Isigaba se-lymphoma sibheka ukuthi ungakanani umzimba wakho othintwa i-lymphoma, futhi sinikeza ulwazi ngokuthi yiziphi izinhlobo zokwelashwa ezingcono kakhulu kuwe.
Kusho ukuthini ukwenza isiteji?
Isiteji sisho ukuthi ungakanani umzimba wakho othintwa i-lymphoma yakho - noma ukuthi isisabalele kangakanani lapho iqale khona.
Ama-lymphocyte angahamba kunoma iyiphi ingxenye yomzimba wakho. Lokhu kusho ukuthi amaseli e-lymphoma (ama-lymphocyte anomdlavuza), angaphinde ahambe kunoma iyiphi ingxenye yomzimba wakho. Kuzodingeka wenze izivivinyo ezengeziwe ukuze uthole lolu lwazi. Lezi zivivinyo zibizwa ngokuthi yi-staging test futhi uma uthola imiphumela, uzothola ukuthi une-lymphoma yesigaba sokuqala (I), isigaba sesibili (II), isigaba sesithathu (III) noma sesine (IV) lymphoma.
I-Staging Lymphoma - I-Ann Arbor noma i-Lugano Staging System
Isigaba sakho se-lymphoma sizoncika ku:
- Zingaki izindawo zomzimba wakho ezine-lymphoma
- Lapho i-lymphoma ihlanganisa uma ingaphezulu, ngezansi noma ezinhlangothini zombili ze-diaphragm yakho (umsipha omkhulu, omise okwedome ngaphansi kwezimbambo zakho ezihlukanisa isifuba sakho nesisu sakho)
- Kungakhathaliseki ukuthi i-lymphoma isisabalele kumnkantsha wakho wethambo noma ezinye izitho ezifana nesibindi sakho, amaphaphu, isikhumba noma ithambo.
Izigaba I no-II zibizwa ngokuthi 'isigaba sokuqala noma esilinganiselwe' (okubandakanya indawo elinganiselwe yomzimba wakho).
Izigaba III kanye ne-IV zibizwa ngokuthi 'isiteji esithuthukisiwe' (sabalale kakhulu). Kubalulekile ukwazi ukuthi ngokungafani namanye ama-cancer, ama-lymphoma amaningi asezingeni eliphezulu angelapheka. Khuluma nodokotela wakho mayelana namathuba akho okwelashwa noma ukukhululwa isikhathi eside.
1 internship | Indawo eyodwa ye-lymph node iyathinteka, noma ngaphezulu noma ngaphansi kwe-diaphragm*. |
2 internship | Izindawo ezimbili noma ngaphezulu zama-lymph node ziyathinteka ohlangothini olulodwa lwe-diaphragm*. |
3 internship | Okungenani indawo eyodwa ye-lymph node ngaphezulu kanye ne-lymph node eyodwa engaphansi kwe-diaphragm* iyathinteka. |
4 internship | I-Lymphoma itholakala kuma-lymph nodes amaningi futhi isisakazekele kwezinye izingxenye zomzimba (isb. amathambo, amaphaphu, isibindi). |
Ulwazi lwesiteji olwengeziwe
Udokotela wakho angase futhi akhulume ngesiteji sakho esebenzisa incwadi, efana no-A,B, E, X noma S. Lezi zincwadi zinikeza ulwazi olwengeziwe mayelana nezimpawu onazo noma ukuthi umzimba wakho uthinteka kanjani i-lymphoma. Lonke lolu lwazi lusiza udokotela wakho ukuthi akutholele uhlelo olungcono kakhulu lwezokwelapha.
Incwadi | Okusho | Ukubaluleka |
A noma B |
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E & X |
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S |
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(Ubende bethu yisitho sethu uhlelo lwe-lymphatic ehlunga futhi ehlanze igazi lethu, futhi iyindawo lapho ama-B-cell ethu ephumula khona futhi enze amasosha omzimba) |
Ukuhlolwa kwesiteji
Ukuze uthole ukuthi yisiphi isigaba onaso, ungacelwa ukuthi wenze ezinye zalezi zivivinyo ezilandelayo:
Icwecwe le-computer tomography (CT)
Lezi zithwebuli zithatha izithombe zengaphakathi lesifuba sakho, isisu noma i-pelvis. Banikeza izithombe ezinemininingwane enikeza ulwazi olwengeziwe kune-X-ray evamile.
Ukuskena kwe-Positron emission tomography (PET)
Lesi iskena esithatha izithombe zengaphakathi lomzimba wakho wonke. Uzonikezwa futhi ufake inaliti ngomuthi othile othathwa amaseli anomdlavuza - njengamaseli e-lymphoma. Umuthi osiza ukuskena kwe-PET ukukhomba lapho i-lymphoma ikuphi kanye nosayizi nokuma ngokugqamisa izindawo ezinamaseli e-lymphoma. Lezi zindawo ngezinye izikhathi zibizwa ngokuthi "ezishisayo".
Ukukhishwa kwe-Lumbar
Ukubhoboza i-lumbar kuyinqubo eyenziwa ukuhlola ukuthi unayo yini i-lymphoma endaweni yakho isimiso sezinzwa esiyinhloko (CNS), okuhlanganisa ubuchopho bakho, umgogodla kanye nendawo ezungeze amehlo akho. Kuzodingeka uhlale unganyakazi phakathi nenqubo, ngakho izingane kanye nezingane zingase zibe ne-anesthetic evamile ukuze zilalise isikhashana lapho inqubo yenziwa. Abantu abadala abaningi bazodinga kuphela umuthi obulala izinzwa wasendaweni ukuze inqubo iqede indawo.
Udokotela wakho uzokufaka inaliti emhlane wakho, futhi akhiphe uketshezi oluncane olubizwa ngokuthi “uketshezi lwe-cerebral spinal” (CSF) kusuka eduze komgogodla wakho. I-CSF iwuketshezi olusebenza kancane njengesibambisi sokwethuka ku-CNS yakho. Iphinde ithwale amaprotheni ahlukene kanye nokutheleleka okulwa namaseli omzimba afana ne-lymphocyte ukuvikela ubuchopho bakho nomgogodla. I-CSF ingasiza futhi ukukhipha noma iluphi uketshezi olwengeziwe okungenzeka unalo ebuchosheni bakho noma eduze komgogodla wakho ukuvimbela ukuvuvukala kulezo zindawo.
Isampula ye-CSF izobe isithunyelwa ku-pathology futhi ihlolwe noma yiziphi izimpawu ze-lymphoma.
I-bone yomnkantsha i-biopsy
- I-Bone marrow aspirate (BMA): lokhu kuhlola kuthatha inani elincane loketshezi olutholakala endaweni yomnkantsha.
- I-Bone marrow aspirate trephine (BMAT): lokhu kuhlola kuthatha isampula elincane lomnkantsha wethambo.
Amasampula abe esethunyelwa ku-pathology lapho ehlolelwa khona izimpawu ze-lymphoma.
Inqubo ye-biopsies yomnkantsha ingahluka kuye ngokuthi ulashwa kuphi, kodwa ngokuvamile izofaka isibulali-zinzwa sasendaweni ukuze ndikindiki indawo.
Kwezinye izibhedlela, ungase unikezwe i-sedation elula ekusiza ukuthi uphumule futhi ingakuvimba ekukhumbuleni inqubo. Nokho abantu abaningi abakudingi lokhu futhi esikhundleni salokho bangase babe “nempempe eluhlaza” abangayincela. Le nlozi eluhlaza inomuthi obulala izinhlungu kuwo (obizwa ngePenthrox noma i-methoxyflurane), owusebenzisa njengoba kudingeka kuyo yonke inqubo.
Qiniseka ukuthi ubuza udokotela wakho ukuthi yini etholakalayo ukuze ukhululeke kakhudlwana phakathi nenqubo, futhi ukhulume nabo ngalokho ocabanga ukuthi kuyoba inketho engcono kakhulu kuwe.
Ulwazi olwengeziwe mayelana nama-biopsies omnkantsha lungatholakala ekhasini lethu lewebhu lapha.
Ukuhlelwa kwe-CLL - Uhlelo lwesiteji lwe-RAI
Isiteji se-CLL sihluke kancane kunezinye izinhlobo ze-lymphoma, ngoba i-CLL iqala egazini nomnkantsha wethambo.
Uhlelo lwesiteji lwe-RAI luzobheka i-CLL yakho ukuze lubone ukuthi uyakwenza, noma awunakho kwalokhu okulandelayo:
- amazinga aphezulu e-lymphocyte egazini lakho noma emnkantsheni wakho - lokhu kubizwa nge-lymphocytosis (lim-foe-cy-toe-sis)
- ukuvuvukala kwama-lymph nodes - lymphadenopathy (limf-a-den-op-ah-thee)
- i-spleen ekhulisiwe - i-splenomegaly (i-splen-oh-meg-ah-lee)
- amazinga aphansi amangqamuzana egazi abomvu egazini lakho - anemia (a-nee-mee-yah)
- amazinga aphansi eplatelet egazini lakho – thrombocytopenia (throm-bow-cy-toe-pee-nee-yah)
- isibindi esikhulisiwe - i-hepatomegaly (hep-at-o-meg-a-lee)
Kusho ukuthini isigaba ngasinye se-RAI
| Isigaba se-RAI 0 | I-Lymphocytosis futhi akukho ukwanda kwama-lymph nodes, i-spleen, noma isibindi, kanye nenani legazi elibomvu eliseduze nezibalo zeplatelet. |
| Isigaba se-RAI 1 | I-Lymphocytosis kanye nama-lymph nodes akhulisiwe. Ubende nesibindi akukhulisiwe futhi inani lamangqamuzana egazi abomvu kanye nenani leplatelet livamile noma liphansi kancane. |
| Isigaba se-RAI 2 | I-Lymphocytosis kanye ne-spleen ekhulisiwe (futhi mhlawumbe isibindi esikhulisiwe), noma ngaphandle kwama-lymph nodes. Amangqamuzana egazi abomvu nezibalo zeplatelet zivamile noma ziphansi kancane |
| Isigaba se-RAI 3 | I-Lymphocytosis kanye ne-anemia (amangqamuzana egazi abomvu ambalwa kakhulu), anama-lymph node akhulisiwe, ubende, noma isibindi. Izibalo zamaplatelet ziseduze kokujwayelekile. |
| Isigaba se-RAI 4 | I-Lymphocytosis plus thrombocytopenia (ama-platelet ambalwa kakhulu), ane-anemia noma ngaphandle kwayo, ama-lymph nodes akhulisiwe, i-spleen, noma isibindi. |
*I-Lymphocytosis isho ama-lymphocyte amaningi kakhulu egazini lakho noma umnkantsha
I-Clinical Grading ye-Lymphoma
Amaseli akho e-lymphoma anephethini yokukhula ehlukile, futhi abukeka ehlukile kumaseli avamile. Ibanga le-lymphoma yakho yindlela amaseli akho e-lymphoma akhula ngayo ngokushesha, okuthinta indlela yokubukeka ngaphansi kwe-microscope. Amabanga amabanga 1-4 (aphansi, aphakathi nendawo, aphezulu). Uma une-lymphoma yebanga eliphakeme, amaseli akho e-lymphoma azobukeka ehluke kakhulu kumaseli avamile, ngoba akhula ngokushesha kakhulu ukuze athuthuke kahle. Uhlolojikelele lwamabanga angezansi.
- I-G1 – ibanga eliphansi – amaseli akho abukeka esondele kokujwayelekile, futhi akhula futhi asakazeke kancane.
- I-G2 - ibanga eliphakathi nendawo - amaseli akho aqala ukubukeka ehlukile kodwa amanye amaseli avamile akhona, futhi akhula futhi asakazeke ngesilinganiso esimaphakathi.
- I-G3 - ibanga eliphezulu - amaseli akho abukeka ehluke kakhulu ngamaseli ambalwa avamile, futhi akhula futhi asakazeke ngokushesha.
- I-G4 – ibanga eliphezulu – amaseli akho abukeka ehluke kakhulu kokujwayelekile, futhi akhula futhi asakazeke ngokushesha.
Lonke lolu lwazi lwengeza kuso sonke isithombe esakha udokotela wakho ukusiza ukunquma uhlobo olungcono kakhulu lokwelashwa kwakho.
Kubalulekile ukuthi ukhulume nodokotela wakho mayelana nezici zakho eziyingozi ukuze ube nombono ocacile wokuthi yini ongayilindela ekwelashweni kwakho.
