Ngezinye izikhathi kungathatha isikhashana futhi ukuhlolwa okuningi kutholakale ukuthi une-lymphoma. Lokhu kungenxa yokuthi izimpawu ze-lymphoma zivame ukufana kakhulu nezimpawu zezinye, izifo ezivame kakhulu, ngakho udokotela wakho angase akuhlolele lezi ezinye izifo kuqala. Uma izimpawu zakho ziqhubeka, banganquma ukuhlola i-lymphoma. Ukuhlolwa kwe-lymphoma kungase kwenziwe udokotela wangakini kodwa ngokuvamile, uma esola ukuthi une-lymphoma, uzokudlulisela kudokotela onguchwepheshe obizwa ngokuthi i-hematologist noma i-oncologist ukuze uthole ukuhlolwa okwengeziwe.
Uzodinga i-biopsy ukuze uhlole i-lymphoma, futhi uma une-lymphoma uzodinga ukuhlolwa okwengeziwe ukuze uhlole isiteji kanye nebanga le-lymphoma yakho. Leli khasi lizodlula ezinhlotsheni ezahlukene zokuhlolwa kanye nama-biopsies asetshenziselwa ukuxilonga i-lymphoma, izikena ezisetshenziselwa ukufaka i-lymphoma esiteji nezinye izinhlobo zokuhlola ongase uzidinge.
Kuyini Ukuxilonga, Isiteji kanye Nokugreda?
Sifo
Isiteji
Ukubamba
Itholakala kanjani i-lymphoma?
Ukuze uhlole i-lymphoma, uzodinga i-biopsy yendawo yomzimba wakho ethintekile. Lokhu kungase kusho ukuthi udinga i-biopsy ye-lymph node yakho, isikhumba, uketshezi oluzungeze umgogodla wakho noma umnkantsha. Kwezinye izimo ungase udinge i-biopsy yezicubu ezisephashini lakho, esiswini noma emathunjini.
Ngeke udinge zonke lezi zivivinyo. Udokotela wakho uzokhipha i-biopsy engcono kakhulu ngokusekelwe esimweni sakho ngasinye. Chofoza izihloko ezingezansi ukuze ufunde ngezinhlobo ezahlukene ze-lymph node biopsy.
Izinhlobo ze-biopsies
Uzothola isibulali-zinzwa sasendaweni ukuze uvale indawo ye-biopsy yakho, futhi kwezinye izimo ungase futhi ube ne-anesthetic evamile. Lokhu kuzoncika endaweni ye-lymph node noma izicubu ezokwenziwa i-biopsy, nokuthi kulula kangakanani ngodokotela ukuthi afinyelele kuyo.
Izingane cishe zizohlale zine-anesthetic evamile ukuze zilale nge-biopsy. Lokhu kusiza ukubavimba ekucindezelekeni, futhi kuqinisekisa ukuthi bahlala benganyakazi phakathi nenqubo.
I-excisional biopsy i-biopsy eyenziwa ngesikhathi sokuhlinzwa okuncane. Kuyindlela ephumelela kakhulu yokuxilonga i-lymphoma ku-lymph node ngoba yonke i-lymph node iyasuswa futhi ihlolwe ku-pathology.
Lapho i-lymph node ezokhishwa iseduze nesikhumba sakho, ungase wenze le nqubo ngesikhathi uvukile. Uzothola isibulali-zinzwa sasendaweni ukuze uvale indawo ukuze ungezwa ubuhlungu. Ungase ube nezitishi ngemva kwenqubo ezombozwa ngesambatho esincane. Udokotela noma umhlengikazi wakho uzokwazi ukukutshela ukuthi uzozikhipha nini izithungo nokuthi ungayiphatha kanjani indlela ogqoka ngayo ukuze ugweme izifo.
Kuthiwani uma i-lymph node ijule emzimbeni wami?
Uma i-lymph node ijulile ngaphakathi emzimbeni wakho, ungase ube nesibulala-zinzwa esivamile ukuze ulale ngesikhathi senqubo. Cishe uzoba nezitishi kanye nokugqoka okuncane phezu kwazo lapho uvuka. Udokotela wakho noma umhlengikazi uzokhuluma nawe mayelana nendlela yokuphatha okokugqoka kanye nokuthi udinga nini ukukhipha imithungo.
Kwezinye izimo kungase kube nokubambezeleka ekutholeni i-excisional biopsy, ngoba idinga ukuhlinzwa, futhi kungaba nohlu lokulinda ukuze kungene.
I-incisional biopsy ifana ne-excisional biopsy, kodwa esikhundleni sokususa yonke i-lymph node, ingxenye kuphela ye-lymph node ikhishwa.
Lokhu kungenziwa uma i-lymph node inkulu kakhulu, noma ama-lymph nodes akho ehlanganiswe - okusho ukuthi ahlangene namanye ama-lymph node. Kwezinye izimo kungase kube nokubambezeleka ekutholeni i-excisional biopsy, ngoba idinga ukuhlinzwa, futhi kungaba nezinhlu zokulinda.
I-core biopsy isetshenziselwa ukuthatha isampula elincane le-lymph node noma isikhumba esithintekile uma unokuqubuka okusolisayo noma isigaxa. Ngezinye izikhathi zibizwa nangokuthi i-need biopsy. Ngokuvamile kwenziwa nge-anesthesia yendawo, futhi kuye ngokuthi ikuphi, udokotela angase asebenzise i-ultrasound noma i-CT scan ukuze asize ukuqondisa inaliti endaweni efanele.
Ngenxa yokuthi isampula lithathwa ngenaliti engenalutho, isampula lincane kakhulu kune-excisional noma i-incisional biopsy. Lokhu kusho ukuthi ngezinye izikhathi amangqamuzana anomdlavuza angase angalandwa kusampula, okuholela ekutheni i-lymphoma igeje. Kodwa ama-core biopsy angasiza uma kukhona ukubambezeleka isikhathi eside kwe-excisional noma i-incisional biopsy. Ungase udinge okungaphezulu kwe-biopsy eyodwa eyinhloko ukuze uhlole i-lymphoma.
I-biopsy yenaliti enhle isebenzisa inaliti encane esetshenziselwa i-core biopsy. Ngokuvamile akunconywa ukuxilonga i-lymphoma ngoba ayinikezi isampula enkulu ngokwanele ukuze uthole umphumela othembekile.
Kodwa-ke, ngezinye izikhathi, i-biopsy yenaliti enhle ingenziwa ukuze kuhlolwe ezinye izinto, futhi ingase ithathe amaseli e-lymphoma. Uzothunyelwa kwezinye izivivinyo uma kubonakala sengathi kukhona amaseli e-lymphoma ku-biopsy yakho.
Nakuba odokotela abaningi bekubiza uma kukhona okukukhathazayo emiphumeleni yakho yokuhlolwa, akubona bonke abakwenzayo. Futhi akuvamile, imiphumela ingalahleka noma iphuthelwe. Njalo yenza isikhathi sokulandelela nodokotela wakho ukuze uthole imiphumela yokuhlolwa kwegazi, amaskeni kanye nama-biopsies.
Uzoxhumana nini nodokotela wakho
Xhumana nodokotela noma unesi wakho ukuze uthole iseluleko uma uthola noma yiziphi izimpawu ezilandelayo:
- Izimpawu zokutheleleka okuhlanganisa izinga lokushisa elingu-38º noma ngaphezulu, ukugodola nokuqhaqhazela, ubomvu noma ukuphuma okungajwayelekile enxebeni.
- Ukopha okunganqamuki ngemva kokufaka iphakethe elibandayo (noma uphizi oqandisiwe) phezu kwesayithi, noma eligcwalisa yonke ingubo.
- Ubuhlungu obungathuthuki nge-paracetamol (ebuye yaziwe ngePanadol, iPanamax noma iDymadon).
Iyini i-Bone Marrow Biopsy?
I-bone marrow biopsy inqubo eyenziwa ukususa isampula yomnkantsha wakho ngaphakathi kwethambo lakho. Ngokuvamile ithathwa ethanjeni le-hip, kodwa kwezinye izimo ingathathwa kwamanye amathambo. Le biopsy ingasetshenziswa ukusiza ukuxilonga ezinye izinhlobo ze-lymphoma, futhi isetshenziselwa ukwenza ezinye izinhlobo ezincane.
Iyini i-Lumbar puncture?
Ungalulekwa ukuthi ube nokubhoboza i-lumbar (LP) uma kunethuba lokuthi une-lymphoma uhlelo oluyisisekelo senzwa (CNS), okuhlanganisa ubuchopho bakho, umgogodla nendawo ngemuva kwamehlo akho.
Ngesikhathi se-LP, uzolala ngohlangothi futhi udokotela uzokunikeza umjovo we-anesthetic yendawo emhlane wakho. Lokhu kuzoyithuntubeza indawo ukuze ungezwa ubuhlungu ngenqubo (nakuba isibulali-zinzwa sasendaweni singaluma isikhashana).
Uma indawo isindikindiki, udokotela uzofaka inaliti emhlane wakho, phakathi kwamathambo emhlane wakho (ama-vertebrae) kanye nendawo lapho uketshezi lwe-cerebral spinal (CSF) i. Bazobe sebekhipha isampula encane yoketshezi ukuze bahlole i-lymphoma.
Uzoba nendwangu encane phezu kwendawo inaliti eyangena kuyo futhi kungase kudingeke ukuthi ubeke phansi amahora angu-1-4. Abahlengikazi bakho bazokwazisa ukuthi uzolala isikhathi esingakanani.
Yini enye esetshenziselwa ukubhoboza i-lumbar?
Kwezinye izimo lapho une-lymphoma ku-CNS yakho, noma unethuba lokuthi izosabalala lapho, ukubhoboza i-lumbar nakho kwenziwa ukuze kulethwe i-chemotherapy ngqo ku-CSF yakho. Uma lokhu sekwenziwe, kubizwa nge-“intrathecal (IT) chemotherapy”.
Iyini i-Endoscopy
I-endoscopy iyinqubo esetshenziswa uma udokotela ecabanga ukuthi ungase ube ne-lymphoma epheshaneni lakho lesisu (GI). Ipheshana lakho le-GI lifaka phakathi kwakho:
- umlomo
- umphimbo (okuwukudla kwepayipi okwehla emlonyeni wakho kuye esiswini sakho)
- isisu
- amathumbu amancane (amathumbu)
- amathumbu amakhulu
Ngesikhathi sokwenza i-endoscopy i-radiologist noma udokotela ohlinzayo ufaka ishubhu elincanyana emlonyeni wakho futhi aliphakele lize lifike emphinjeni wakho (ipayipi elithwala ukudla lisuka emlonyeni likuyise esiswini), esiswini namathumbu amancane. Lokhu kubavumela ukuthi babheke ipheshana lakho lesisu ukuze bathole izimpawu ze-lymphoma. Bangakwazi futhi ukuthatha isampula encane ye-biopsy ngesikhathi se-endoscopy ukuze bayithumele ku-pathology.
Lokhu kuzokwenziwa nge-sedative kanye ne-anesthetic ngakho akufanele uzwe ubuhlungu noma ukhumbule inqubo. Kwezinye izimo ungase ube ne-anesthetic evamile ukuze ulale nge-endoscopy.
Yiziphi izikena engizidingayo?
Kunezinhlobo ezimbalwa zokuskena eziwusizo ukusiza ukuxilonga noma i-lymphoma yesiteji, futhi ulandelele ukuthi i-lymphoma yakho isabela kanjani ekwelashweni. Ngaphambi kokuskena, sicela wazise ama-radiographer uma:
- kukhona, noma kungenzeka ukuthi ukhulelwe, noma uma uncelisa.
- ukwesaba izindawo ezivalekile (claustrophobia).
- abe nobunzima bokubeka noma ukuma ezindaweni ezithile.
- ube nobuhlungu noma isicanucanu.
- noma yikuphi ukungezwani komzimba nezinto ezithile.
Ukuze ufunde kabanzi mayelana nezinhlobo ezahlukene zokuskena nokuthi kungani zingasetshenziswa, chofoza izihloko ezingezansi.
I-Ultrasound iyiskena esisebenzisa amaza omsindo ukwenza isithombe. I-ultrasonographer (umuntu owenza i-ultrasound) izofaka ijeli endaweni ehlolwayo, futhi isebenzise idivayisi efana ne-wand ukuze igijime phezu kwesikhumba sakho, ethumela amaza omsindo emzimbeni wakho. Njengoba amagagasi ebuyela emuva kudala isithombe sangaphakathi emzimbeni wakho.
Ama-Ultrasound avame ukusetshenziswa ukusiza ukuthola ama-lymph nodes avuvukele ukuze udokotela akwazi ukuthatha i-biopsy. Ingasetshenziswa futhi ukusiza ukuthola imithambo emihle noma ukubuka izitho zomzimba wakho.
Kuye ngokuthi iyiphi ingxenye yomzimba wakho ehlolwayo, kungase kudingeke uphuze amanzi futhi ube nesinye esigcwele i-ultrasound.
I-CT scan iyiskena esingabheka ingaphakathi lomzimba wakho futhi sinikeze isithombe se-3D. Ngokuvamile isetshenziswa lapho kuphela ingxenye ethile yomzimba wakho idinga ukubonakala, njengesifuba noma isisu sakho. Bangakunikeza isithombe somzimba wakho ukusuka phambili ukuya emuva nangaphezulu kuya phansi. Izikena zivame ukusetshenziselwa ukuhlola izimila, ama-lymph nodes avuvukele nezinye izimo.
Kungase kudingeke ukuthi ube nomjovo onoketshezi olubizwa ngokuthi ukugqama, esiza ukwenza izithombe zicace. I-Contrast ijovwa ngokushesha, futhi inomphumela ongemuhle ongavamile wokwenza uzizwe sengathi umanzise ibhulukwe lakho. Ingazizwa ifudumele futhi ingathuki, kodwa ayihlali isikhathi eside.
Uzolala embhedeni ongena uphuma emshinini weCT. Kuyashesha kakhulu futhi ngokuvamile kuthatha imizuzu eyi-10-15 kuphela.
Izikena ze-MRI zisebenzisa omazibuthe namaza omsakazo ukwakha isithombe sangaphakathi emzimbeni wakho. Kufana ne-CT scan ngokuthi uzolala embhedeni futhi uhanjiswe futhi uphume emshinini we-MRI. Kodwa-ke, ukuskena kwe-MRI kungathatha isikhathi eside, futhi kuye ngokuthi iyiphi ingxenye yomzimba wakho ehlolwayo, kungathatha imizuzu engu-15 - 90 (ihora elingu-1 nengxenye). Kuphinde kube ukuskena okunomsindo kakhulu njengoba omagnet bezulazula ngaphakathi emshinini.
Uma unenkinga ngemisindo emikhulu, noma ezindaweni ezivalekile, sicela wazise abahlengikazi ngaphambi kokuskena kwakho ukuze bakwenze ukhululeke kakhudlwana. Bavame ukuba nama-headphone ukuze ulalele umculo, noma ungase udinge umuthi wokulwa nokukhathazeka ukuze uzizwe uzolile – nokho-ke, abantu abaningi abakudingi lokhu.
Uma une-lymphoma ebuchosheni bakho noma entanjeni yomgogodla, cishe uzoba ne-MRI scan, kodwa ungaba ne-MRI ngezinye izizathu futhi lapho udokotela wakho efuna ukubheka izingxenye ezahlukene zomzimba wakho.
Izithombe ezivela ku-MRI zibukeka njengesithombe esingezansi.
Ama-PET scan anikeza isithombe sengaphakathi lomzimba wakho wonke, futhi akhanyisa izindawo ezihlaselwe i-lymphoma. Uzonikezwa umjovo womuthi okhipha imisebe othathwa yinoma yimaphi amangqamuzana anomdlavuza, uwenze agqame ku-PET scan. Kuthatha cishe imizuzu engama-30-60 ukwenza, kodwa kufanele uvumele okungenani amahora ama-2 ukuze uthole i-aphoyintimenti kukho konke.
Uzodinga ukubeka futhi uzoba nokuphumula okukhethekile kwezingalo nemilenze yakho ukuze uqiniseke ukuthi bangathola izithombe ezinhle kakhulu. Uma unenkinga yokuhlala esikhundleni isikhathi eside, sicela wazise abasebenzi ukuze baqinisekise ukuthi unethezekile ngangokunokwenzeka.
Ungase ucelwe ukuthi ugweme okunye ukudla neziphuzo ezinsukwini eziholela ku-PET scan yakho. Uma ungazange unikezwe imiyalelo, sicela ushayele ucingo umnyango wemithi yenuzi lapho uthola khona i-PET scan ukuze uthole iseluleko.
Ngenxa yomuthi okhipha imisebe ozowunikezwa, kuzodingeka ugweme ukuba phakathi kwabesifazane abakhulelwe noma izingane ezincane kuze kube usuku olulodwa olugcwele (amahora angu-24).
Ukuhlolwa kwegazi
Cishe uzoba nokuhlolwa kwegazi okuningana ngenkathi uhlola ukuxilongwa kwe-lymphoma. Uma une-lymphoma futhi uthola ukwelashwa, uzophinde ube nokuhlolwa kwegazi kulo lonke ukwelashwa kwakho. Okunye ukuhlolwa kwegazi okuvame ukusetshenziswa uma une-lymphoma kubalwe ngezansi. Nokho, ukuhlolwa kwegazi onakho kuzoncika esimweni sakho ngasinye.
Ukubalwa Kwegazi Okugcwele
Lokhu ngolunye lokuhlolwa kwegazi okuvamile ozoba nakho. Itshela odokotela ngezinombolo, izinhlobo, ukuma nobukhulu bamaseli egazini lakho. Amaseli ahlukene abukwayo kulesi sivivinyo yilawa;
- Amaseli Egazi Abomvu (RBCs) lamangqamuzana athwala umoya-mpilo emzimbeni wakho.
- Amaseli Egazi Amhlophe (WBCs) ziyingxenye ebalulekile yamasosha ethu omzimba futhi zisisiza ukuba sihlale sinempilo silwa nezifo kanye nezifo. Kunezinhlobo ezahlukene zama-WBCs (neutrophils, eosinophils, basophils nabanye). Ingqamuzana ngalinye linendima ethile ekulweni nezifo. Ama-lymphocyte nawo angamaseli amhlophe egazi, kodwa izinombolo ezincane kuphela ezivame ukutholakala egazini lakho, njengoba zihlala kakhulu egazini lakho. uhlelo lwe-lymphatic.
- Amapulatifomu kusiza igazi lakho ukuthi lihlule, livimbele imihuzuko nokopha.
Iqembu legazi kanye ne-crossmatch
Uzoba nalokhu uma udinga ukumpontshelwa igazi, ukuze uqiniseke ukuthi bathola igazi elikulungele.
Ukuhlolwa kokusebenza kwesibindi (LFTs)
Zisetshenziselwa ukubona ukuthi isibindi sakho sisebenza kahle kangakanani.
Ukuhlolwa kokusebenza kwezinso
Zisetshenziselwa ukuhlola ukuthi izinso zakho zisebenza kahle kangakanani.
I-Lactate dehydrogenase (LDH)
I-LDH ihlola ukulimala kwezicubu zomzimba emzimbeni wakho.
I-C-Reactive Protein (CRP)
I-CRP isetshenziselwa ukuhlola izimpawu zokuvuvukala emzimbeni wakho.
Izinga le-sedimentation ye-Erythrocyte (ESR)
I-ESR iphinde ihlole izimpawu zokuvuvukala emzimbeni wakho.
I-Plasma Viscosity (PV)
I-PV isho ukushuba kwegazi lakho. Lokhu ukuhlolwa okubalulekile okufanele ube nakho uma une-subtype ye-lymphoma ebizwa ngokuthi i-Waldenstrom's macroglobulinemia.
I-Serum protein electrophoresis (SPEP)
I-SPEP ikala amaprotheni angavamile egazini lakho uma une-lymphoma encane ebizwa ngokuthi i-Waldenstrom's macroglobulinemia.
Isilinganiso samazwe ngamazwe esijwayelekile (INR) kanye ne-Prothrombin Time (PT)
Ukuhlolwa kwe-INR ne-PT kukala ukuthi kuthatha isikhathi esingakanani ukuthi igazi lakho liqale ukwakha amahlule. Lokhu kungenzeka ukwenze ngaphambi kwenqubo yokuhlinzwa, ukubhoboza i-lumbar noma i-bone marrow biopsies.
Ukuhlola ukuchayeka kumagciwane
Lokhu kuyahlolwa njengoba amanye ama-lymphoma evame kakhulu kubantu abanamagciwane athile. Uma unalawa magciwane, udokotela wakho uzodinga ukucabangela lawa lapho ekukhethela uhlelo olufanele lokwelapha. Amanye amagciwane ongase uhlolelwe wona ahlanganisa;
- I-Human immunodeficiency virus (HIV)
- I-Hepatitis B no-C
- I-Cytomegalovirus (CMV)
- I-Epstein Barr virus (EBV).
Ithimba lezokwelapha lingase liphakamise okunye ukuhlolwa kwegazi kuye ngezimo ngazinye.
Ngaphambi kokuba uqale ukwelashwa, udokotela wakho uzophinde afune ukwenza izivivinyo ezengeziwe ukuze aqiniseke ukuthi umzimba wakho uyakwazi ukubekezelela ukwelashwa okuhleliwe. Ungafunda kabanzi mayelana nokuhlolwa okuyisisekelo okuhlukene nokuhlolwa kokusebenza kwezitho ngokuchofoza isixhumanisi esingezansi.
Yiziphi izivivinyo ze-Cytogenetic?
Amanye ama-poeple ane-lymphoma anezinguquko ku-DNA yawo nezakhi zofuzo. Lezi zinguquko zibalulekile ngoba zinganikeza ulwazi mayelana nokuthi yiluphi uhlobo lokwelashwa olungcono kakhulu kuwe oluzoba. Ungase unikezwe izinhlobo ezimbalwa zokuhlola ezihlola i-DNA nezakhi zofuzo kumaseli akho e-lymphoma, noma ezihlola amaprotheni ahlukene atholakala kumaseli akho e-lymphoma.
Kungathatha amaviki ambalwa ukuthola le miphumela yokuhlolwa.
Ukuze ufunde kabanzi mayelana nalezi zivivinyo, chofoza isixhumanisi esingezansi.
Ilinde imiphumela
Ngeke uthole imiphumela, uma une scan noma okunye ukuhlolwa. Umbiko uzobhalwa futhi uthunyelwe kudokotela wakho, futhi ungathatha isonto lonke.
Buza ukuthi udokotela wakho uzoba nini nemibiko ukuze wenze i-aphoyintimenti ukuze uthole imiphumela yakho. Udokotela wakho angase afune ukulinda aze abe nayo yonke imiphumela yokuhlolwa kwakho ngaphambi kokuba akubone ukuze akwazi ukukunikeza ulwazi olungcono kakhulu. Lokhu kungenxa yokuthi ukuhlolwa ngakunye kunikeza ingxenye eyodwa yesithombe kuphela, futhi udokotela wakho uzodinga yonke imiphumela yakho ukuze axilongwe kahle, futhi anqume ngezinhlobo ezingcono kakhulu zokwelapha - uma udinga ukwelashwa.
Kungaba isikhathi esicindezelayo sokulinda imiphumela. Kuhle ukukhuluma nomndeni wakho nabangane ngendlela ozizwa ngayo. Ungakwazi futhi ukufinyelela kubahlengikazi bethu be-Lymphoma Care ngokuchofoza ku Xhumana nathi inkinobho ngaphansi kwaleli khasi.
Isifinyezo
- Ziningi izivivinyo ezihlukene ozozidinga ukuze uthole ukuxilongwa kwe-lymphoma, uthole uhlobo lwakho oluncane, isigaba se-lymphoma yakho nangesikhathi sokwelashwa kwakho kwe-lymphoma.
- Ukuhlolwa kungabandakanya ukuhlolwa kwegazi, ama-biopsies, izikena kanye nokuhlolwa kwe-cytogenetic.
- Kungathatha amasonto ambalwa ukuthola yonke imiphumela yakho, kodwa kubalulekile ukuthi udokotela wakho abe nalo lonke ulwazi ngaphambi kokuba akunikeze ukuxilonga, noma akwenzele uhlelo lokwelapha.
- Uma udonsa kanzima ngesikhathi ulindele imiphumela yokuhlolwa ungathinta abahlengikazi be-Lymphoma Australia ngokuchofoza ku- Xhumana nathi inkinobho ezansi kwekhasi.
