Okubalulekile kweHodgkin Lymphoma
I-Lymphoma ingumdlavuza ovela eqenjini lamhlophe amangqamuzana egazi okuthiwa i-lymphocytes. Umzimba wakho uxhomeke ezinhlobonhlobo ezahlukene ze-lymphocytes ukwenza imisebenzi ehlukene ohlelweni lwezivikelo mzimba. Lawa ma-lymphocyte angamaseli akhulayo ngezigaba, uhlobo oluthile lwe-tadpoles eba amaxoxo. Futhi, njengoba umdlavuza ungakhula ngezinhlobo ezahlukene ze-lymphocytes nasezigaba ezihlukahlukene zokuthuthukiswa kwazo, izinhlobo eziningi ze-lymphoma zingenzeka.
I-Hodgkin lymphoma (HL) ne- non-Hodgkin lymphoma (i-NHL) yizigaba ezimbili eziyinhloko ze-lymphoma . I-HL ibizwa nangokuthi isifo sikaHodgkin, futhi amagama amabili achaza isifo esisodwa kuphela-asikho into efana nesifo se-Hodgkin esingeyona i-lymphoma. Udokotela ogama lakhe linguThomas Hodgkin waqala ukuthola i-HL ngawo-1800, futhi i-lymphoma ibizwa igama lakhe kuze kube yilolu suku.
I-Hodgkin Lymphoma: I-Cancer ye-Lymph Nodes
I-HL ijwayele ukuqala ema-lymph nodes , njengama-lymphomas amaningi.
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Ukubhekana Nokuthola Ukwesekwa Uma Unesifo Se-Hodgkin
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Ukuzala nokukhulelwa Lapho Uphila Ne-Hodgkin Lymphoma
Ngamunye wethu unamakhulu ama-lymph nodes, amancane, izitho ezinobhontshisi abasiza ukuhlala beqaphele umthamo womzimba okuthiwa i-lymph.
Kuyini i-lymph? Uma ucabanga ukubeka igazi lakho nge-strainer microscopic, amaseli wegazi namaprotheni amakhulu ahlale e-strainer ngenkathi uketshezi luzodlula. Leli ketshezi lifana ne-lymph. Amaseli e-lymph ayindaba ehlukile. Amaseli amhlophe omzimba omzimba ahambela ohlelweni lwe-lymphatic ukwenza imisebenzi yesistimu yomzimba. Amangqamuzana amhlophe ajikeleza lymph, futhi eziningi zazo zihlala emagqumeni lymph.
Ama-lymph nodes ahlala ngokuhlelekile eceleni kwenethiwekhi yamashaneli agcwele amanzi lymph-flu, ekhonza njengama-postposts, noma ama-checkpoints.
I-lymph node ngayinye ihlunga uketshezi olutholayo kusuka ezitsheni ze-lymph ezidonsa indawo ethile yomzimba.
Ngesinye isikhathi abantu bayazi ukuthi i-lymph nodes njenge-bumps ngaphansi kwesikhumba, noma okuthiwa izigulane ezivuvukala ezingase zibangelwe ukutheleleka. Iningi lesikhathi, ama-lymph node enempilo noma engaphenduliyo ayengabonwa. Ukwengeza, ezinye izitho zomzimba zitholakala ngaphakathi ngaphakathi komzimba, eduze kwenhliziyo, phakathi kwamaphaphu, noma ngaphakathi ngaphakathi kwesisu, ukukhipha nokuhlunga i-lymph fluid ezivela ezingxenyeni zangaphakathi nezicubu. Kulezi zindawo, kungenzeka zingabonakali isikhathi esithile, ngisho noma zivuvukala noma zikhula.
I-Node yokuvuvukala i-Hodgkin lymphoma cishe iphakama engxenyeni engenhla yomzimba, emagqumeni omzimba entanyeni, engaphansi, noma ngaphakathi kwesifuba.
Yini Ebangela I-Hodgkin Lymphoma?
Ososayensi abazi ukuthi yini ebangela ikakhulukazi i-Hodgkin lymphoma. Kunezici ezithile eziyingozi, kodwa ukuba khona kwengozi kungabonakali nganoma iyiphi indlela ukuthi i-HL izokhula, futhi akuyona imbangela yengozi ukuthi iyini imbangela lapho i-HL ikhula khona.
Izingozi ezinjalo zibandakanya igciwane elidala i-mono, noma i-mononucleosis, ebizwa nge-Epstein-Bar virus. Umlando womndeni ubuye ubungozi obunzima, kodwa awazi ukuthi kanjani noma ngani; okungukuthi, kungase kube khona izakhi zofuzo ezabelwana ngazo ezenza amalunga omndeni angene kakhulu ku-HL, noma mhlawumbe abantu emndenini ofanayo babe nezifo ezifanayo zobuntwana ezibabeka engozini ye-HL. Ukuba nesimiso sokuzivikela esifuthakathaka futhi kwandisa ingozi yeHL. Ukuzivikela okunjalo okungakhubazekile kungavela ku-HIV / AIDS, ezinye izifo ezihlukahlukene, noma emithini yemithi esetshenziselwa ukuvimbela impendulo yomzimba.
Ubani Othola I-Hodgkin Lymphoma?
I-Hodgkin lymphoma ayitholakali kakhulu kune-NHL jikelele, kubalwa cishe amaphesenti angu-10 azo zonke izimo ze-lymphoma. Kungenzeka kuzo kokubili izingane kanye nabantu abadala, futhi kunezinhlobo ezimbili zeminyaka ephakeme:
- Izinsana kanye nabantu abadala abasha abaneminyaka engu-15 kuya kwengu-40
- Abantu abadala abadala abangaphezu kweminyaka engu-55
Ngakho-ke, yize i-HL ingavamile kakhulu, uma kungase kubonakale sengathi abantu abaneminyaka engama-20 ubudala bathola ukutholakala kaningi kaningi, futhi lokhu kungenzeka ngenxa yeqembu lokuqala lesikhulu.
Ihluke kanjani ku-Non-Hodgkin Lymphoma?
Umuntu ngamunye nge-HL kungenzeka ukuthi indaba yakhe ayitshele. Kodwa-ke, ngokuvamile, i-Hodgkin lymphoma iyiqembu elincane kakhulu, elincane kakhulu lama-lymphomas kune-NHL. I-HL ivela kumaseli e-B, noma i-B-lymphocyte, njengamanye izinhlobo ze-NHL. Noma kunjalo, ngokungafani ne-NHL, i-HL inezinhlanu kuphela ezijwayelekile ezihlonishwayo (ngaphezulu ngalokhu ngezansi); I-NHL inezinombolo zazo.
I-HL ne-NHL nayo ihluke ngendlela ukuthi ivela kanjani futhi isakazwa nge-lymph nodes ehlukahlukene. I-HL inamathuba amaningi okuqala nokusabalalisa ngendlela ehlelekile, ngendlela ehlelekile-kusuka ku-lymph node kuya ku-lymph node. Kungavamile kakhulu futhi sekwephuzile lesi sifo kwenza i-HL ingene egazini bese isakazeka kabanzi. Ezimweni eziningi ze-NHL, kucatshangwa kusukela ekuhambeni ukuthi ama-nodes amaningi ezingxenyeni ezihlukene zomzimba angase ahileleke, kuze kuqinisekiswe ngenye indlela.
Izimpawu ze-Hodgkin Lymphoma
Abantu abane-HL bangase bahlakulele izimpawu ezihlukene, kodwa isimo esivame kakhulu ukuxilongwa siphuthumayo (s) sine-lymph node noma okunye okunye.
Ama-lymph nodes angase akhuliswe entanyeni, emagqumeni, noma ekuhlungeni, okwenza uhla olungenabuhlungu , noma ngaphakathi kwesifuba.
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Yiziphi Izidakamizwa Zesibili Ezingabantu Ezinezifo ZaseHodgkin?
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Izimpawu nezibonakaliso ze-Hodgkin Lymphoma
Ngokuvamile, labo abane-HL bangase babe nesisindo, umkhuhlane , ukuhlambalaza noma ukugcoba ukujula ebusuku, okubizwa ngokuthi yi- B izimpawu .
Isibonakaliso esingavamile kakhulu kodwa esibonakalayo se-HL ubuhlungu buhambisana nokusetshenziswa kweziphuzo ezidakayo. Ososayensi abazi kahle ukuthi kungani lokhu kwenzeka, kodwa kungenzeka ngenxa yokwandiswa kwemikhumbi ngaphakathi kwezinto ezibandakanya i-lymph nodes ekuphenduleni utshwala.
Ukuxilongwa kwe-Hodgkin Lymphoma
I-lymph node ekhulisiwe engeke ihambe akufanele ilandelwe. Noma kunjalo, izimbangela zokukhulisa i-lymph node ziningi , futhi eziningi zazo azikona umdlavuza. Uma i-lymph node esolwayo isanda kusha, ngokuvamile kuvame ukulinda ukuze kuqinisekiswe ukuthi ayivuvuzi ngesinye isizathu. Ama-lymph nodes kungenzeka kakhulu ukuba avuvuke ezifweni nezinye izimbangela kunokuba i-lymphoma.
I-Lymph Node Biopsy
Uma kukhishwa i-HL, ama-lymph nodes angase abe ne-biopsied. I-biopsy yinkqubo lapho isampula yamathambo ethathwe ku-lymph node noma kwezinye izingxenye zomzimba futhi ithunyelwe ebhokisithri ukuze ihlolwe futhi ihlolwe. Kuye indawo yendawo ye-lymph node, inqubo ingase ibe elula kakhulu noma ihileleke kancane, kepha kunoma yikuphi ngokuvamile kubhekwa njengokuhlinzwa okuncane. Amacala angenziwa esikhungweni sokuhlinzeka ngeziguli noma esibhedlela esibhedlela.
Esikhathini se-biopsy esinqunyiwe, unikezwa umjovo we-anesthetic wendawo ukuze ungazizwa ubuhlungu ngesikhathi senqubo. Isikhumba esingaphezu kwe-lymph node esolisayo sivulwa nge-incision encane, futhi i-lymph node eyodwa noma ezimbalwa zazo zikhishwa. I-cut is then stitched ivaliwe. I-biopsy ithatha imizuzu engaba ngu-30 kuya ku-45, futhi ungabuyela ekhaya maduzane ngemuva kwenqubo.
Ngaphandle kwalokho, lapho ama-lymph nodes noma amanye amasayithi asolisayo ejulile ngaphakathi emzimbeni, inqubo ye-biopsy ingabandakanya izicathulo zomzimba nokucabangela ukuqondisa inaliti endaweni eqondile yezicubu ezisolisayo. Udokotela angakwazi ukusebenzisa inaliti ukuze afinyelele isampula, esithathwe futhi ithunyelwe ku-pathologist ukuze ahlolwe.
Ukufisa inaliti enhle kuyinkqubo eyenziwa ngezinye izikhathi, ikakhulukazi njengesinyathelo sokuqala lapho kunokukhathazeka ukuthi i-noode entanyeni ingabandakanywa nomdlavuza wekhanda nentamo. I-aspire enhle kakhulu, noma kunjalo, ayinikezi kahle njengesampula njenge-biopsy eyinqaba yokuxilongwa kokuqala kwe-HL.
Ngezinye izikhathi ezinye izingosi ezifana nomnumongo wethambo ziyi-biopsied, kodwa lokhu akuvamile ukuyingxenye yokuhlolwa kwesimo se-HL zakuqala.
Izivivinyo zegazi
Ukuhlolwa kwegazi njengokubala okuphelele kwegazi noma i- CBC kuhilela isiteleka esenziwe ngokuzenzekelayo ukuhlanganisa amaseli egazi ezinhlobonhlobo ukuze unqume ukuthi izinombolo zakho zingena ebangeni elivamile noma elingavamile. Okutholakako akusho ngqo ku-HL. Ngezinye izikhathi ezinye izimpawu ezivela egazini zingasetshenziselwa ukwengeza ulwazi oluhambelanayo ne-pregnosis. Futhi ukuhlolwa kwezifo ezithile ezibangelwa amagciwane kuyingxenye yokuhlola kokuqala kwebhu.
Ama-PET Scans nokufanekisa
Ukuhlolwa kwe-PET eminyakeni yamuva sekubalulekile ekuqalisweni kokuqala kweHodgkin lymphoma. Ukuhlola kwe-PET kungasiza futhi ukutshela umehluko phakathi kwezicubu ezisebenzayo nezindawo ezifayo ezihlala emzimbeni ngemuva kokuba umuntu one-HL aphathwe. Izinkombandlela ezivela kuNational Comprehensive Cancer Network zincoma i- PET / CT ukuze ziqale ukuhlolwa kanye nokuhlolwa kokugcina kokuphendula ngeziguli ezine-HL .
Ukuhlola kwe-PET kanye nokuhlola kwe-CT yizinhlobo ezimbili ezihlukene zokucabanga ezivame ukwenza ndawonye ukuze isithombe esihle se-anatomy senziwe nge-CT kuyilapho amandla e-PET ehlanganiswa ukuthola izindawo zezifo ezikhanya. Isisindo endaweni yesifuba, noma i-mediastinum, ukutholakala okuvamile kakhulu ku-HL yesigaba se-PET / CT.
Indima ye-PET iyaqhubeka nokuguquka, futhi kunesithakazelo esikhulu ku-PET ukuskena kwesikhashana, lapho ungabona khona impendulo oya kuyo ekwelashweni olunikeziwe ngaphambi kokuba lo mgomo uqede. Ezimweni eziningi, i-jury isasesikhathini esihle kakhulu sokuskena kwe-PET kanye nemiphumela yokushintsha ukwelashwa.
Izinhlobo ze-Hodgkin Lymphoma
Kunezinhlobo ezinhlanu ezinkulu ze-HL okungatholakala ukuthi unayo. I-Classical Hodgkin lymphoma yigama elidala elisetshenziselwa ukuchaza iqembu lezinhlobo ezine ezivamile ezihlanganisa ndawonye amaphesenti angaba ngu-95 azo zonke izimo ze-HL emazweni athuthukile. Kulezi zinhlobo eziyisihlanu eziyinhloko, kuphela ezine zokuqala ziyi-HL yakudala:
I-Nodular Sclerosing Hodgkin Lymphoma (NSHL)
- Uhlobo oluvame kakhulu lwe-HL; i-akhawunti yamaphesenti angama-60 kuya kuma-70 amaphesenti kuwo wonke amacala we-HL
- Okuvamile kubantu besifazane futhi ikakhulukazi kuthinta abantu abasha
- Ithinta kakhulu ama-node entanyeni noma emagumbini, noma ngaphakathi kwesifuba
I-Mixed Cellularity Hodgkin Lymphoma (MCHL)
- Olunye uhlobo olujwayelekile lwe-HL, lubalwa ngamaphesenti angu-15 kuya ku-30 amaphesenti okuxilongwa
- Okuvamile emazweni asathuthuka
- Ithinta abantu kunoma yimuphi ubudala
- Kungenzeka ukuthi kuhileleke isisu kunokuhlukahluka okuvamile kwe-nodular sclerosing, futhi kungenzeka ukuthi kungabandakanyi ama-node ngaphakathi kwesifuba
- Ulaka, kodwa luphilisa kakhulu
I-Lymphocyte Isusiwe iHodgkin Lymphoma (LDHL)
- Ifomu elingavamile kakhulu le-HL elenza amaphesenti angu-1 kuphela amacala
- Kubonakala kubantu asebekhulile futhi ngokuvamile kutholakala esiteshini esithuthukile; futhi kuvame kakhulu kulabo abanesandulela ngculazi
I-Lymphocyte-ecebile i-Classical Hodgkin Lymphoma (LRCHL)
- I-subtype engavamile; ilandisa ngamaphesenti angaba ngu-5 kuya ku-6 amaphesenti okuxilongwa
- Ithinta abantu ikakhulukazi kuma-30s noma ama-40
- Iningi liyatholakala kuzinyathelo zokuqala; impendulo yokwelapha ihle kakhulu
- Kutholakale kuningi lymph nodes ezimbalwa; kwenzeka engxenyeni engenhla yomzimba.
Lokho kushiya uhlobo olulodwa nje lwe -HL engeyona ye-classic :
I-Lymphocyte Nodular Predominant Hodgkin Lymphoma (NLPHL)
- Manje kubhekwa uhlobo olukhethekile lwe-HL oluhlukile kwezinye izinhlobo ezingenhla
- Ama-akhawunti wamaphesenti angu-4 kuya ku-5 amaphesenti okuxilongwa
- Amaseli amancane afana ne-NHL
- Isifo semitholampilo esifana ne-lymphocyte-ecebile uhlobo lwe-HL ye-classical, ne-lymph nodes ehilelekile ejwayelekile entanyeni nasezintweni
Iyini Isibikezelo?
Ngokuvamile, i-HL ibhekwa njengenye yezinhlobo zokwelapha zegazi ezingaphathwa futhi ezinophephekayo uma zibanjwa ezinyathelweni zayo zakudala, futhi zingase ziphuluke ngisho nasezigaba eziningana. Kodwa-ke, kukhona namacala abuyele ngemuva kokwelashwa kanye / noma okunzima kakhulu ukwelashwa.
Izibalo zamazinga okuHlalisa ama-HL namanani okuphila akulula ngaso sonke isikhathi ukuqonda noma ukufaka isicelo kumuntu oyedwa; ngakho-ke usebenza nodokotela ukuze uqonde izinketho zokwelapha futhi ukuguqulwa kubalulekile.
Ukwelashwa kwe-Hodgkin Lymphoma
Uma uthola ukuthi une-HL futhi uyazibuza ngezinketho zakho zokwelashwa, khuluma nodokotela wakho mayelana nesigaba sakho esithile nokuthi lokho kusho ukuthini. I-Chemotherapy noma i-radiation ingase iphakanyiswe, kodwa okulungile ukuthi uzoxhomeka kuhlobo lwakho oluthile lwe-HL, icala, iminyaka yakho, impilo yakho yonke, nokuningi.
Funda kabanzi mayelana nokwelashwa kwe-Hodgkin lymphoma .
Uma uthola ukwelashwa, qiniseka ukubona udokotela wakho uma ubona noma yini entsha ehlobene nesimo sakho noma unemiphumela emibi, okunye okungase iphethwe ngokwemithi. Uma unombuzo mayelana nesimo sakho noma ukuthi ulawulwa kanjani, ungalokothi unganqikazi ukukhuluma nodokotela wakho ngokuqhubekayo noma ukufuna umbono wesibili.
Izwi elivela
Kufanele ucabange ukwenza i-aphoyintimenti nodokotela wakho uma unesifo noma izimpawu ezibuhlungu. Ngesinye isikhathi i-lymph node evuvukala ingumlutha womzimba, okubalulekile ukukhumbula. Kodwa ukungazinaki i-lymph node ephikisayo kungase kusho nokuthi akulahlekelwa amathuba okuthola nokutholwa ngokushesha.
Uma wena noma othandekayo uthola ukuthi unesifo se-Hodgkin lymphoma, kuvamile ukuba uzizwe udidekile futhi uhlezi kancane. Ukwenza umqondo wazo zonke izinhlobo ze-lymphoma kanye nokwelashwa kungaba umsebenzi obangele. Uma ufunda, qiniseka ukuthi imithombo yakho ibhekisela eHodgkin lymphoma ngokuqondile, hhayi nje i-lymphoma ngokujwayelekile.
Kulo, sihlose ukuchazela izinto ngokusekelwe kwisayensi engcono kakhulu, kodwa njalo esiNgisi esicacile. Hlola emuva kaningi futhi esigabeni ngasinye sohambo lwakho lomdlavuza, bese usebenzisa ezinye izinsiza zeziguli ezifana ne-American Cancer Society kanye neLeukemia & Lymphoma Society.
Ngezinye izikhathi kungakusiza ukukhuluma nomuntu oye wahamba ngeHodgkin lymphoma nakho konke lokho okuxilongwa futhi ukwelashwa kufaka phakathi. Imihlangano yokuphepha, izingqungquthela, ngisho nemithombo yezokuxhumana yindlela enhle kakhulu yokuxhumana nabanye abangabelana ngempi yakho noma babe nakho okufanayo nokuqonda.
> Imithombo:
> I-American Cancer Society. Yiziphi izici ezingozini ze-Hodgkin?
> Hutchings M. Kanjani usizo lwe-PET / CT ekukhetheni ukwelashwa kweziguli ezine-Hodgkin lymphoma? Uhlelo lwe-Hematology Uhlelo lwe-Soc Hematol Educ Educator . 2012; 2012: 322-7.
> Townsend W, iLinch D. Hodgkin's lymphoma kubantu abadala. I-Lancet . 2012; 380 (9844): 836-47.