Ngamanye amaxesha kunokuthatha ixesha kwaye iimvavanyo ezininzi zifunyanwe nge-lymphoma. Oku kungenxa yokuba iimpawu ze-lymphoma zihlala zifana kakhulu nezinye, izigulo eziqhelekileyo, ngoko ugqirha wakho unokuvavanyela ezi zigulo kuqala. Ukuba iimpawu zakho ziyaqhubeka, banokugqiba ukuvavanya i-lymphoma. Uvavanyo lwe-lymphoma lunokwenziwa ngugqirha wengingqi yakho kodwa rhoqo, ukuba bayakrokrela ukuba une-lymphoma, baya kukuthumela kugqirha oyincutshe obizwa ngokuba yi-hematologist okanye i-oncologist ukuze ufumane ezinye iimvavanyo.
Uya kufuna i-biopsy ukuxilonga i-lymphoma, kwaye ukuba unayo i-lymphoma uya kufuna iimvavanyo ezininzi ukujonga inqanaba kunye nebakala le-lymphoma yakho. Eli phepha liza kuhamba ngeentlobo ezahlukeneyo zovavanyo kunye ne-biopsies ezisetyenziselwa ukuxilonga i-lymphoma, izikena ezisetyenziselwa ukwenza i-lymphoma yeqonga kunye nezinye iintlobo zovavanyo onokulufuna.
Yintoni i-Diagnostic, Staging and Grading?
Ukuqondwa
Ukucwangcisa
UkuGcina
Ifunyaniswa njani i-lymphoma?
Ukuxilonga i-lymphoma, uya kufuna i-biopsy yendawo yomzimba wakho echaphazelekayo. Oku kunokuthetha ukuba ufuna i-biopsy ye-lymph node yakho, ulusu, ulwelo olujikeleze umqolo wakho okanye umongo wethambo. Kwezinye iimeko unokufuna i-biopsy yezicubu kwimiphunga yakho, isisu okanye izibilini.
Awuyi kufuna zonke ezi mvavanyo. Ugqirha wakho uya kwenza eyona biopsy ilungileyo ngokusekwe kwimeko yakho. Cofa kwizihloko ezingezantsi ukuze ufunde malunga neentlobo ezahlukeneyo ze-lymph node biopsy.
Iintlobo ze-biopsies
Uya kuba nesithomalalisi sasekhaya sokuthoba indawo ye-biopsy yakho, kwaye kwezinye iimeko unokuba ne-anesthetic jikelele. Oku kuya kuxhomekeka kwindawo ye-lymph node okanye izicubu eziza kwenziwa i-biopsy, kwaye kulula kangakanani ukuba ugqirha afike kuyo.
Phantse abantwana baya kusoloko beneyeza lokuthomalalisa iintlungu jikelele ukuze balale nge-biopsy. Oku kunceda ukubanqanda ekubandezelekeni, kwaye kuqinisekisa ukuba bahlala behleli ngexesha lenkqubo.
I-excisional biopsy yi-biopsy eyenziwa ngexesha lotyando oluncinci. Yeyona ndlela isebenzayo yokuxilonga i-lymphoma kwi-lymph node kuba yonke i-lymph node isusiwe kwaye ihlolwe kwi-pathology.
Xa i-lymph node kufuneka isuswe ikufuphi nesikhumba sakho, unokwenza le nkqubo xa uvukile. Uza kuba nesithomalalisi sendawo sokuthomalalisa indawo leyo ukuze ungeva ntlungu. Unokuba nemithungo emva kwenkqubo eya kugqunywa ngesinxibo esincinci. Ugqirha wakho okanye umongikazi uya kuba nakho ukukuxelela ixesha lokukhupha izititshi kunye nendlela yokulawula ukunxiba kwakho ukuthintela usulelo.
Kuthekani ukuba i-lymph node ingaphakathi emzimbeni wam?
Ukuba i-lymph node inzulu ngaphakathi emzimbeni wakho, unokuba ne-anesthetic jikelele ngoko uya kulala ngexesha lenkqubo. Uya kuba nemithungo kunye nempahla encinci phezu kwabo xa uvuka. Ugqirha wakho okanye umongikazi uya kuthetha nawe malunga nendlela yokulawula ukunxitywa kunye nokuba kufuneka ususwe nini imithungo.
Kwezinye iimeko kunokulibaziseka ekufumaneni i-excisional biopsy, kuba ifuna utyando, kwaye kunokubakho uluhlu lokulinda lokungena.
I-incisional biopsy ifana ne-excisional biopsy, kodwa endaweni yokususa yonke i-lymph node, kuphela inxalenye ye-lymph node isusiwe.
Oku kunokwenziwa ukuba i-lymph node inkulu kakhulu, okanye ii-lymph nodes zakho zidibene - oku kuthetha ukuba zidibene kunye nezinye ii-lymph nodes. Kwezinye iimeko kunokubakho ukulibaziseka ekufumaneni i-excisional biopsy, kuba ifuna utyando, kwaye kunokubakho uluhlu lokulinda.
I-core biopsy isetyenziselwa ukuthatha isampulu encinci ye-lymph node okanye ulusu oluchaphazelekayo ukuba unerhashalala okanye iqhuma elikrokrayo. Ngamanye amaxesha zikwabizwa ngokuba yinaliti ye-biopsy. Ngokuqhelekileyo kwenziwa nge-anesthetic yendawo, kwaye kuxhomekeke kwindawo ekuyo, ugqirha unokusebenzisa i-ultrasound okanye i-CT scan ukunceda ukukhokela inaliti kwindawo efanelekileyo.
Kuba isampulu ithathwa ngenaliti enomngxuma, isampulu incinci kakhulu kune-excisional or incisional biopsy. Oku kuthetha ukuba ngamanye amaxesha iiseli ezinomhlaza zinokungathathwa kwisampulu, okukhokelela ekubeni i-lymphoma iphoswe. Kodwa i-biopsies engundoqo inokuba luncedo xa kukho ukulibaziseka kwexesha elide le-excisional okanye i-incisional biopsy. Unokufuna ngaphezulu kwe-biopsy enye engundoqo ukuxilonga i-lymphoma.
Inaliti ecolekileyo ye-biopsy isebenzisa inaliti encinci esetyenziselwa i-core biopsy. Ngokuqhelekileyo akukhuthazwa ukuxilonga i-lymphoma kuba ayinikezeli isampuli enkulu ngokwaneleyo ukufumana umphumo othembekileyo.
Nangona kunjalo ngamanye amaxesha, i-biopsy yenaliti entle inokwenziwa ukujonga ezinye izinto, kwaye inokuthatha iiseli ze-lymphoma. Uya kuthunyelwa kwezinye iimvavanyo ukuba kubonakala ngathi kukho iiseli ze-lymphoma kwi-biopsy yakho.
Ngelixa oogqirha abaninzi bekubiza ukuba kukho into ekukhathazayo kwiziphumo zovavanyo lwakho, ayingabo bonke abakwenzayo. Kwaye kunqabile, iziphumo zinokulahleka okanye ziphoswe. Soloko usenza idinga lokulandelela kunye nogqirha wakho ukuze ufumane iziphumo zovavanyo lwegazi, iskeni kunye ne-biopsies.
Uqhagamshelane nini nogqirha wakho
Qhagamshelana nogqirha wakho okanye umongikazi ngengcebiso ukuba ufumana naziphi na ezi mpawu zilandelayo:
- Iimpawu zosulelo kubandakanywa ubushushu obungama-38º nangaphezulu, iingqele kunye nokungcangcazela, ubofu okanye ukukhutshwa okungaqhelekanga enxebeni.
- Ukopha okungayekiyo emva kokubeka ipakethe ebandayo (okanye ii-ertyisi ezikhenkcezisiweyo) phezu kwesiza, okanye egcwalisa yonke into yokunxiba.
- Intlungu engaphucukanga ngeparacetamol (eyaziwa ngokuba yiPanadol, iPanamax okanye iDymadon).
Yintoni iBone Marrow Biopsy?
I-biopsy yomongo yinkqubo eyenziwa ukususa isampulu yomongo wakho ngaphakathi kwethambo lakho. Ngokuqhelekileyo kuthathwa kwithambo le-hip, kodwa kwezinye iimeko zingathathwa kwamanye amathambo. Le biopsy ingasetyenziselwa ukunceda ukufumanisa ezinye ii-subtypes ze-lymphoma, kwaye isetyenziselwa ukwenza ezinye iindidi ezincinci.
Yintoni iLumbar puncture?
Unokucetyiswa ukuba ube ne-lumbar puncture (LP) ukuba kukho ithuba lokuba une-lymphoma kwindawo yakho. kwinkqubo yomnatha (CNS), equka ingqondo yakho, intambo yomgogodla kunye nommandla emva kwamehlo akho.
Ngexesha le-LP, uya kulala ngecala kwaye ugqirha uya kukunika inaliti ye-anesthetic yendawo emqolo wakho. Oku kuya kuyiphazamisa indawo ukuze ungaziva naziphi na iintlungu ngale nkqubo (nangona i-anesthetic yasekhaya inokuhlaba ixesha elifutshane).
Nje ukuba indawo iphazamiseke, ugqirha uya kufaka inaliti emqolo wakho, phakathi kwamathambo emqolo wakho (i-vertebrae) kunye nendawo apho cerebral spinal fluid (CSF) yi. Emva koko baya kususa isampulu encinci yolwelo ukuvavanya i-lymphoma.
Uya kuba nesinxibo esincinci phezu kwendawo inaliti eyangena kuyo kwaye unokufuna ukubeka i-1-4 iiyure. Abongikazi bakho baya kukwazisa ukuba uya kufuna ukubeka ixesha elingakanani.
Yintoni enye esetyenziselwa ukugqobhoza kwelumbar?
Kwezinye iimeko apho une-lymphoma kwi-CNS yakho, okanye unethuba lokuba iya kusasazeka apho, ukuhlatywa kwe-lumbar kwenziwa kwakhona ukuhambisa ichemotherapy ngqo kwi-CSF yakho. Xa oku kusenziwa, kubizwa ngokuba yi-“intrathecal (IT) chemotherapy”.
Yintoni i-Endoscopy
I-endoscopy yinkqubo esetyenziswayo ukuba ugqirha ucinga ukuba unokuba ne-lymphoma kwiphecana lakho lesisu (GI). Iphecana lakho le-GI libandakanya:
- emlonyeni
- ummizo (okukukutya kombhobho okwehla emlonyeni wakho ukuya esiswini sakho)
- esiswini
- amathumbu amancinci (amathumbu)
- amathumbu amakhulu
Ngexesha le-endoscopy i-radiologist okanye ugqirha wotyando ufaka ityhubhu ebhityileyo emlonyeni wakho kwaye uyondle ukuya kummizo wakho (umbhobho othwala ukutya ukusuka emlonyeni wakho ukuya esiswini sakho), isisu kunye nesisu esincinci. Oku kubavumela ukuba bajonge i-gastrointestinal tract yakho ngeempawu ze-lymphoma. Basenokuthatha isampuli encinci ye-biopsy ngexesha le-endoscopy ukuthumela kwi-pathology.
Oku kuya kwenziwa ngesithomalalisi kunye ne-anesthetic ukuze ungeva naziphi na iintlungu okanye ukhumbule inkqubo. Kwezinye iimeko unokuba ne-anesthetic jikelele ukuze ulale nge-endoscopy.
Zeziphi iskeni endizifunayo?
Kukho iintlobo ezininzi zeskena eziluncedo ekuncedeni ukuxilonga okanye isiteji se-lymphoma, kunye nokulandelela indlela i-lymphoma yakho esabela ngayo kunyango. Ngaphambi kokuba wenze iskena, nceda wazise iiradiographers ukuba:
- ukuba, okanye ukhulelwe, okanye ukuba uncancisa.
- ukoyika iindawo ezivaliweyo (claustrophobia).
- unobunzima bokubeka okanye ukuma kwiindawo ezithile.
- ube naziphi na iintlungu okanye isicaphucaphu.
- ukuba nakuphi na ukwaliwa.
Ukufunda ngakumbi malunga neentlobo ezahlukeneyo zeskena kwaye kutheni zingasetyenziswa, cofa kwizihloko ezingezantsi.
I-ultrasound siskena esisebenzisa amaza esandi ukwenza umfanekiso. I-ultrasonographer (umntu owenza i-ultrasound) uya kubeka ijeli phezu kwendawo ejongwayo, kwaye usebenzise isixhobo esifana ne-wand ukugijima phezu kwesikhumba sakho, esithumela amaza omsindo emzimbeni wakho. Njengoko amaza ebuyela umva yenza umfanekiso wangaphakathi emzimbeni wakho.
Ii-Ultrasounds zihlala zisetyenziselwa ukunceda ukufumana i-lymph nodes ezidumbileyo ukuze ugqirha akwazi ukuthatha i-biopsy. Ingasetyenziselwa ukunceda ukufumana imithambo elungileyo okanye ukujonga amalungu emzimbeni wakho.
Ngokuxhomekeke kwiyiphi inxalenye yomzimba wakho ejongwayo, unokufuna ukusela amanzi kwaye ube nesinye esipheleleyo se-ultrasound.
I-CT scan sisikena esinokujonga ngaphakathi emzimbeni wakho kwaye sinikeze umfanekiso we-3D. Ngokuqhelekileyo isetyenziswa xa kuphela inxalenye ethile yomzimba wakho ifuna ukubonakala, njengesifuba okanye isisu sakho. Banokubonelela ngomfanekiso womzimba wakho ukusuka phambili ukuya ngasemva nangaphezulu ukuya phezulu. Izikena zihlala zisetyenziselwa ukujonga amathumba, ii-lymph nodes ezidumbileyo kunye nezinye iimeko.
Kusenokufuneka ube nenaliti enolwelo olubizwa ngokuba ngumahluko, onceda ukwenza imifanekiso ecacileyo. I-Contrast itofwa ngokukhawuleza, kwaye inesiphumo esingaqhelekanga sokwenza uzive ngathi umanzise ibhulukhwe yakho. Inokuziva ishushu kakhulu kwaye ingoyiki, kodwa ayihlali ixesha elide.
Uya kulala ebhedini ehamba ngaphakathi nangaphandle kumatshini weCT. Ikhawuleza kakhulu kwaye ihlala ithatha malunga nemizuzu eyi-10-15 kuphela.
Izikena ze-MRI zisebenzisa imagnethi kunye namaza erediyo ukwenza umfanekiso ongaphakathi emzimbeni wakho. Kufana ne-CT scan ngokuba uya kulala ebhedini kwaye uhanjiswe ngaphakathi nangaphandle kumatshini we-MRI. Nangona kunjalo, i-MRI scans inokuthatha ixesha elide, kwaye kuxhomekeke kwiyiphi inxalenye yomzimba wakho ehlolwayo, inokuthatha i-15 - 90 imizuzu (i-1 kunye nesiqingatha seyure). Ikwasisikena esingxola kakhulu njengoko iimagnethi zijikeleza ngaphakathi kumatshini.
Ukuba unengxaki ngengxolo evakalayo, okanye kwiindawo ezivaliweyo, nceda wazise abongikazi phambi kweskeni sakho ukuze bakwenze ukhululeke ngakumbi. Bahlala benee-headphones ukuze umamele umculo, okanye usenokufuna iyeza elithile lokuthomalalisa ukuxhalaba ukukunceda uzive uzolile – nangona kunjalo, abantu abaninzi abayifuni le nto.
Ukuba une-lymphoma engqondweni yakho okanye kwintambo yomgogodla, uya kuba ne-MRI scan, kodwa unokuba ne-MRI ngezinye izizathu xa ugqirha wakho efuna ukujonga kwiindawo ezahlukeneyo zomzimba wakho.
Imifanekiso evela kwi-MRI ijongeka njengomfanekiso ongezantsi.
I-PET scan inika umfanekiso wengaphakathi lomzimba wakho uphela, kwaye ikhanyise iindawo ezichatshazelwe yi-lymphoma. Uya kunikwa inaliti yeyeza le-radioactive elifunxwa zizo naziphi na iiseli ezinomhlaza, nto leyo ezenza zicace kwi-PET scan. Kuthatha malunga nemizuzu engama-30 ukuya kwengama-60 ukwenza, kodwa kufuneka uvumele ubuncinci iiyure ezi-2 kwidinga kubo bonke.
Kuya kufuneka ukuba ulale kwaye uya kuba nokuphumla okukhethekileyo kweengalo kunye nemilenze yakho ukuze uqiniseke ukuba banokufumana eyona mifanekiso ilungileyo. Ukuba unengxaki yokuhlala kwindawo ixesha elide, nceda wazise abasebenzi ukuze baqinisekise ukuba ukhululekile kangangoko.
Unokucelwa ukuba ukuphephe ukutya kunye neziselo kwiintsuku ezikhokelela kwi-PET scan yakho. Ukuba awunikwanga imiyalelo, nceda ufowunele isebe lamayeza enyukliya apho usenza iskena sakho sePET ukuze ufumane iingcebiso.
Ngenxa yeyeza le-radioactive oya kulinikwa, kuya kufuneka ukuphephe ukuba kufutshane nabasetyhini abakhulelweyo okanye abantwana abancinci ukuya kuthi ga kusuku olunye olupheleleyo (iiyure ezingama-24).
Ukuhlolwa kwegazi
Uya kuba neemvavanyo ezininzi zegazi ngelixa uvavanya ukuxilongwa kwe-lymphoma. Ukuba une-lymphoma kwaye unonyango, uya kuba novavanyo lwegazi kulo lonke unyango lwakho. Ezinye zeemvavanyo zegazi eziqhelekileyo ezisetyenziswa xa une-lymphoma zidweliswe ngezantsi. Nangona kunjalo, uvavanyo lwegazi onalo luya kuxhomekeka kwimeko yakho.
Ubalo lwegazi olupheleleyo
Olu lolona vavanyo luqhelekileyo lwegazi oya kuba nalo. Ixelela oogqirha malunga namanani, iindidi, imilo kunye nobukhulu beeseli egazini lakho. Iiseli ezohlukeneyo ezijongwayo kolu vavanyo zezi;
- Iiseli zeGazi eziBomvu (RBCs) ezi seli zithwala ioksijini zijikeleze umzimba wakho.
- Iiseli zeGazi eziMhlophe (WBCs) ziyinxalenye ebalulekileyo yamajoni ethu omzimba kwaye zisinceda ukuba sihlale sisempilweni silwe usulelo kunye nesifo. Kukho iintlobo ezahlukeneyo ze-WBCs (ii-neutrophils, ii-eosinophils, ii-basophils kunye nezinye). Iseli nganye inendima ethile ekulweni usulelo. I-Lymphocytes nazo ziiseli ezimhlophe zegazi, kodwa ngamanani amancinci kuphela ahlala efunyanwa egazini lakho, njengoko ehlala kakhulu kwigazi lakho. inkqubo ye-lymphatic.
- Iiplatelets nceda igazi lakho lijije, lithintele ukugruzuka nokopha.
Iqela legazi kunye ne-crossmatch
Uya kuba nako oku ukuba ufuna utofelo-gazi, ukuze uqiniseke ukuba bafumana igazi elifanelekileyo kuwe.
Uvavanyo lokusebenza kwesibindi (LFTs)
Zisetyenziselwa ukubona ukuba isibindi sakho sisebenza kakuhle kangakanani.
Iimvavanyo zokusebenza kwezintso
Zisetyenziselwa ukujonga ukuba zisebenza kakuhle kangakanani izintso zakho.
I-Lactate dehydrogenase (LDH)
I-LDH ihlola umonakalo weeseli zomzimba emzimbeni wakho.
I-C-Reactive Protein (CRP)
I-CRP isetyenziselwa ukujonga iimpawu zokudumba emzimbeni wakho.
Ixabiso le-sedimentation ye-erythrocyte (ESR)
I-ESR iphinda ijonge iimpawu zokuvuvukala emzimbeni wakho.
I-Plasma Viscosity (PV)
I-PV ibhekisa kubunzima begazi lakho. Olu luvavanyo olubalulekileyo onokuthi ube nalo ukuba ngaba une-subtype ye-lymphoma ebizwa ngokuba yi-Waldenstrom's macroglobulinemia.
ISerum protein electrophoresis (SPEP)
I-SPEP ilinganisa iiproteni ezingaqhelekanga egazini lakho ukuba unohlobo oluncinane lwe-lymphoma ebizwa ngokuba yi-Waldenstrom's macroglobulinemia.
Umlinganiselo oqhelekileyo wamazwe ngamazwe (INR) kunye nexesha leProthrombin (PT)
Iimvavanyo ze-INR kunye ne-PT zilinganisa ukuba kuthatha ixesha elingakanani ukuba igazi lakho liqalise ukwenza amahlwili. Unokwenza oku ngaphambi kwenkqubo yotyando, ukuhlatywa kwe-lumbar okanye i-biopsy yomongo wamathambo.
Uvavanyo lokuvezwa kwiintsholongwane
Ezi zivavanywa njengoko ezinye ii-lymphomas zixhaphake kakhulu kubantu abaneentsholongwane ezithile. Ukuba unazo ezi ntsholongwane, ugqirha wakho kuya kufuneka azithathele ingqalelo ezi xa ekhethela isicwangciso sonyango esilungileyo. Ezinye iintsholongwane onokuthi uzihlolele ziquka;
- Intsholongwane kaGawulayo (i-HIV)
- IHepatitis B kunye noC
- I-Cytomegalovirus (CMV)
- Intsholongwane ka-Epstein Barr (EBV).
Iqela lezonyango lingacebisa olunye uvavanyo lwegazi ngokuxhomekeke kwiimeko zomntu.
Ngaphambi kokuba uqale unyango, ugqirha wakho uya kufuna ukwenza iimvavanyo ezininzi ukuqinisekisa ukuba umzimba wakho uyakwazi ukunyamezela unyango olucwangcisiweyo. Unokufunda ngakumbi malunga novavanyo olusisiseko olwahlukileyo kunye novavanyo lomsebenzi welungu ngokucofa ikhonkco elingezantsi.
Ziziphi iimvavanyo ze-Cytogenetic?
Ezinye iipoeple ezine-lymphoma zineenguqu kwi-DNA yazo kunye nofuzo. Olu tshintsho lubalulekile kuba lunokunika ulwazi malunga nokuba lolona hlobo lulungileyo lonyango luya kuba yintoni na. Unokunikwa iintlobo ezininzi zeemvavanyo ezijonga i-DNA kunye nofuzo kwiiseli zakho ze-lymphoma, okanye ukujonga iiprotheni ezahlukeneyo ezifumaneka kwiiseli zakho ze-lymphoma.
Kungathatha iiveki ezininzi ukufumana ezi ziphumo zovavanyo.
Ukufunda ngakumbi ngezi mvavanyo, cofa ikhonkco elingezantsi.
Ilinde iziphumo
Awuyi kufumana naziphi na iziphumo, xa une scan okanye olunye uvavanyo. Ingxelo iya kubhalwa kwaye ithunyelwe kugqirha wakho, kwaye inokuthatha ukuya kwiveki.
Buza ukuba ugqirha wakho uya kuba nazo nini iingxelo ukuze wenze idinga ukuze ufumane iziphumo zakho. Ugqirha wakho unokufuna ukulinda ade abe nazo zonke iziphumo zovavanyo lwakho ngaphambi kokuba akubone ukuze akwazi ukukunika ulwazi olungcono. Oku kungenxa yokuba uvavanyo ngalunye lunika inxalenye enye yomfanekiso kuphela, kwaye ugqirha wakho uya kufuna zonke iziphumo zakho ukwenza uxilongo olufanelekileyo, kwaye uthathe isigqibo ngeentlobo zonyango ezingcono - ukuba ufuna unyango.
Isenokuba lixesha loxinzelelo lokulinda iziphumo. Kuhle ukuthetha nosapho kunye nabahlobo bakho ngendlela oziva ngayo. Ungafikelela kubahlengikazi bethu beLymphoma ngokucofa apha Qhagamshelana nathi iqhosha ezantsi kweli phepha.
isishwankathelo
- Kukho iimvavanyo ezininzi ezahlukeneyo oza kuzidinga ukuze ufumane ukuxilongwa kwe-lymphoma, fumana i-subtype yakho, inqanaba le-lymphoma yakho kunye nexesha lonyango lwakho lwe-lymphoma.
- Iimvavanyo zingabandakanya iimvavanyo zegazi, i-biopsies, i-scans kunye neemvavanyo ze-cytogenetic.
- Kungathatha iiveki ezininzi ukufumana zonke iziphumo zakho, kodwa kubalulekile ukuba ugqirha wakho abe nalo lonke ulwazi phambi kokuba akunike ukuxilongwa, okanye akwenzele isicwangciso sonyango.
- Ukuba uyasokola ngelixa ulinde iziphumo zovavanyo ungaqhagamshelana nabongikazi baseLymphoma Australia ngokucofa i Qhagamshelana nathi iqhosha elisezantsi kwephepha.
