T-selo lymphomas: mitundu, zizindikiro, matenda, mankhwala ndi madokotala ananena zawo

T-selo lymphomas zambiri matenda odwala mu ukalamba, koma achinyamata ndi ana komanso sachedwa matenda. Ndipo anthu amadwala kawirikawiri kuposa akazi.

ndi T-selo lymphomas Kodi

Lymphoma - chotupa chotupa lymphoid minofu ndi ziwalo zina. Pankhani ya lymphoma T-selo, matendawa amakhudza khungu ndi lymph mfundo (ie ndi epidermotropny khalidwe). The zofunika kuti zimakhudzidwa pakutchulidwa wa neoplasms ndi T-lymphocytes (maselo zambiri kupereka yankho okwanira m'thupi). T-selo lymphoma (chithunzi ankaimira pansipa) akhoza kupangidwa chifukwa cha kudzikundikira pathological minofu zinthu ma.

Zoyambitsa ndi zinthu chinapangitsa

• chibadwa
• Immunodeficiencies.
• Nthawi yaitali zinthu chowawa: dzuwa limakhala lamphamvu, aukali mankhwala wothandizira.
• Age mbali (odwala okalamba).
• Kupezeka kwa mavairasi mu chamoyo (HIV, Epstein-Barr, chiwindi C, B, T-lymphocyte HIV), matenda matumbo.
• Pamaso pa masinthidwe a chitetezo, limba ndi minofu kupatsidwa zina, immunosuppressive mankhwala kusankhidwa.

Mfundo zonsezi akhoza kukula chifukwa (motero, imautsa chitukuko cha matenda), nkhawa, kutupikana, overloads mantha, kulephera kumvera boma la mpumulo ndi ntchito.

Gawo

• T-selo lymphoma khungu. lymphomas zofanana zambiri kukhala chifukwa cha masinthidwe zosiyanasiyana T lymphocytes, zikubweretsa ndi chulutsa kusalankhula wa otsiriza ndipo, chotero, iye anawagwiritsa ntchito pofotokoza mu wosanjikiza wa khungu. Yodziwika ndi mawonekedwe yogwira polymorph totupa yatsoka lymphomas (zolengeza, zotupa, Madontho, matuza). Ndi odwala choyamba amadandaula zosayembekezereka wa wazikang'a kapena kuyabwa mawanga, kenako yosintha mu mipukutuyi, ndipo kenako mu chotupa foci.
• Zotumphukira T-selo lymphoma. mfundo imeneyi imaphatikizapo lymphomas onse amene T-selo kapena chiyambi NK-selo (kupatula neoplasm wa mwana T-maselo ndi T-lymphoblastic khansa). Nthawi zambiri, lymphomas izi zimachitika ndi zotupa magazi, khungu, mafupa ndi ziwalo, ndi mwanabele, akakufunsani kusintha infiltrative anati.
• Angioimmunoblastic T-selo lymphoma. Timakusonyeza monga kusindikiza lymphoid minofu (pa Kupenda histological a mwanabele) immunoblast ndi madzi a m'magazi maselo, ndi wotsatira kusintha wathunthu wa matabwa ake ndi mapangidwe ziwiya nthenda magazi.
• T-selo lymphoblastic lymphoma. Novobrazovanie, ozikidwa pa kuvutika maselo T. maselo T sakhwimitsa zipatso zamphumphu, phata awo amasandulika osasamba mu mawonekedwe, iwo mwamsanga ndi kumangolira kugwa. Anakumana mtundu uwu lymphoma ali osowa. Ngati inu choti nawonso chitsanzo masiyanidwe matenda ndi khansa ya m'magazi pachimake.
• T-selo Non-Hodgkin a lymphoma. Bwaloli gulu lalikulu la zotupa amene wapangidwa okhwima T-lymphocytes ndi sananene kuti matenda Hodgkin a (i.e., matenda Hodgkin a). Kukhala gulu lino limadalira Kupenda histological (ndi chlamydia mu Kukonzekera wapezeka yeniyeni ma zinthu Berezovsky-Sternberg pa lymphomas sanali Hodgkin ali palibe).

siteji kakulidwe

1. Kugonjetsedwa kwa mfundo imodzi lymph.
2. Kufala kwa chotupa kuti mfundo ziwiri lymph kuti zili mbali imodzi ya chifundamtima.
3. Angapo lymph nyumba mbali zonse za chifundamtima.
4. Lymph mfundo ndi ziwalo, pamaso pa metastases mu impso, mafupa, chiwindi kapena ziwalo thirakiti m'mimba.

zizindikiro General

Kukhalapo kapena kusapezeka kwa ena mawonetseredwe matenda zimatengera mtundu wa chotupa ndi malo ake. Komabe, pali zizindikiro zimene chibadidwe pafupifupi onse lymphoma T-selo:

• Thukuta usiku.
• Rapid kuwonda umboni.
• Mycosis fungoides.
• Low kalasi ntchito mu thupi kutentha.
• Pafupipafupi kutopa ndi mphwayi.

mycosis fungoides

Mycosis fungoides - chimodzi cha mawonetseredwe zambiri zomwe T-selo lymphoma. Umapezeka peresenti makumi asanu ndi awiri odwala ndi matenda, ndipo mitundu itatu: chakale, anadula mutu ndi erythrodermic.

Chakale mycosis fungoides umadutsa magawo atatu a chitukuko:

• Erythematous - ndi zizindikiro matenda ofanana psoriasis, chikanga ndi zina zotero. Odwala lipoti pamaso pa Madontho chowulungika kapena zozungulira mawonekedwe, konsekonse lakuthwa, zamitundu yosiyanasiyana, ndi mtundu pinki-violet ndi wazikang'a pamwamba. zinthu otere nthawi zambiri ili pa nkhope ndi torso, pang'onopang'ono kuwonjezeka mu kuchuluka ndi kudutsa mbali zina. zotupa amenewa salabadira mankhwala ndipo sangathe unachitikira kwa nthawi yaitali, kapena mwadzidzidzi kutha. Komanso, Madontho akhoza pamodzi ndi kuyabwa, amene sanasiye kudzera ochiritsira.
• Patchy infiltrative - zikadzatha zaka zochepa isanayambike. Mu malo ya pamwamba Madontho mipukutuyi ndi wandiweyani, anamaliza kapena nepravilnymi koma bwino malire, wofiirira ndi ukuchoka padziko. Pamalo a mipukutuyi tchulani mbali ya bulauni kapena khungu manja. ukuwonjezeka kuyabwa, izo akukulirakulira. Pali mofulumira kuwonda ndi malungo, lymphadenopathy akhoza kukhalapo.
• Chotupa - pamalo kapena mipukutuyi pa khungu palibe anasinthidwa maonekedwe a wandiweyani wofiira ndi wachikasu sabweretsa chisoni chotupa mtundu ozungulira kapena pang'ono flattened mawonekedwe, kooneka ngati bowa chipewa. The awiri a dongosolo ngati ranges ku millimeters wani mpaka twente, ndipo chiwerengero angakhale osiyana. Pamene chotupa cha zikadzawonongedwa, zilonda zopweteka aumbike mwa malo ake, kuya amene imakhala fascia kapena fupa. Nthawi zambiri zimakhudza ndulu, lymph mfundo, mapapo ndi chiwindi. Narostaet kuledzera ndi kufooka. Odwala kudzafa chifukwa chakuti mtima, amyloidosis, chibayo.

mawonekedwe Eritrodermicheskoy amakhala ndi zikamera wa narostaet chowawa kuyabwa, redness ndi kutupa, maonekedwe a confluent erythematous-squamous mawanga, hyperkeratosis pa Yakanjedza ndi zidendene, komanso tsitsi imfa. Phunzirani mfundo zonse lymph mu axillary ndi, inguinal, femoral ndi malo cubital. Pamene zikupezeka plotnoelastichnye mapaketi sabweretsa chisoni palpation lymph osati soldered kuti zimakhala ozungulira (khungu). Lihodradka anati (mpaka madigiri 39), kuwonda, Thukuta usiku ndi kutopa. Woopsa zotsatira n'zotheka pamene kujowina kuledzera ndi zachititsanso mtima kulephera.

Pamaso pa mawonekedwe anadula mutu pa khungu labwino pali mipukutuyi angapo, kenako kupeza zilonda harater. Imfa amapezeka odwala mwa chaka.

Matenda mawonetseredwe a lymphomas cutaneous

T-selo lymphoma wa khungu zambiri amapezeka motsutsa likhale kuleza wogwila zosayenera zochizira matenda dermatological. Zoyambitsa yatsoka yake nsungu mavairasi, dzuwa, kake kakupsa ndi dzuwa ndi zina zotero. lymphomas wofanana ndi mbali ziwiri: chachikulu (ndondomeko isanafalikire mu dermis a) sekondale (pamene zotupa ndizo zotsatira za lymphocyte kusalola ziwalo mkati).

Zizindikiro zazikulu ndi:

• Polymorphic ziwengo.
• Kutuluka kuyabwa.
• Kupezeka kwa ang'ono, zinthu mosabisa mu mawonekedwe nodular.
• Maonekedwe chikasu mipukutuyi, kenako yosintha mu matumba a hyperpigmentation ndi manja (pamene zolengeza mawonekedwe).
• Chithunzi matenda chokhala psoriasis (mtundu melkouzelkovoy).
• Dryness, kutupa, redness ndi khungu kwa khungu (mtundu erythrodermic matenda).

Symptomatology wa lymphomas zotumphukira

matenda Clinic zimadalira gawo ndi mtundu wa ndondomeko pathological.

Yodziwika ndi ponso minofu lymphoid mu khosi, groin ndi axillary zigawo.

Odwala amadandaula thukuta kwambiri, sankatha kulemera, kusafuna kudya, kufooka ambiri, malungo, ndi pamaso pa ndulu zikuluzikulu ndi chiwindi (omwe ndi ofala kwambiri) - ndi kufupika kwa mpweya, chifuwa kobwereza ndi kumverera kwa kulemera m'mimba.

diagnostics

• Anayendera, zosonkhanitsira madandaulo ndi anamnesis oncologist.
• General magazi ndi kusanthula mkodzo.
• Magazi sayansi komanso mayeso kwa chitetezo ku matenda a chiwindi mavairasi.
• A biopsy wa mfundo kuonongeka lymph (zomwe zimathandiza kuti atsimikizire matenda a lymphoma T-selo).
• US.
• MR.
• CT.
• Onkoskrining thupi.
• Immunofenotipirovannoe kuphunzira.
• Maselo majini nkhani.
• Cytogenetic kusanthula.

mankhwala

Chithandizo cha lymphoma T-selo zimadalira mawonekedwe ndi siteji ya ndondomekoyi.

Mwachitsanzo, kwa erythematous fungoides siteji mycosis wapadera anticancer mankhwala si anaikidwa ndipo corticosteroids akunja interferon ntchito.

Odana ndi chotupa mankhwala kugwira mankhwala amphamvu ndi radiotherapy.

Malinga ndi mawonekedwe a matenda (indolent, mwamakani, ndi kwambiri mwamakani) anatsimikiza ndi kutalika ndi zikuchokera chithandizo, ndi kukhazikitsa.

Indolent lymphoma si ankachitira, koma nthawi zonse ankaona ngati ndondomeko m'kati, machenjerero kusintha.

Mankhwalawa mitundu aukali ntchito osakaniza mankhwala chemotherapeutic ndi Rituximab (monoclonal oteteza).

Pankhani lymphomas kwambiri mwamakani, izo n'kukulemberani mankhwala ogwiritsa ntchito pa matenda a leukemias pachimake.

Nthawi zambiri mankhwala amphamvu pamodzi ndi kupatsidwa zina maselo.

Komabe, mankhwala ambiri lymphoma ndi kuchititsa makumi atatu cheza mankhwala (wonenedwa Elekta Synergy), ndi pambuyo pa kulandira nthumwi chemotherapeutic.

Zovuta kulandira nthumwi chemotherapeutic ingakhale monga iyi: m'mapapo, chifuwa, ndi zina zotero. mankhwala cheza kungavute ndi chitukuko cha atherosclerosis inatsekeratu.

Pambuyo mankhwala bwino mokakamizidwa konzanso.

T-selo lymphoma: Mapa

• Pamene yake kudziwika matenda (siteji koyamba) ndi ntchito mankhwala mlingo zokwanira zisanu kupulumuka peresenti eyite-faifi, ndipo odwala Dokotala - kuti nainte.
• Ponena angioimmunoblastic lymphoma zanyengo zokhumudwitsa. Wapakati moyo amayembekezeka odwala matenda amenewa ndi awiri ndi theka - zaka zitatu. Mlingo apulumuke yekha gawo limodzi la odwala ndi zaka zisanu.
• Mu kukhalapo kwa T-lymphoblastic mawonekedwe madokotala ananena zawo zimadalira pamaso / pakalibe chotupa a m'mafupa. Ngati m'mafupa si bwanji, zotsatira zake zimakhala zambiri zabwino. Apo ayi, kusintha peresenti makumi awiri okha a odwala akhoza kuyembekezera.
• Kulosera tsogolo la matenda ndi kupulumuka bowa avium ndipo zimadalira pa mawonekedwe kwa ndondomekoyi. Choncho, pamene kupulumuka bala mawonekedwe - kwa zaka khumi, ndi madokotala ananena zawo ndi akumane ngati inalowa a chibayo, ndi zina zotero, eritrodermicheskoy mawonekedwe sorovozhdaetsya kujowina mavuto osiyanasiyana chifukwa mu imfa amapezeka mkati awiri - zaka zisanu; pamene mawonekedwe headless kwa madokotala ananena zawo osauka, munthu amafa mwa chaka.