Isishwankathelo se-cutaneous (isikhumba) lymphoma
I-Lymphoma luhlobo lomhlaza oluqala kwiiseli ezimhlophe zegazi ezibizwa ngokuba yi-lymphocytes. Ezi seli zegazi zihlala zihlala kwi-lymphatic system, kodwa ziyakwazi ukuhamba nakweliphi na ilungu lomzimba wethu. Ziiseli ezibalulekileyo zesistim somzimba wethu, ukulwa usulelo kunye nesifo, kunye nokunceda ezinye iiseli zomzimba zisebenze ngokufanelekileyo.
Malunga Lymphocytes
Sineentlobo ezahlukeneyo ze-lymphocytes, kunye namaqela aphambili I-B-cell lymphocytes kwaye T-cell lymphocytes. Bobabini i-B kunye ne-T-cell lymphocytes inomsebenzi okhethekileyo, one "inkumbulo ye-immunological". Oku kuthetha ukuba xa sinosulelo, isifo, okanye ukuba ezinye iiseli zethu zonakaliswe (okanye ziguqulwe), ii-lymphocyte zethu zihlola ezi seli kwaye zenze "imemori ye-B okanye i-T-cell" ekhethekileyo.
Ezi seli zenkumbulo zigcina lonke ulwazi malunga nendlela yokulwa usulelo, okanye ukulungisa iiseli ezonakeleyo ukuba usulelo olufanayo okanye umonakalo uphinda wenzeke kwakhona. Ngale ndlela banokutshabalalisa okanye balungise iiseli ngokukhawuleza nangempumelelo ngakumbi kwixesha elizayo.
- I-B-cell lymphocyte yenza amajoni omzimba (i-immunoglobulins) ukunceda ukulwa nosulelo.
- Iiseli ze-T zinceda ukulawula iimpendulo zethu zokhuselo lomzimba ukuze amajoni ethu omzimba asebenze ngokufanelekileyo ukulwa nosulelo, kodwa ikwanceda ukunqanda impendulo yokuzikhusela xa usulelo luphelile.
I-Lymphocytes ingaba ziiseli ze-lymphoma ezinomhlaza
I-Cutaneous lymphomas iyenzeka xa iiseli ze-B okanye ii-T-seli ezihamba eluswini lwakho ziba nomhlaza. Iiseli ze-lymphoma ezinomhlaza emva koko ziyahlukana kwaye zikhule ngokungalawulekiyo, okanye zingafi xa kufuneka.
Bobabini abadala kunye nabantwana banokufumana i-lymphomas ye-cutaneous kwaye abaninzi abantu abane-lymphoma ye-cutaneous baya kuba neeseli ze-T ezinomhlaza. Kuphela ngabantu aba-5 kwabangama-20 abane-cutaneous lymphoma abaya kuba ne-B-cell lymphoma.
I-lymphomas edibeneyo yohlulwe ngokwe:
- Ukuyekelela - I-Indolent lymphomas ikhula ngokukhawuleza kwaye ihlala idlula kwizigaba apho "ilele" ingabangeli bungozi kuwe. Usenokungadingi naluphi na unyango ukuba une-indolent cutaneous lymphoma, nangona abanye abantu baya kwenza. Uninzi lwe-lymphomas indolent ayisasazeki kwezinye iindawo zomzimba wakho, nangona ezinye zinokugubungela iindawo ezahlukeneyo zesikhumba. Ngokuhamba kwexesha, ezinye i-lymphomas ezingenasiphelo zingaqhubela phambili kwinqanaba, oku kuthetha ukuba zisasazeka kwezinye iindawo zomzimba wakho, kodwa oku kunqabile kunye ne-lymphomas eninzi.
- Iyaxaka -I-lymphomas ezinobundlobongela zii-lymphomas ezikhula ngokukhawuleza ezinokukhula ngokukhawuleza kwaye zisasazeke kwezinye iindawo zomzimba wakho. Ukuba une-aggressive cutaneous lymphoma, kuya kufuneka uqale unyango ngokukhawuleza emva kokuba ufumene isifo.
Iimpawu zeCutaneous Lymphoma
I-Indolent cutaneous lymphoma
Awukwazi ukuba naziphi na iimpawu ezibonakalayo ukuba une-lymphoma engapheliyo. Ngenxa yokuba i-lymphomas i-indolent ikhula ngokukhawuleza, ikhula kwiminyaka emininzi, ngoko ke i-rash okanye isilonda esikhumbeni sakho sinokungabonakali. Ukuba ufumana iimpawu zinokubandakanya:
- irhashalala elingasukiyo
- iindawo ezirhawuzelayo okanye ezibuhlungu eluswini lwakho
- ezisicaba, ezibomvu, amaxolo eluswini
- izilonda ezinokuqhekeka kwaye zophe kwaye zingapholi njengoko kulindelekile
- ububomvu ngokubanzi kwiindawo ezinkulu zolusu
- iqhuma elinye, okanye ezininzi eluswini lwakho
- Ukuba unombala omnyama wesikhumba, unokuba neendawo zolusu ezikhanyayo kunezinye (kunokuba zibe bomvu).
Iipatches, iipapules, iiplakhi kunye namathumba - Yintoni umahluko?
Izilonda onazo nge-cutaneous lymphomas zisenokuba yirhashalala eqhelekileyo, okanye zisenokubizwa ngokuba ngamabala, iipapules, iiplakhi okanye amathumba.
Iziqwengana – zidla ngokuba ziindawo ezithe tyaba zolusu ezingafaniyo nolusu olujikelezileyo. Ziyakwazi ukugudiswa okanye zibe namaxolo kwaye zinokukhangeleka njengerhashalala jikelele.
Iphepha – ziindawo ezincinci, eziqinileyo eziphakanyisiweyo eluswini, kwaye zinokukhangeleka njengeqhakuva eliqinileyo.
Iiplaques – ziindawo eziqinileyo zolusu ezihlala ziphakanyiswe kancinci, iindawo ezityebileyo zolusu ezihlala zinexolo. Iiplakhi zihlala ziphosakele nge-eczema okanye i-psoriasis.
Amathumba – amaqhuma aphakanyisiweyo, amaqhuma okanye amaqhuqhuva anokuthi ngamanye amaxesha abe zizilonda ezingapholiyo.
I-Aggressive kunye ne-Advanced cutaneous lymphoma
Ukuba une-lymphoma eyingozi okanye ephucukileyo, unokuba nazo naziphi na iimpawu ezingentla, kodwa usenokuba nezinye iimpawu. Oku kunokubandakanya:
- I-lymph nodes ezidumbileyo onokuthi ukwazi ukuzibona okanye uzive njengeqhuma phantsi kwesikhumba sakho - ezi ngokuqhelekileyo ziya kuba sentanyeni, ekhwapheni okanye ethangeni.
- Ukudinwa kukudinwa okugqithisileyo akuphuculwanga kukuphumla okanye ukulala.
- Ukopha okungaqhelekanga okanye ukugruzuka.
- Usulelo oluhlala lubuya okanye alupheli.
- Ukuqhawukelwa ngumphefumlo.
- B-impawu.
Ifunyaniswa njani i-cutaneous lymphoma?
Uya kufuna i-biopsy okanye ii-biopsies ezininzi ukuze uhlolisise i-lymphoma ye-cutaneous. Uhlobo lwe-biopsy onayo luya kuxhomekeka kuhlobo lwerhashalala okanye izilonda onazo, apho zibekwe khona emzimbeni wakho kunye nokuba zikhulu kangakanani. Kuya kuxhomekeka nokuba lusu lwakho kuphela oluchaphazelekayo, okanye ukuba i-lymphoma isasazeke kwezinye iindawo zomzimba wakho ezifana ne-lymph nodes, amalungu, igazi okanye umongo wethambo. Ezinye zeentlobo ze-biopsies ezinokucetyiswa kuwe zidweliswe ngezantsi.
I-skin biopsy
I-biopsy yolusu kuxa isampulu yerhashalala okanye isilonda sakho isusiwe kwaye ithunyelwe kwi-pathology ukuze ivavanywe. Kwezinye iimeko, ukuba unesilonda esinye, isilonda sonke sinokususwa. Kukho iindlela ezahlukeneyo zokwenza i-biopsy yolusu, kwaye ugqirha wakho uya kuba nakho ukuthetha nawe malunga ne-biopsy yesikhumba efanelekileyo kwiimeko zakho.
I-lymph node biopsy
Ukuba une-lymph nodes ezidumbileyo ezinokubonwa okanye zivakale, okanye eziye zabonakala kwi-scans, unokuba ne-biopsy ukuze ubone ukuba i-lymphoma isasazekile kwii-lymph nodes zakho. Kukho iintlobo ezimbini eziphambili ze-lymph node biopsies ezisetyenziselwa ukuxilonga i-lymphoma.
Ziquka:
Inaliti biopsy enkulu – apho inaliti isetyenziselwa ukususa isampulu ye-lymph node echaphazelekayo. Uya kuba nesithomalalisi sendawo sokuthomalalisa indawo ukuze ungeva ntlungu ngexesha lale nkqubo. Kwezinye iimeko, ugqirha okanye i-radiologist inokusebenzisa i-ultrasound ukukhokela inaliti kwindawo efanelekileyo ye-biopsy.
I-biopsy ekhethekileyo – nge-excisional biopsy uya kuba ne-anesthetic jikelele ukuze ulale ngenkqubo. I-lymph node yonke okanye isilonda siyasuswa ngexesha kunye ne-excisional biopsy ukuze yonke indawo okanye i-lesion ihlolwe kwi-pathology yeempawu ze-lymphoma. Uya kuba nemithungo embalwa kunye nokunxiba xa uvuka. Umongikazi wakho uya kukwazi ukuthetha nawe malunga nendlela yokunyamekela inxeba, kwaye nini/ukuba kufuneka ususwe imithungo.
Iintlobo ezincinci ze-indolent cutaneous T-cell lymphomas
I-Mycosis Fungoides lolona didi luqhelekileyo lwe-indolent cutaneous T-cell lymphoma. Idla ngokuchaphazela abantu abadala, kwaye amadoda kaninzi kancinci kunabasetyhini, nangona kunjalo abantwana banakho ukuphuhlisa iMF. Ebantwaneni ichaphazela amakhwenkwe namantombazana ngokulinganayo kwaye idla ngokufunyaniswa xa ikwiminyaka eyi-10.
I-MF idla ngokuchaphazela ulusu lwakho kuphela, kodwa malunga nomntu om-1 kwabalishumi unokuba nohlobo olundlongo-ndlongo lwe-MF olunokusasazeka kwii-lymph nodes zakho, igazi kunye namalungu angaphakathi. Ukuba une-MF endlongondlongo, uya kufuna unyango olufana nolo nyango lunikezelwayo kwezinye i-T-cell lymphoma enobundlavini.
I-ALCL ye-cutaneous esisiseko yi-lymphoma engapheliyo (ekhula kancinane) eqala kwiiseli ze-T kumaleko wolusu lwakho.
Olu hlobo lwe-lymphoma ngamanye amaxesha lubizwa ngokuba yi-subtype ye-cutaneous lymphoma kwaye ngamanye amaxesha ibizwa ngokuba yi-subtype ye I-Anaplastic Enkulu Yeseli Lymphoma (ALCL). Isizathu sokuhlelwa ngokwahlukeneyo kukuba iiseli ze-lymphoma zineempawu ezifanayo kwezinye iindidi ze-ALCL ezifana neeseli ezinkulu kakhulu ezibonakala zahluke kakhulu kwiiseli zakho ze-T eziqhelekileyo. Nangona kunjalo, idla ngokuchaphazela kuphela ulusu lwakho kwaye ikhula ngokucothayo.
Ngokungafaniyo ne-subtypes enobungozi ye-cutaneous lymphoma kunye ne-ALCL, unokungadingi naluphi na unyango lwe-PCALCL. Unokuhlala kunye ne-PcALCL ubomi bakho bonke, kodwa kubalulekile ukwazi, ukuba unokuphila kakuhle kunye nayo, kwaye ingabi nayo nayiphi na impembelelo embi kwimpilo yakho. Ngokuqhelekileyo ichaphazela kuphela ulusu lwakho kwaye kunqabile isasazeka kwisikhumba sakho kwamanye amalungu omzimba wakho.
I-PCALCL ihlala iqala ngerhashalala okanye amaqhuma eluswini lwakho anokuthi arhawuzelelwe okanye abe buhlungu, kodwa asenokungakukhathazi. Ngamanye amaxesha, kusenokufana nesilonda esingapholiyo njengoko ubunokulindela ukuba siphole. Naluphi na unyango lwe-PCALCL lunokuphucula nakuphi na ukurhawuzelelwa okanye iintlungu, okanye ukuphucula inkangeleko ye-lymphoma kunokunyanga i-lymphoma ngokwayo. Nangona kunjalo, ukuba i-PCALCL ichaphazela kuphela indawo encinci yesikhumba, inokususwa ngotyando okanye nge-radiotherapy.
I-PcALCL ixhaphake kakhulu kubantu abaphakathi kweminyaka engama-50-60, kodwa inokuchaphazela nabani na ubudala, kuquka nabantwana.
I-SPTCL ingenzeka kubantwana nakubantu abadala kodwa ixhaphake kakhulu kubantu abadala, kunye ne-avareji yobudala ekuxilongweni kweminyaka engama-36 ubudala. Ibizwa ngolu hlobo kuba ikhangeleka njengenye imeko ebizwa ngokuba yi-panniculitis, eyenzeka xa izicubu ezinamafutha phantsi kwesikhumba zidumba, nto leyo ebangela ukuba kuvele amaqhuma. Malunga nomntu omnye kwabahlanu abane-SPTCL uya kuba nesifo esele sikhona esibangela ukuba amajoni akho omzimba ahlasele umzimba wakho.
I-SPTCL yenzeka xa iiseli ze-T ezinomhlaza zihamba kwaye zihlale kumaleko anzulu esikhumba sakho kunye nezicubu ezinamafutha, ezibangela ukuba amaqhuma aphume phantsi kwesikhumba sakho onokukubona okanye ukuziva. Usenokuqaphela amacwecwe esikhumbeni sakho. Uninzi lwezilonda zijikeleze i-2cm ngobukhulu okanye ngaphantsi.
Ezinye iziphumo ebezingalindelekanga onokuzifumana nge-SPTCL ziquka:
- amahlwili egazi okanye ukopha okungaqhelekanga
- bhinqa
- i-haemophagocytic lymphohistiocytosis-imeko apho uneeseli ezininzi zokhuselo lomzimba ezidala umonakalo kumongo wakho, iiseli zegazi ezisempilweni kunye namalungu.
- Isibindi esandisiweyo kunye/okanye udakada.
I-Lymphomatoid papulosis (LyP) inokuchaphazela abantwana kunye nabantu abadala. Ayingomhlaza ngoko ngokusemthethweni ayilohlobo lwe-lymphoma. Nangona kunjalo, ithathwa njenge-precursor ye-T-cell lymphoma ye-cutaneous efana ne-Mycosis Fungoides okanye i-Primary Cutaneous Anaplastic Large Cell Lymphoma, kwaye ngokungaqhelekanga. Hodgkin Lymphoma. Ukuba ufunyaniswe ukuba unale meko akunakufuna naluphi na unyango, kodwa uya kujongwa ngakumbi ngugqirha wakho ngazo naziphi na iimpawu ze-LyP ejika ibe ngumhlaza.
Yimeko echaphazela ulusu lwakho apho unokuba namaqhuma aphumayo esikhumbeni sakho. Izilonda zinokuqala kancinci kwaye zikhule zibe nkulu. Ziyakwazi ukuqhekeka kwaye zophe ngaphambi kokuba zome kwaye zihambe ngaphandle kokungenelela kwezonyango. Kungathatha ukuya kwiinyanga ezi-2 ukuba izilonda ziphele. Nangona kunjalo, ukuba zibangela intlungu okanye ukurhawuzelelwa okanye ezinye iimpawu ezingathandekiyo unokufumana unyango lokuphucula ezi mpawu.
Ukuba uhlala ufumana irhashalala okanye izilonda ezinje, bona ugqirha wakho malunga ne-biopsy.
Iintlobo ezincinci ze-indolent B-cell cutaneous lymphomas
Primary Cutaneous Follicle Centre Lymphoma (pcFCL) i indolent (ekhula kancinane) B-cell lymphoma. Iqhelekile kwihlabathi lasentshona kwaye ichaphazela izigulane ezikhulileyo, kunye ne-avareji yobudala ekuxilongweni iminyaka engama-60.
Olu lolona hlobo luqhelekileyo lweCutaneous B-Cell Lymphoma. Iqhele ukuvila (ikhula kancinane) kwaye ikhula kwiinyanga, okanye iminyaka. Ngokuqhelekileyo kubonakala njengezilonda ezibomvu okanye ezimdaka okanye amathumba eluswini lwentloko yakho, intamo, isifuba, okanye isisu. Abantu abaninzi abasoze bafune unyango lwe-pcFCL kodwa ukuba uneempawu ezingathandekiyo, okanye ukhathazwa yinkangeleko yayo, unokunikwa unyango lokuphucula iimpawu okanye imbonakalo ye-lymphoma.
I-Primary Cutaneous Marginal Zone Lymphoma (pcMZL) yintlupheko yesibini eqhelekileyo ye-B-cell cutaneous lymphomas kwaye ichaphazela amadoda ngokuphindwe kabini kunabasetyhini, nangona kunjalo ingenzeka nakubantwana. Ixhaphake kakhulu kubantu abadala abaneminyaka engaphezu kwama-55, kunye nabantu abaye banesifo seLyme ngaphambili.
Utshintsho lwesikhumba lunokuphuhla kwindawo enye, okanye kwiindawo ezininzi ezijikeleze umzimba wakho. Ngokuqhelekileyo iqala ezingalweni zakho, esifubeni okanye ngasemva njengombala opinki, obomvu okanye omfusa okanye amaqhuma.
Olu tshintsho lwenzeka ixesha elide, ngoko ke lusenokungabonakali kakhulu. Usenokungadingi naluphi na unyango lwe-pcMZL, kodwa unyango lunokunikwa ukuba uneempawu ezibangela ukuba ukhathazeke.
Olu luhlobo olunqabileyo lwe-CBCL olufumaneka kwizigulana ezingakhuselekanga kwaye zinentsholongwane ye-Epstein-Barr - intsholongwane ebangela i-glaular fever.
Uya kuba nesilonda esinye kuphela esikhumbeni sakho okanye kwindlela yakho yesisu okanye emlonyeni. Uninzi lwabantu alufuni unyango kolu hlobo luncinci lwe-CBCL. Nangona kunjalo, ukuba uthatha amayeza e-immunosuppressive, ugqirha wakho unokuphonononga ithamo ukuvumela amajoni akho omzimba ukuba aphile kancinci.
Kwiimeko ezinqabileyo, unokufuna unyango nge-monoclonal antibody okanye iyeza le-anti-viral.
Iintlobo ezincinci ze-Aggressive Lymphoma
I-Sezary Syndrome ibizwa ngokuba ziiseli ze-T ezinomhlaza zibizwa ngokuba ziiseli zeSezary.
Yeyona T-cell lymphoma (CTCL) eyingozi kakhulu ye-cutaneous cutaneous (CTCL) kwaye ngokungafaniyo nezinye iindidi ze-CTCL, iiseli ze-lymphoma (Sezary) azifumaneki kuphela kumaleko esikhumba sakho, kodwa nakwigazi lakho kunye nomongo wethambo. Basenokusasazeka kwii-lymph nodes kunye namanye amalungu.
I-Sezary Syndrome inokuchaphazela nabani na kodwa ixhaphake ngakumbi kumadoda angaphezulu kweminyaka engama-60 ubudala.
Iimpawu onokuzifumana ngeSezary Syndrome ziquka:
- B-impawu
- ukurhawuzelelwa kakhulu
- ukudumba kwamalungu enkovu
- ukudumba kwesibindi kunye / okanye udakada
- ukujiya kolusu ezintendeni zezandla zakho okanye ezinyaweni zeenyawo zakho
- ukutyeba komnwe wakho kunye neenzipho
- ukulahleka kweenwele
- Ukuwa kweciko iliso lakho (oku kubizwa ngokuba yi-ectropion).
Ngenxa yokukhula ngokukhawuleza kweeseli zeSezary, unokuphendula kakuhle kwi-chemotherapy esebenza ngokutshabalalisa iiseli ezikhula ngokukhawuleza. Nangona kunjalo, ukuphinda kuxhaphake ngeSezary Syndrome, okuthetha ukuba nasemva kwempendulo entle, kusenokwenzeka ukuba eso sifo sibuye kwaye sidinga unyango olungakumbi.
Le yi-T-cell lymphoma enqabileyo kakhulu kwaye inobundlongondlongo ekhokelela kwizilonda ezininzi zolusu ezikhula ngokukhawuleza kulusu phezu komzimba wonke. Izilonda zingamapapule, amaqhuqhuva okanye amaqhuqhuva anokuthi abe nesilonda kwaye abonakale njengezilonda ezivulekileyo. Ezinye zinokujongeka njengeeplakhi okanye amabala kwaye ezinye zinokopha.
Ezinye iimpawu zingabandakanya:
- B-impawu
- Ukuphelelwa kwesidlo
- ukukhathala
- isifo sohudo
- ukuhlanza
- ukudumba kwamalungu enkovu
- isibindi esandisiweyo okanye udakada.
Ngenxa yobundlongondlongo, i-PCAETL inokusasazeka kwiindawo ezingaphakathi emzimbeni wakho kubandakanya i-lymph nodes kunye namanye amalungu.
Uya kufuna unyango nge-chemotherapy ngokukhawuleza emva kokuxilongwa.
I-Primary Cutaneous (isikhumba) Diffuse Enkulu B-cell lymphoma luhlobo olunqabileyo lwe-lymphoma echaphazela ngaphantsi kwe-1 kubantu be-100 abane-NHL.
Oku kuqhelekile kunezinye iindidi zeCutaneous B-Cell Lymphomas. Ixhaphake kakhulu kwabasetyhini kunamadoda kwaye ithande ukuba ndlongondlongo okanye ukukhula ngokukhawuleza. Oku kuthetha ukuba kunye nokuchaphazela ulusu lwakho, inokusasazeka ngokukhawuleza kwezinye iindawo zomzimba wakho, kubandakanya i-lymph nodes kunye namanye amalungu.
Inokukhula kwiiveki ukuya kwiinyanga, kwaye ihlala ichaphazela abantu abadala malunga neminyaka engama-75 ubudala. Ihlala iqala emilenzeni yakho (uhlobo lomlenze) njengesilonda esinye okanye ngaphezulu / amathumba kodwa inokukhula kwiingalo zakho kunye ne-torso (isifuba, umva kunye nesisu).
Ibizwa ngokuba yi-Primary Cutaneous Diffuse Large B-cell Lymphoma kuba ngelixa iqala kwiiseli ze-B kumaleko esikhumba sakho, iiseli ze-lymphoma zifana nezo zifumaneka kwezinye ii-subtypes ze-Diffuse Large B-cell Lymphoma (DLBCL). Ngenxa yesi sizathu, le nxalenye ye-B-cell Lymphoma ye-cutaneous isoloko iphathwa ngokufanayo nezinye ii-subtypes ze-DLBCL. Ukuze ufumane inkcazelo engakumbi nge-DLBCL, cofa apha.
Ukuxilongwa kwe-Cutaneous Lymphoma
Emva kokuba kuqinisekisiwe ukuba une-lymphoma ye-cutaneous, kuya kufuneka ube neemvavanyo ezininzi ukuze ubone ukuba i-lymphoma isasazeke nakwamanye amalungu omzimba wakho.
Uhlolo loqobo
Ugqirha wakho uya kwenza uvavanyo lomzimba kwaye akhangele ulusu kuwo wonke umzimba wakho ukuze ubone ukuba ungakanani ulusu lwakho oluchatshazelwa yi-lymphoma. Basenokucela imvume yakho yokuthatha iifoto ukuze babe nerekhodi yokuba yayikhangeleka njani na phambi kokuba uqale naluphi na unyango. Baya kuthi ke basebenzise ezi ukujonga ukuba kukho ukuphucuka konyango. Imvume lukhetho lwakho, akunyanzelekanga ukuba ube neefoto ukuba awuziva ukhululekile koku, kodwa ukuba uyavuma, kuya kufuneka usayine ifomu yemvume.
I-Positron Emission Tomography (PET) Iskena
I<em>PET scan siskena somzimba wakho uphela. Yenziwa kwicandelo elikhethekileyo lesibhedlele elibizwa ngokuba “liyeza lenyukliya” kwaye uya kunikwa inaliti yeyeza le-radioactive elifunxa naziphi na iiseli ze-lymphoma. Xa iskena sithathwa, iindawo ezine-lymphoma emva koko zikhanyise kwi-scan ukubonisa apho i-lymphoma kunye nobukhulu kunye nokumila kwayo.
I-Computed Tomography (CT) scan
I-CT scan yi-X-reyi ekhethekileyo ethatha imifanekiso emi-3 emacala ngaphakathi emzimbeni wakho. Ngokuqhelekileyo kuthatha iskena sommandla womzimba wakho njengesifuba sakho, isisu okanye i-pelvis. Le mifanekiso ingabonisa ukuba ngaba une-lymph nodes ezidumbileyo ngaphakathi emzimbeni wakho, okanye iindawo ezibonakala zinomhlaza kumalungu akho.
I-Bone Marrow Biopsy
Uninzi lwabantu abane-lymphoma ye-cutaneous abayi kufuna i-biopsy yomongo wethambo. Nangona kunjalo, ukuba une-subtype enobudlova, unokufuna enye ukujonga ukuba i-lymphoma isasazeke kumongo wakho wethambo.
Iintlobo ezimbini ze-biopsies zithathwa ngexesha le-bone marrow biopsy:
- I-Bone marrow aspirate (BMA): olu vavanyo luthatha inani elincinci lolwelo olufumaneka kwisithuba somongo wethambo
- Umongo wethambo aspirate trephine (BMAT): olu vavanyo luthatha isampulu encinci yomongo wethambo
Inkqubo yesiteji ye-TNM/B ye-cutaneous lymphoma
Ukuma kwe-cutaneous lymphoma kusebenzisa inkqubo ebizwa ngokuba yi-TNM. Ukuba une-MF okanye i-SS kuya kongezwa unobumba owongezelelweyo - TNMB.
T = ubukhulu be Tummour - okanye ungakanani umzimba wakho ochatshazelwa yi-lymphoma.
N = i-lymph Nii-odes ezibandakanyekayo - ijonga ukuba i-lymphoma iye kwii-lymph nodes zakho, kwaye zingaphi ii-lymph nodes ezine-lymphoma kuzo.
M = MI-etastasis - ihlola ukuba, kunye nokuba i-lymphoma isasazeke kangakanani ngaphakathi emzimbeni wakho.
B = Blood - (i-MF okanye i-SS kuphela) ijonga ukuba ingakanani na i-lymphoma egazini lakho kunye nomongo wethambo.
I-TNM/B Ukuma kwe-Cutaneous Lymphoma |
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I-Lymphoma yesikhumba |
I-Mycosis fungoides (MF) okanye i-Sezary Syndrome (SS) kuphela |
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TUkuxhamlaokanye ulusucha phazela |
T1 – unesilonda esinye kuphela.T2 – unesilonda esingaphezulu kwesinye kodwa izilonda zikwindawo enye, okanye iindawo ezimbini ezisondeleleneyo umzimba wakho.T3 – unezilonda kwiindawo ezininzi zomzimba wakho. |
T1 - ngaphantsi kwe-10% yesikhumba sakho esichaphazelekayo.T2 – ngaphezu kwe-10 % yolusu lwakho luchaphazelekile.T3 – unethumba elinye okanye ngaphezulu elikhulu kune-1cm.T4 – une-erythema (ubomvu) egubungela ngaphezu kwe-80% yomzimba wakho. |
NUbunzimaNodes |
N0 -i-lymph nodes zakho ukubonakala eqhelekileyo.N1 – elinye iqela le-lymph nodes libandakanyeka.N2 -Amaqela amabini okanye ngaphezulu ee-lymph nodes achaphazeleka entanyeni yakho, ngaphezulu kwe-clavicle yakho, phantsi kweengalo; i-groin okanye amadolo.N3 - i-lymph nodes ngaphakathi, okanye kufuphi nesifuba sakho, imiphunga kunye neendlela zomoya, imithwalo yegazi emikhulu (i-aortic) okanye i-hips ibandakanyeka. |
N0 -I-lymph nodes zakho zibonakala ziqhelekileyo.N1 – une-lymph nodes ezingaqhelekanga ezinotshintsho lwebakala eliphantsi.N2 – Une-lymph nodes ezingaqhelekanga ezinotshintsho kwibakala eliphezulu.Nx – une-lymph nodes ezingaqhelekanga, kodwa ibakala alaziwa. |
MUkudlulela(usasazeko) |
M0 – akukho nanye kwi-lymph nodes yakho echaphazelekayo.M1 -i-lymphoma isasazeke kwii-lymph nodes ngaphandle kwesikhumba sakho. |
M0 – akukho nalinye kumalungu akho angaphakathi abandakanyekayo, njengemiphunga, isibindi, izintso, ingqondo.M1 -i-lymphoma isasazeke kwelinye okanye ngaphezulu kwamalungu akho angaphakathi. |
BIgazi |
N / A |
B0 – ngaphantsi kwe-5% (5 kwi-100 ngalinye) iilymphocyte ezinomhlaza egazini lakho.Ezi seli zomhlaza egazini lakho zibizwa ngokuba ziiSezary cells.B1 -Ngaphezu kwe-5% ye-lymphocytes egazini lakho ziiseli zeSezary.B2 -Ngaphezu kwe-1000 iiseli zeSezary kwixabiso elincinci kakhulu (i-1 microliter) yegazi lakho. |
Ugqirha wakho unokusebenzisa ezinye iileta ezinje ngo “a” okanye “b” ukuchaza ngakumbi iiseli zakho ze-lymphoma. Ezi zinokubhekisa kubungakanani be-lymphoma yakho, indlela ezikhangeleka ngayo iiseli, nokuba zonke ziphuma kwiseli enye engaqhelekanga (clones) okanye ngaphezulu kweseli enye engaqhelekanga.Cela ugqirha wakho ukuba akuchazele inqanaba lakho lomntu ngamnye kunye nebakala, kwaye kuthetha ntoni kunyango lwakho. |
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Unyango lwe-Indolent Cutaneous Lymphoma
Uninzi lwe-lymphomas engapheliyo ayinakunyangwa kodwa nangona kunjalo, abantu abaninzi abane-indolent cutaneous lymphomas abasayi kufuna unyango.
I-Indolent cutaneous lymphomas nayo ayisoloko iyingozi kwimpilo yakho, ngoko ke naluphi na unyango onalo luya kuba lokulawula iimpawu zakho kunokunyanga isifo sakho.
Ezinye iimpawu ezinokuthi zixhamle kunyango ziquka:
- intlungu
- kubetha
- amanxeba okanye izilonda ezigcina ukopha
- iintloni okanye ukuxhalaba okunxulumene nendlela i-lymphoma ebonakala ngayo.
Iintlobo zonyango zinokubandakanya oku kulandelayo.
Unyango olujoliswe kwingingqi okanye lwesikhumba.
Unyango oluphambili ziikhrim ozihlikihlayo kwindawo ye-lymphoma, ngelixa unyango olujongwe lusu lunokubandakanya i-radiotherapy okanye i-phototherapy. Apha ngezantsi sisishwankathelo sonyango oluthile onokuthi ulunikwe.
Corticosteroids - zinetyhefu kwiiseli ze-lymphoma kwaye zinceda ukuzitshabalalisa. Basenokunciphisa ukuvuvukala kwaye bancede ukuphucula iimpawu ezifana nokurhawuzelela.
Ii-retinoids - ngaba amayeza afana kakhulu ne-vitamin A. Anokunceda ukunciphisa ukuvuvukala, nokulawula ukukhula kweeseli eluswini. Zisetyenziswa kancinci, kodwa ziluncedo kwezinye iintlobo ze-skin lymphoma.
Ifototherapy- luhlobo lonyango olusebenzisa izibane ezikhethekileyo (i-UV rhoqo) kwiindawo zolusu lwakho ezichatshazelwa yi-lymphoma. I-UV iphazamisa inkqubo yokukhula kweeseli, kwaye ngokonakalisa inkqubo yokukhula, i-lymphoma iyatshatyalaliswa.
Radiotherapy – isebenzisa iiX-reyi ukwenza umonakalo kwiDNA yeseli (imfuzo yeseli) nto leyo eyenza kube nzima ukuba i-lymphoma ikwazi ukuzilungisa. Oku kubangela ukuba iseli ife. Ngokuqhelekileyo kuthatha iintsuku ezimbalwa okanye iiveki emva kokuba unyango lwemitha luqalisile ukuba iiseli zife. Esi siphumo sinokuhlala iinyanga ezininzi, oku kuthetha ukuba iiseli ze-lymphoma ezinomhlaza kwindawo/iindawo ezinyangweyo zinokutshatyalaliswa neenyanga emva kokuba unyango lugqityiwe.
Kwezinye iimeko unokwenza utyando, nokuba kuphantsi kweyeza lokuthomalalisa lasekuhlaleni okanye eliqhelekileyo ukususa yonke indawo yesikhumba echatshazelwe yi-lymphoma. Oku kunokwenzeka ngakumbi ukuba unesilonda esinye okanye amanxeba amancinci amaninzi. Isetyenziswa ngokuqhelekileyo njengenxalenye yenkqubo yokuxilonga i-lymphoma yakho, kunokuba ibe yonyango nangona kunjalo.
Unyango lwenkqubo
Ukuba unemimandla emininzi yomzimba wakho echatshazelwa yi-lymphoma, unokuxhamla kunyango lwenkqubo efana nechemotherapy, i-immunotherapy okanye unyango olujoliswe kuyo. Ezi zichazwe ngokubanzi phantsi kwecandelo elilandelayo – Unyango lwe-aggressive cutaneous lymphoma.
Unyango lwe-Aggressive okanye i-Advanced Cutaneous Lymphoma
I-lymphomas enobudlova kunye / okanye i-cutaneous lymphomas iphathwa ngokufanayo nezinye iintlobo ze-lymphoma enobudlova kwaye inokubandakanya:
Unyango lwenkqubo
I-Chemotherapy luhlobo lonyango oluhlasela ngokuthe ngqo iiseli ezikhula ngokukhawuleza, ngoko inokusebenza ngokutshabalalisa i-lymphomas ekhula ngokukhawuleza. Kodwa ayinakukwazi ukuwenza umahluko phakathi kweeseli ezisempilweni kunye nomhlaza ezikhula ngokukhawuleza, ngoko ke inokubangela iziphumo ebezingalindelekanga ezingafunekiyo ezinje ngokulahleka kweenwele, isicaphucaphu kunye nokugabha, okanye urhudo okanye ukuqhina.
I-Immunotherapies inokunceda amajoni akho omzimba afumane kwaye alwe ne-lymphoma ngokufanelekileyo. Oku banokukwenza ngeendlela ezininzi. Ezinye, ezifana ne-monoclonal antibodies zinamathele kwi-lymphoma ukuze uncede amajoni akho omzimba "abone" i-lymphoma ukuze ikwazi ukuyibona kwaye iyitshabalalise. Bayakwazi nokuchaphazela isakhiwo sodonga lweseli ye-lymphoma, okubangela ukuba bafe.
- Rituximab ngumzekelo we-antibody ye-monoclonal enokuthi isetyenziswe ukunyanga yiza B-cell lymphomas kuquka i-B-cell lymphoma yesikhumba ukuba bane-CD20 marker kubo.
- Mogamulizumab ngumzekelo we-antibody ye-monoclonal evunyiweyo kubantu abane I-Mycosis Fungides okanye i-Sezary Syndrome.
- Brentuximab vedotin ngumzekelo we-antibody "conjugated" ye-monoclonal evunyiweyo kwezinye iindidi ze T-iseli i-lymphoma ene-CD30 marker kuzo. Inetyhefu encanyathiselwe (edibeneyo) kwi-antibody, kwaye i-antibody ihambisa i-toxin ngqo kwiseli ye-lymphoma ukuyitshabalalisa ngaphakathi.
Ezinye, ezifana ne-interleukins kunye ne-interferon ziiprotheni ezikhethekileyo ezenzeka ngokwemvelo emzimbeni wethu, kodwa zinokuthathwa njengeyeza. Basebenza ngokunyusa amajoni akho omzimba, ukumnceda ukuba avuse ezinye iiseli zokhuselo lomzimba, kwaye ngokuxelela umzimba wakho ukuba wenze iiseli ezingaphezulu zokhuselo lomzimba ukulwa ne-lymphoma.
Unokuba ne-immunotherapies ngokwabo, okanye ngokudibanisa nezinye iintlobo zonyango ezifana ne-chemotherapy.
Unyango olujoliswe kuyo ngamayeza enziwe ajolise kwinto ethile kwiseli ye-lymphoma, ngoko ke kaninzi aneziphumo ebezingalindelekanga ezimbalwa kunolunye unyango. La mayeza asebenza ngokuphazamisa iimpawu ezifunekayo iiseli ze-lymphoma ukuze ziphile. Xa zingayifumani le miqondiso, iiseli ze-lymphoma ziyayeka ukukhula, okanye zilambe ngenxa yokuba azifumani izondlo ezifunekayo ukuze ziphile.
Ukufakelwa kweseli
Ukutshintshwa kweeseli ze-stem zisetyenziswa kuphela ukuba i-lymphoma yakho ayiphenduli kwezinye iindlela zonyango (i-refractory), okanye ibuyele emva kwexesha lokuxolelwa (ukuphinda ubuyele). Lunyango olunamanyathelo amaninzi apho ezakho, okanye iiseli eziziintloko zomnikeli (iiseli zegazi ezingekavuthwa kakhulu) zisuswa ngenkqubo ebizwa ngokuba yi-apheresis, zize ke zinikwe wena kamva, emva kokuba unedosi ephezulu yechemotherapy.
Nge-cutaneous lymphoma, kuqhelekile ukuba ufumane iiseli ze-stem kumnikeli kuneyakho. Olu hlobo lofakelo lwe-stem cell lubizwa ngokuba yi-Allogeneic Stem Cell transplant.
Ifotopheresis eyongeziweyo (ECP)
I-photopheresis ye-Extracorporeal lunyango olusetyenziswa kakhulu kwi-MF kunye ne-SS. Yinkqubo "yokuhlamba" igazi lakho kunye nokwenza iiseli zakho zokuzivikela zisebenze ngakumbi kwi-lymphoma ukuze kubulawe iiseli ze-lymphoma. Ukuba ufuna olu nyango, ugqirha wakho uya kuba nakho ukukunika ulwazi oluthe kratya.
Uvavanyo lweZliniki
Kucetyiswa ukuba nangaliphi na ixesha kufuneka uqale unyango ubuze ugqirha wakho malunga nolingo lwezonyango onokuthi ulufanelekele. Ulingo lwezonyango lubalulekile ukufumana amayeza amatsha, okanye indibaniselwano yamayeza ukuphucula unyango lwe-cutaneous lymphoma kwixesha elizayo.
Basenokukunika ithuba lokuzama iyeza elitsha, indibaniselwano yamayeza okanye olunye unyango ongenakukwazi ukulufumana ngaphandle kolingo. Ukuba unomdla wokuthatha inxaxheba kulingo lwezonyango, buza ugqirha wakho ukuba loluphi ulingo lwezonyango olufanelekileyo.
Kukho unyango oluninzi kunye nendibaniselwano zonyango olutsha oluvavanywayo ngoku kulingo lwezonyango kwihlabathi jikelele kwizigulana ezinee-lymphomas ezisanda kuxilongwa kunye neziphinde zavela.
Iinketho zonyango lwe-aggressive okanye i-late-stage cutaneous lymphoma | |
B-cell cutaneous | T-cell cutaneous |
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Kwakhona buza ugqirha wakho wegazi okanye i-oncologist malunga nalo naluphi na ulingo lwezonyango onokuthi ulufanelekele. | |
Kwenzeka ntoni xa unyango lungasebenzi, okanye i-lymphoma ibuyile
Ngamanye amaxesha unyango lwe-lymphoma alusebenzi ekuqaleni. Xa oku kusenzeka kubizwa ngokuba yi-refractory lymphoma. Kwezinye iimeko, unyango lunokusebenza kakuhle, kodwa emva kwexesha lokuxolelwa i-lymphoma inokubuya - oku kubizwa ngokuba yi-relapse.
Nokuba une-lymphoma ebuyileyo okanye i-refractory, ugqirha wakho uya kufuna ukuzama unyango olwahlukileyo olunokusebenza ngcono kuwe. Olu nyango lulandelayo lubizwa ngokuba lunyango lodidi lwesibini, kwaye lunokusebenza ngakumbi kunonyango lokuqala.
Thetha nogqirha wakho malunga nokulindela unyango lwakho, kwaye siya kuba yintoni isicwangciso ukuba nayiphi na kubo ayisebenzi.
Yintoni omawuyilindele xa unyango luphelile
Xa ugqibile unyango lwakho ugqirha wakho oyingcali useza kufuna ukukubona rhoqo. Uya kuhlolwa rhoqo kubandakanywa novavanyo lwegazi kunye neskeni. Ukuba ulufumana kangaphi olu vavanyo kuya kuxhomekeka kwimeko yakho kwaye ugqirha wakho wegazi uya kuba nakho ukukuxelela ukuba bafuna ukukubona kangaphi na.
Isenokuba lixesha elinika umdla okanye ixesha loxinzelelo xa ugqiba unyango – ngamanye amaxesha zombini. Akukho ndlela ilungileyo okanye ingalunganga yokuziva. Kodwa kubalulekile ukuthetha ngeemvakalelo zakho kunye nezinto ozifunayo nabantu obathandayo.
Inkxaso iyafumaneka ukuba unengxaki yokujongana nokuphela konyango. Thetha neqela lakho elinyangayo - ugqirha wakho wegazi okanye umongikazi oyingcali kumhlaza njengoko enokukwazi ukukuthumela kwiinkonzo zokucetyiswa ngaphakathi esibhedlele. Ugqirha wakho wengingqi (ugqirha jikelele – GP) naye angakunceda kule nto.
Abongikazi beLymphoma Care
Unganika omnye wabongikazi boNonophelo lweLymphoma umnxeba okanye i-imeyile. Cofa nje kwiqhosha elithi "Qhagamshelana nathi" ezantsi kwesikrini ukuze ufumane iinkcukacha zoqhagamshelwano.
isishwankathelo
- I-Cutaneous lymphoma luhlobo olungaphantsi lwe-Non-Hodgkin Lymphoma ephuma kwiiseli zegazi ezinomhlaza ezibizwa ngokuba yi-lymphocytes, ezihamba kwaye zihlala kumaleko wolusu lwakho.
- I-Indolent Cutaneous Lymphomas ayinakufuna unyango njengoko isoloko ingabiyongozi kwimpilo yakho, kodwa unokuba nonyango lokulawula iimpawu ukuba zikwenza ungakhululeki, okanye ukuba i-lymphoma isasazeka kwii-lymph nodes okanye kwamanye amalungu omzimba wakho.
- I-Aggressive Cutaneous Lymphomas ifuna unyango kwakamsinya nje emva kokuba ufunyanisiwe.
- Kukho oogqirha abahlukeneyo abahlukeneyo abanokulawula ukhathalelo lwakho, kwaye oku kuya kuxhomekeka kwiimeko zakho.
- Ukuba i-lymphoma yakho ichaphazela impilo yakho yengqondo okanye isimo sakho sengqondo unokucela ugqirha wakho ukuba akuthumele kwingcali yezengqondo ukuze ikuncede ukwazi ukumelana nayo.
- Unyango oluninzi lujolise ekuphuculeni iimpawu zakho; nangona kunjalo, unokufuna unyango lokulawula i-lymphoma, kwaye ezi zinokubandakanya i-chemotherapy, i-monoclonal antibodies, unyango olujoliswe kuyo kunye nokufakelwa kwe-stem cell.
