ndikutuluka magazi asanawume ndikuchoka popanda chithandizo chilichonse chamankhwala. Zitha kutenga miyezi iwiri kuti zotupazo zithe. Komabe, ngati zimayambitsa kupweteka kapena kuyabwa kapena zizindikiro zina zosasangalatsa mutha kulandira chithandizo kuti musinthe izi.
Ngati nthawi zambiri mumatupa kapena zotupa monga chonchi, onani dokotala wanu kuti akuyeseni.
Ma subtypes a indolent B-cell cutaneous lymphomas
Primary Cutaneous Follicle Center Lymphoma (pcFCL) ndi indolent (ikukula pang'onopang'ono) B-cell lymphoma. Ndizofala kumayiko akumadzulo ndipo zimakhudza odwala okalamba, omwe ali ndi zaka zakubadwa amakhala zaka 60.
Uwu ndiye mtundu wodziwika bwino wa Cutaneous B-Cell Lymphoma. Nthawi zambiri imakhala yosasamala (kukula pang'onopang'ono) ndipo imakula pakapita miyezi, kapena zaka. Nthawi zambiri amawoneka ngati zotupa zofiira kapena zofiirira kapena zotupa pakhungu la mutu, khosi, pachifuwa, kapena pamimba. Anthu ambiri sadzafunikira chithandizo cha pcFCL koma ngati muli ndi zizindikiro zosasangalatsa, kapena mukuvutitsidwa ndi mawonekedwe ake, mutha kupatsidwa chithandizo kuti muchepetse zizindikiro kapena mawonekedwe a lymphoma.
Primary Cutaneous Marginal Zone Lymphoma (pcMZL) ndi yachiwiri yodziwika bwino ya B-cell cutaneous lymphomas ndipo imakhudza amuna kawiri kuposa akazi, komabe imathanso kuchitika mwa ana. Zimapezeka kwambiri mwa anthu okalamba azaka zopitilira 55, komanso anthu omwe adadwalapo kale matenda a Lyme.
Kusintha kwa khungu kumatha kuchitika pamalo amodzi, kapena malo angapo kuzungulira thupi lanu. Nthawi zambiri zimayambira pamanja, pachifuwa kapena kumbuyo ngati pinki, zofiira kapena zofiirira kapena zotupa.
Zosinthazi zimachitika kwa nthawi yayitali, kotero sizingawonekere. Simungafune chithandizo chilichonse cha pcMZL, koma chithandizo chingaperekedwe ngati muli ndi zizindikiro zomwe zikukudetsani nkhawa.
Uwu ndi mtundu wosowa kwambiri wa CBCL womwe umapezeka mwa odwala omwe ali ndi kachilombo ka Epstein-Barr - kachilombo kamene kamayambitsa matenda a glandular fever.
Mudzakhala ndi chilonda chimodzi chokha pakhungu lanu kapena m'mimba mwako kapena mkamwa. Anthu ambiri safuna chithandizo cha mtundu uwu wa CBCL. Komabe, ngati mukumwa mankhwala a immunosuppressive, dokotala wanu angayang'anenso mlingowo kuti chitetezo chanu cham'thupi chichiritse pang'ono.
Nthawi zina, mungafunike chithandizo ndi monoclonal antibody kapena anti-virus mankhwala.
Mitundu ya Aggressive Lymphoma
Sezary Syndrome imatchedwa chifukwa ma T-maselo a khansa amatchedwa Sezary cell.
Ndi T-cell lymphoma (CTCL) yoopsa kwambiri ya cutaneous cutaneous cutaneous (CTCL) ndipo mosiyana ndi mitundu ina ya CTCL, maselo a lymphoma (Sezary) amapezeka osati m'magulu a khungu lanu, komanso m'magazi anu ndi m'mafupa. Angathenso kufalikira ku ma lymph nodes ndi ziwalo zina.
Sezary Syndrome imatha kugwira aliyense koma imapezeka mwa amuna azaka zopitilira 60.
Zizindikiro zomwe mungapeze ndi Sezary Syndrome ndi monga:
- B-zizindikiro
- kuyabwa kwambiri
- zotupa zam'mimba zotupa
- kutupa chiwindi ndi / kapena ndulu
- kukhuthala kwa khungu m'manja mwanu kapena kumapazi anu
- kukhuthala kwa chala chanu ndi zikhadabo
- kupweteka tsitsi
- kugwa kwa chivindikiro cha diso lanu (izi zimatchedwa ectropion).
Chifukwa cha kukula mofulumira kwa maselo a Sezary, mukhoza kuyankha bwino ku chemotherapy yomwe imagwira ntchito powononga maselo omwe akukula mofulumira. Komabe, kubwereranso kumakhala kofala ndi Sezary Syndrome, kutanthauza kuti ngakhale mutayankhidwa bwino, n'kutheka kuti matendawa abwereranso ndipo amafunikira chithandizo china.
Ichi ndi T-cell lymphoma yosowa kwambiri komanso yaukali yomwe imabweretsa zilonda zambiri pakhungu zomwe zimakula mwachangu pakhungu pathupi lonse. Zilondazo zimatha kukhala zotupa, zotupa kapena zotupa zomwe zimatha kukhala ndi zilonda zowonekera. Zina zimatha kuwoneka ngati zigamba kapena zigamba ndipo zina zimatha kutulutsa magazi.
Zizindikiro zina zitha kuphatikiza:
- B-zizindikiro
- Kutaya njala
- kutopa
- kutsekula
- kusanza
- zotupa zam'mimba zotupa
- chiwindi chokulitsa kapena ndulu.
Chifukwa chaukali, PCAETL imatha kufalikira kumadera mkati mwa thupi lanu kuphatikiza ma lymph nodes ndi ziwalo zina.
Mudzafunika chithandizo ndi chemotherapy mwamsanga mutazindikira.
Khungu Loyamba (Khungu) Limafalikira B-cell Yaikulu lymphoma ndi mtundu wosowa wa lymphoma womwe umakhudza anthu osachepera 1 mwa 100 omwe ali ndi NHL.
Izi ndizochepa kwambiri poyerekeza ndi mitundu ina ya Cutaneous B-Cell Lymphomas. Imafala kwambiri mwa amayi kuposa amuna ndipo imakonda kukhala yaukali kapena ikukula mwachangu. Zomwe zikutanthauza kuti komanso zimakhudza khungu lanu, zimatha kufalikira mwachangu kumadera ena a thupi lanu, kuphatikiza ma lymph nodes ndi ziwalo zina.
Itha kukula pakadutsa milungu ingapo mpaka miyezi, ndipo nthawi zambiri imakhudza anthu okalamba azaka zapakati pa 75. Nthawi zambiri zimayambira pamiyendo yanu (mtundu wa mwendo) ngati chotupa chimodzi kapena zingapo koma zimathanso kukula m'mikono ndi torso (chifuwa, msana ndi pamimba).
Amatchedwa Primary Cutaneous Diffuse Large B-cell Lymphoma chifukwa pamene imayambira mu B-cell mu zigawo za khungu lanu, maselo a lymphoma ndi ofanana ndi omwe amapezeka m'magulu ena a Diffuse Large B-cell Lymphoma (DLBCL). Pachifukwa ichi, subtype iyi ya cutaneous B-cell Lymphoma nthawi zambiri imachitidwa mofanana ndi ma subtypes ena a DLBCL. Kuti mudziwe zambiri pa DLBCL, dinani apa.
Kukhazikika kwa Cutaneous Lymphoma
Zikatsimikiziridwa kuti muli ndi cutaneous lymphoma, muyenera kuyezetsa zambiri kuti muwone ngati lymphoma yafalikira ku ziwalo zina za thupi lanu.
Kufufuza mwakuthupi
Dokotala wanu adzayesa thupi lanu ndikuyang'ana khungu lanu lonse kuti awone momwe khungu lanu limakhudzidwira ndi lymphoma. Angapemphe chilolezo chanu kuti ajambule zithunzi kuti akhale ndi mbiri ya momwe zimawonekera musanayambe chithandizo chilichonse. Adzagwiritsa ntchito izi kuti aone ngati pali kusintha kwamankhwala. Chilolezo ndi chisankho chanu, simukuyenera kukhala ndi zithunzi ngati simukumva bwino ndi izi, koma ngati mukuvomera, muyenera kusaina fomu yololeza.
Positron Emission Tomography (PET) Scan
PET scan ndi sikani ya thupi lanu lonse. Zimachitidwa m'chigawo chapadera cha chipatala chotchedwa "nyukiliya mankhwala" ndipo mudzapatsidwa jekeseni wa mankhwala a radioactive omwe maselo aliwonse a lymphoma amamwa. Akajambula, madera omwe ali ndi lymphoma amawunikira pa sikelo kuti awonetse komwe kuli lymphoma ndi kukula kwake ndi mawonekedwe ake.
Computed Tomography (CT) scan
CT scan ndi X-ray yapadera yomwe imatenga zithunzi za 3 dimensional mkati mwa thupi lanu. Nthawi zambiri pamafunika jambulani gawo la thupi lanu monga chifuwa, pamimba kapena chiuno. Zithunzizi zitha kuwonetsa ngati muli ndi ma lymph node otupa mkati mwa thupi lanu, kapena malo omwe amawoneka ngati khansa m'ziwalo zanu.
Bone Marrow Biopsy
Anthu ambiri omwe ali ndi cutaneous lymphoma sangafunikire fupa la mafupa. Komabe, ngati muli ndi subtype yaukali, mungafunike imodzi kuti muwone ngati lymphoma yafalikira ku mafupa anu.
Mitundu iwiri ya biopsy imatengedwa panthawi ya mafupa a mafupa:
- Bone marrow aspirate (BMA): mayesowa amatenga madzi pang'ono omwe amapezeka mu fupa la mafupa
- Bone marrow aspirate trephine (BMAT): mayesowa amatenga chitsanzo chaching'ono cha minofu ya mafupa
TNM/B staging system for cutaneous lymphoma
Kupanga kwa cutaneous lymphoma kumagwiritsa ntchito njira yotchedwa TNM. Ngati muli ndi MF kapena SS muwonjezere kalata - TNMB.
T = kukula kwa Tmour - kapena kuchuluka kwa thupi lanu kumakhudzidwa ndi lymphoma.
N = lymph Nmayendedwe okhudzidwa - amafufuza ngati ma lymphoma apita ku ma lymph nodes anu, komanso ndi ma lymph nodes angati omwe ali ndi lymphoma mkati mwake.
M = Metastasis - imayang'ana ngati, komanso momwe lymphoma yafalikira mkati mwa thupi lanu.
B = Blood - (MF kapena SS yokha) imayang'ana kuchuluka kwa lymphoma m'magazi anu ndi m'mafupa.
TNM/B Gawo la Cutaneous Lymphoma |
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Matenda a Lymphoma |
Mycosis fungoides (MF) kapena Sezary Syndrome (SS) kokha |
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TKutupakapena khunguzakhudzidwa |
T1 - muli ndi chotupa chimodzi chokha.T2 - muli ndi zotupa zambiri pakhungu koma zotupa zili pamalo amodzi, kapena mbali ziwiri zoyandikana thupi lanu.T3 - muli ndi zotupa m'madera ambiri a thupi lanu. |
T1 - Khungu lanu lochepera 10% limakhudzidwa.T2 - kuposa 10% ya khungu lanu limakhudzidwa.T3 - muli ndi chotupa chimodzi kapena zingapo zazikulu kuposa 1cm.T4 - muli ndi erythema (kufiira) kukuta 80% ya thupi lanu. |
NZilondaNode |
N0 - ma lymph nodes anu kuwoneka bwino.N1 - gulu limodzi la ma lymph nodes limakhudzidwa.N2 - magulu awiri kapena angapo a ma lymph nodes amakhudzidwa pakhosi panu, pamwamba pa clavicle, m'manja mwanu; kubuula kapena mawondo.N3 - ma lymph nodes mkati, kapena pafupi ndi chifuwa chanu, mapapo ndi mpweya, mitsempha yaikulu ya magazi (aortic) kapena m'chiuno imakhudzidwa. |
N0 - Ma lymph nodes anu amaoneka ngati abwinobwino.N1 - muli ndi ma lymph nodes omwe sali bwino komanso kusintha kocheperako.N2 - Muli ndi ma lymph nodes omwe ali ndi kusintha kwakukulu.Nx - muli ndi ma lymph nodes omwe sali bwino, koma mlingo wake sudziwika. |
MMetastasis(kufalitsa) |
M0 - palibe lymph node yanu yomwe imakhudzidwa.M1 - lymphoma yafalikira ku ma lymph nodes kunja kwa khungu lanu. |
M0 - palibe ziwalo zanu zamkati zomwe zikukhudzidwa, monga mapapo, chiwindi, impso, ubongo.M1 - lymphoma yafalikira ku chimodzi kapena zingapo za ziwalo zanu zamkati. |
Bmagazi |
N / A |
B0 - ochepera 5% (5 mwa 100 aliwonse) omwe ali ndi khansa m'magazi anu.Maselo a khansawa m'magazi anu amatchedwa Sezary cell.B1 - Kuposa 5% ya ma lymphocyte m'magazi anu ndi maselo a Sezary.B2 - Maselo opitilira 1000 a Sezary ochepa kwambiri (1 microliter) yamagazi anu. |
Dokotala wanu angagwiritse ntchito zilembo zina monga "a" kapena "b" kuti afotokozenso maselo anu a lymphoma. Izi zingatanthauze kukula kwa lymphoma yanu, momwe maselo amawonekera, komanso ngati onse amachokera ku selo limodzi losazolowereka (clones) kapena maselo oposa achilendo.Funsani dokotala wanu kuti afotokoze siteji yanu payekha ndi kalasi, ndi zomwe zikutanthauza pa chithandizo chanu. |
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Chithandizo cha Indolent Cutaneous Lymphoma
Ma lymphoma ambiri osachiritsika sangachiritsidwe komabe ngakhale izi, anthu ambiri omwe ali ndi ma indolent cutaneous lymphomas sadzasowa chithandizo.
Ma Indolent cutaneous lymphomas nthawi zambiri sakhala owopsa ku thanzi lanu, ndiye kuti chithandizo chilichonse chomwe mungakhale nacho chikhala chowongolera matenda anu m'malo mochiza matenda anu.
Zizindikiro zina zomwe zingapindule ndi chithandizo ndi izi:
- ululu
- kuyabwa
- zilonda kapena zilonda zomwe zimatuluka magazi
- manyazi kapena nkhawa zokhudzana ndi momwe lymphoma imawonekera.
Mitundu ya chithandizo ingaphatikizepo zotsatirazi.
Chithandizo cham'deralo kapena pakhungu.
Mankhwala apakhungu ndi zodzoladzola zomwe mumapaka m'dera la lymphoma, pomwe chithandizo chowongolera khungu chimaphatikizapo radiotherapy kapena phototherapy. M'munsimu muli chithunzithunzi chamankhwala ena omwe mungapatsidwe.
Corticosteroids - ndi poizoni kwa maselo a lymphoma ndipo amathandiza kuwawononga. Angathenso kuchepetsa kutupa ndikuthandizira kusintha zizindikiro monga kuyabwa.
Zosakaniza - ndi mankhwala ofanana kwambiri ndi vitamini A. Angathandize kuchepetsa kutupa, ndikuwongolera kukula kwa maselo pakhungu. Amagwiritsidwa ntchito nthawi zambiri, koma amathandiza pamitundu ina ya lymphoma ya khungu.
Phototherapy - ndi mtundu wa chithandizo chomwe chimagwiritsa ntchito nyali zapadera (nthawi zambiri za UV) pakhungu lanu lomwe limakhudzidwa ndi lymphoma. UV amalepheretsa kukula kwa maselo, ndipo powononga kukula kwake, lymphoma imawonongeka.
Radiotherapy - amagwiritsa ntchito ma X-ray kuti awononge DNA ya selo (majini a selo) zomwe zimapangitsa kuti lymphoma ikhale yosatheka kudzikonza yokha. Izi zimapangitsa kuti selo life. Nthawi zambiri zimatenga masiku angapo kapena masabata pambuyo poyambira chithandizo cha radiation kuti maselo afe. Izi zitha kukhala kwa miyezi ingapo, kutanthauza kuti ma cell a khansa omwe ali m'malo ochizira amatha kuwonongedwa ngakhale miyezi ingapo chithandizo chitatha.
Nthawi zina mutha kuchitidwa opaleshoni, mothandizidwa ndi mankhwala oletsa ululu wamba kapena wamba kuti muchotse khungu lonse lomwe limakhudzidwa ndi lymphoma. Izi zimatheka ngati muli ndi chotupa chimodzi kapena zingapo zazing'ono. Amagwiritsidwa ntchito kwambiri ngati njira yodziwira lymphoma yanu, osati ngati mankhwala.
Njira zamankhwala
Ngati muli ndi mbali zambiri za thupi lanu zomwe zimakhudzidwa ndi lymphoma, mukhoza kupindula ndi chithandizo chamankhwala monga chemotherapy, immunotherapy kapena chithandizo chamankhwala. Izi zafotokozedwa mwatsatanetsatane mu gawo lotsatira - Chithandizo cha aggressive cutaneous lymphoma.
Chithandizo cha Aggressive kapena Advanced Cutaneous Lymphoma
Aggressive and/kapena advanced cutaneous lymphomas amachitiridwa chimodzimodzi ndi mitundu ina ya aggressive lymphoma ndipo ingaphatikizepo:
Njira zamankhwala
Chemotherapy ndi mtundu wa chithandizo chomwe chimakhudza mwachindunji maselo omwe akukula mwachangu, motero amatha kuwononga ma lymphoma omwe akukula mwachangu. Koma silingathe kusiyanitsa pakati pa maselo athanzi ndi khansa omwe amakula mofulumira, motero angayambitse zotsatira zina zosafunikira monga kuthothoka tsitsi, nseru ndi kusanza, kapena kutsegula m'mimba kapena kudzimbidwa.
Immunotherapies ingathandize chitetezo chanu cha mthupi kupeza ndikumenyana ndi lymphoma bwino. Angachite zimenezi m’njira zingapo. Zina, monga ma antibodies a monoclonal omwe amamangiriza ku lymphoma kuti athandize chitetezo chanu cha mthupi "kuwona" lymphoma kuti athe kuzindikira ndikuwononga. Amathanso kukhudza kapangidwe ka khoma la cell ya lymphoma, kuwapangitsa kufa.
- Rituximab ndi chitsanzo cha monoclonal antibody yomwe ingagwiritsidwe ntchito pochiza kubwera B-cell lymphomas kuphatikiza B-cell lymphoma ngati ali ndi cholembera CD20.
- Mogamulizumab ndi chitsanzo cha antibody monoclonal ovomerezeka kwa anthu omwe ali ndi Mycosis bowa kapena Sezary Syndrome.
- Brentuximab vedotin ndi chitsanzo cha "conjugated" monoclonal antibody yomwe imavomerezedwa ku mitundu ina ya T-selo lymphoma yomwe ili ndi chizindikiro cha CD30 pa iwo. Ili ndi poizoni yomwe imalumikizidwa (yolumikizana) ku antibody, ndipo antibody imapereka poizoni molunjika mu cell ya lymphoma kuti iwononge mkati.
Zina, monga ma interleukins ndi interferon ndi mapuloteni apadera omwe amapezeka mwachibadwa m'matupi athu, koma amathanso kutengedwa ngati mankhwala. Amagwira ntchito polimbikitsa chitetezo cha mthupi lanu, ndikuwathandiza kudzutsa maselo ena oteteza thupi, ndikuwuza thupi lanu kuti lipange maselo ambiri oteteza chitetezo ku lymphoma.
Mutha kukhala ndi ma immunotherapies paokha, kapena kuphatikiza ndi mitundu ina yamankhwala monga chemotherapy.
Njira zochiritsira zomwe zimagwiritsidwa ntchito ndi mankhwala omwe amapangidwa omwe amalunjika ku selo la lymphoma, choncho nthawi zambiri amakhala ndi zotsatira zochepa kusiyana ndi mankhwala ena. Mankhwalawa amagwira ntchito posokoneza zizindikiro zomwe maselo a lymphoma amafunika kuti apulumuke. Akapanda kupeza zizindikiro zimenezi, maselo a lymphoma amasiya kukula, kapena amafa ndi njala chifukwa sapeza zakudya zomwe amafunikira kuti apulumuke.
Kupanga khungu la tsinde
Kuika maselo a stem kumagwiritsidwa ntchito ngati lymphoma yanu siimayankha ku chithandizo china (ndi chokanirira), kapena kubwereranso pambuyo pa chikhululukiro (kuyambiranso). Ndi chithandizo cha masitepe angapo pomwe ma cell anu, kapena ma cell a wopereka (maselo osakhwima kwambiri amagazi) amachotsedwa kudzera mu njira yotchedwa apheresis, ndiyeno kupatsidwa kwa inu pakapita nthawi, mutatha kumwa mankhwala amphamvu kwambiri.
Ndi cutaneous lymphoma, ndizofala kwambiri kuti mulandire ma cell cell kuchokera kwa wopereka osati anu. Mtundu woterewu wa stem cell transplant umatchedwa kuti Allogeneic Stem Cell transplant.
Extracorporeal photopheresis (ECP)
Extracorporeal photopheresis ndi mankhwala omwe amagwiritsidwa ntchito makamaka pa MF ndi SS. Ndiko "kutsuka" magazi anu ndikupanga maselo anu a chitetezo chamthupi kukhala okhudzidwa kwambiri ndi lymphoma kuti maselo a lymphoma aphedwe. Ngati mukufuna chithandizochi, dokotala wanu adzatha kukupatsani zambiri.
chipatala Mayesero
Ndibwino kuti nthawi iliyonse yomwe mukufuna kuyamba mankhwala mumafunsa dokotala za mayesero a zachipatala omwe mungakhale oyenerera. Mayesero azachipatala ndi ofunikira kuti apeze mankhwala atsopano, kapena osakaniza oti athandizire kuchiza cutaneous lymphoma mtsogolomo.
Akhozanso kukupatsani mwayi woyesera mankhwala atsopano, mankhwala osakaniza kapena mankhwala ena omwe simungathe kupita nawo kunja kwa mayesero. Ngati mukufuna kutenga nawo mbali pamayesero azachipatala, funsani dokotala kuti ndi mayesero ati azachipatala omwe mukuyenera nawo.
Pali mankhwala ambiri komanso kuphatikiza kwatsopano kwamankhwala omwe akuyesedwa pano m'mayesero azachipatala padziko lonse lapansi kwa odwala omwe ali ndi ma lymphoma omwe angowapeza kumene komanso omwe ayambiranso.
Njira zochizira matenda aaggressive or late-stage cutaneous lymphoma | |
B-maselo a khungu | T-cell cutaneous |
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Komanso funsani dokotala wanu wamagazi kapena oncologist za mayeso aliwonse azachipatala omwe mungakhale nawo. | |
Chimachitika ndi chiyani ngati chithandizo sichigwira ntchito, kapena lymphoma imabwereranso
Nthawi zina chithandizo cha lymphoma sichigwira ntchito poyamba. Izi zikachitika zimatchedwa refractory lymphoma. Nthawi zina, chithandizocho chikhoza kugwira ntchito bwino, koma pakapita nthawi yochepetsera lymphoma ikhoza kubwereranso - izi zimatchedwa kubwereranso.
Kaya muli ndi kachilombo koyambitsa matenda a lymphoma kapena refractory, dokotala wanu adzafuna kuyesa mankhwala ena omwe angagwire ntchito bwino kwa inu. Mankhwala otsatirawa amatchedwa chithandizo chamzere wachiwiri, ndipo akhoza kukhala othandiza kwambiri kuposa oyamba.
Lankhulani ndi dokotala wanu zomwe ziyembekezero za chithandizo chanu ziri, ndipo ndondomekoyi idzakhala yotani ngati wina wa iwo sagwira ntchito.
Zomwe mungayembekezere mankhwala akatha
Mukamaliza chithandizo dokotala wanu katswiri adzafunabe kukuwonani pafupipafupi. Mudzayezedwa pafupipafupi kuphatikiza kuyezetsa magazi ndi masikelo. Kangati mumayezetsa izi zimatengera momwe muliri ndipo dokotala wanu wamagazi azitha kukuuzani kangati akufuna kukuwonani.
Itha kukhala nthawi yosangalatsa kapena yovutitsa mukamaliza chithandizo - nthawi zina zonse ziwiri. Palibe njira yolondola kapena yolakwika yomvera. Koma m’pofunika kulankhula za mmene mukumvera komanso zimene mukufunikira ndi okondedwa anu.
Thandizo limapezeka ngati mukukumana ndi vuto lothana ndi kutha kwa chithandizo. Lankhulani ndi gulu lanu lachipatala - dokotala wanu wamagazi kapena namwino wa khansa chifukwa akhoza kukupatsani uphungu kuchipatala. Dokotala wakudera lanu (dokotala wamkulu - GP) athanso kukuthandizani pa izi.
Anamwino Osamalira Lymphoma
Muthanso kuyimbira foni kapena imelo kwa m'modzi mwa anamwino athu a Lymphoma Care. Ingodinani pa batani la "Contact Us" pansi pazenera kuti mumve zambiri.
Chidule
- Cutaneous lymphoma ndi gulu laling'ono la Non-Hodgkin Lymphoma lomwe limachokera ku maselo a khansa otchedwa lymphocytes, omwe amayenda ndikukhala m'magulu a khungu lanu.
- Indolent Cutaneous Lymphomas mwina sangafunikire chithandizo chifukwa nthawi zambiri sakhala owopsa ku thanzi lanu, koma mutha kulandira chithandizo kuti muchepetse zizindikiro ngati zikukuvutani, kapena ngati lymphoma ifalikira ku ma lymph nodes kapena mbali zina za thupi lanu.
- Aggressive Cutaneous Lymphomas amafunika chithandizo mukangopezeka ndi matenda.
- Pali madotolo angapo apadera omwe atha kuyang'anira chisamaliro chanu, ndipo izi zimatengera momwe mungakhalire.
- Ngati lymphoma yanu ikukhudza umoyo wanu wamaganizo kapena maganizo anu mukhoza kufunsa dokotala kuti akutumizireni kwa katswiri wa zamaganizo kuti akuthandizeni kupirira.
- Mankhwala ambiri amapangidwa kuti athetse zizindikiro zanu; Komabe, mungafunikenso chithandizo chamankhwala kuti muzitha kuyang'anira lymphoma, ndipo izi zingaphatikizepo mankhwala amphamvu amphamvu amphamvu, ma monoclonal antibodies, mankhwala ochizira omwe akuwatsogolera ndikusintha ma cell cell.
