Okuqukethwe kanye nokungavamile kweMediastinum
Iyini i-mediastinum nokuthi yiziphi izakhi nama-tissue akhona kule ndawo yesifuba? Iziphi izimo zezokwelapha ezingase zenzeke phakathi kwe-mediastinum? Yiziphi izinhlobo zezixuku ezitholakala emzimbeni noma izicubu ezitholakele ezingxenyeni ezintathu ze-mediastinum?
Incazelo: Mediastinum
I-mediastinum yindawo esifubeni phakathi kwamaphaphu aqukethe inhliziyo, ingxenye ye-windpipe (i- trachea ), i- esophagus , kanye nezitsha ezinkulu ezihlanganisa i-aorta ekhuphuka (umthamo omkhulu ophethe igazi kusuka engxenyeni engakwesokunxele yenhliziyo endleleni eya emzimbeni wonke) kanye nemishanguzo ye-pulmonary-kwesokudla nangesobunxele-ikakhulukazi zonke izitho ezisesibhedlela ngaphandle kwamaphaphu.
Kubuye kunezindawo eziningi ze- lymph nodes nezinzwa. Izwi elithi mediastinum lihunyushwe ngokuthi "emaphakathi" ngesiLatini, ngokubhekiselwe engxenyeni ephakathi kwesifuba.
Ungabona ngeso lengqondo le ndawo ngokubona umdwebo njengezansi, isifuba (i-sternum) njengaphambili, imithwalo yegazi engena futhi iphume enhliziyweni njengephezulu, nomgogodla (ikholomu ye-vertebral) njengecala elingemuva.
Isakhiwo - I-mediastinum ihlukaniswe ngezifunda ezintathu eziyinhloko:
- I-Anterior - I-mediastinum yangaphakathi ikhona ngakwesobunxele kuphela futhi iqukethe imithi emincane kanye namantombazane amancane.
- Ephakathi - I-Mediastinum ephakathi yingxenye enkulu kunazo zonke, futhi iqukethe inhliziyo, imithwalo yegazi kuhlanganise nalabo abahamba kusukela emaphashini kuya enhliziyweni, nama-lymph nodes.
- I-Posterior - I-postast mediastinum iqukethe i-esophagus, imithonjeni eminingi yegazi kanye nemisipha, kanye namagciwane we- mediastinal nodes .
Izimo ezithinta i-Mediastinum
Kunezimo eziningi zezokwelapha ezingathinta izakhiwo ku-mediastinum.
Ezinye zazo zihlanganisa:
- I-Cancer - I-Cancer njenge-lymphomas (kokubili i- Hodgkin's lymphoma kanye ne-non-Hodgkins lymphomas), ezinye izicubu zegciwane lesigciwane, kanye ne-thymomas (i-cancer ye-thymus gland) ivela phakathi kwe-mediastinum.
- Izicubu ze-Benign - Izicubu ze- Benign zegciwane njenge-teratomas ne-dermoid cysts zingenzeka kule ndawo.
- Ama-lymph nodes ama-lymph (ama-lymph nodes aphethwe umdlavuza) - Amanqamu anjengomdlavuza wamaphaphu angasakazeka kuma-lymph nodes kulesi sifunda (i-lymph nodes-mediastinal ne-tracheobronchial nodes.)
- I-Lymphadenopathy - "Ukuvuvukala" i-lymph nodes ku-mediastinum ingenzeka ngezifo ezithile, ikakhulukazi izifo ezithathelwanayo.
- Ama- aneurysms - ama- aneurysms e- Thoracic aortic yisimo esibi esihilela i-mediastinum.
- Umonakalo wamagciwane - Amagundane adlule phakathi kwe-mediastinum angalimaza , isibonelo ngokucindezelwa kwesisu noma i-lymph nodes yomdlavuza kule ndawo.
Masses Mediastinal
Izixuku ezithinta izidakamizwa zivame ukuqala kuqala uma kuthathwa iskena ukuhlola izimpawu ezihlobene nesifuba, njengokukhwehlela, ukuphefumula, noma ezinye izimpawu. Iningi labantu abaningi phakathi kwe-mediastinum bancane futhi abanalo izimpawu. Uma zikhulu zingabangela ukungakwazi ukuphefumula (kunzima ukuphefumula noma ukuthola okwanele okwenziwe ama-tishu) kanye nezinkinga zenhliziyo, njengokungena kwegazi noma ukuncipha kwegazi.
Ubudala bomuntu kanye nendawo ye-mass mediastinal kubalulekile ekucubunguleni ukuxilongwa. Ezinganeni, izixuku ze-mediastinal zenzeka kaningi kwi-mediastinum yangemva kwesikhathi futhi zivame ukuzibulala (ezingenabo umdlavuza.) Ngokuphambene, izixuku eziphakathi komzimba kubantu abadala zivame kakhulu emndenini ongaphakathi, futhi ngokuvamile zibulalayo (umdlavuza).
Ezinye izimbangela zezimbangi zomphakathi ezisuka endaweni zifaka:
- I-anterior mediastinum - Izicubu kulezi zifunda zingase zihlanganise i-thymomas (izicubu ze-thymus, isitho esifubeni esincane kakhulu ebuntwaneni kodwa sinyamalalala kubantu abadala), izilonda zamathambo kanye nezixuku ze-thyroid.
- Mediastinum Ephakathi - Izindwangu ezikhulisiwe ziyisisindo esivamile sobuningi phakathi kwe-mediastinum. Lezi zine-lymph nodes nazo zingahle zihlobene nomdlavuza ongaphansi. I-cysts ye-bronchogenic ingabonakala nakule ndawo, kanye nokukhubazeka kwenhliziyo njengokuthi i-aorta ekhulisiwe.
- I-posterior mediastinum - Amanqamu angama-esophageal nezinye izifo ezingalingani zingase zivele ngemuva kwe-mediastinum ehamba phambili, futhi ama-lymph nodes ekhulisiwe angase aphawulwe lapha. Amanye amathuba afaka ama-sarcom kanye nezicubu ze-ectopic ye-thyroid (izicubu ze-thyroid ezikhulayo endaweni engaphandle kwegciwane le-thyroid.
Umdlavuza we-Lung ungabangela ubukhulu kunoma iyiphi ingxenye ye-mediastinum. Kubalulekile ukuthi uqaphele ukuthi kunezimbangela eziningi ezingalungile ku-mediastinum, futhi kuvame ukuhlolwa okuqhubekayo ukuchaza isizathu esiqondile.
Imigomo efaka i-mediastinum
- I-Pneumomediastinum ibhekisela ekubeni khona kwomoya emkhatsini we-mediastinum, ngokuvamile ehlobene nokuwa kwamaphaphu (pneumothorax.)
- I -mediastinitis yigama elisho ukutheleleka okubandakanya i-mediastinum.
Izinqubo - Mediastinoscopy
Ngomdlavuza ofana nomdlavuza wamaphaphu kanye ne-lymphomas, odokotela bavame ukuhlola i-mediastinum ukubona ukuthi imuphi umdlavuza usakaze kule ndawo. Enye inqubo evumela abahlinzayo ukuba bacabange ukuthi le ndawo ibizwa ngokuthi i- mediastinoscopy . Uma umdlavuza usakazeke kuma-nodes ku-mediastinum ngokuvamile uphathwa ngendlela ehlukile kunomdlavuza ongazange usakaze kule ndawo; ukutholakala kwama-lymph node emzimbeni kubalulekile ekuguleni komdlavuza wamaphaphu .
I-Mediastinoscopy yinkambiso evamile kulabo abathintekayo benomdlavuza wamaphaphu, kepha ulwazi olufanayo ngezinye izikhathi lungase lutholakale manje nge-PET scan.
Izibonelo: Injabulo yayenzelwe inqubo yokwenza ukuthi ngabe umdlavuza wakhe wamaphaphu usulele yini kumakhansela omzimba emndenini wakhe.
> Imithombo:
> Barrington, S., no R. Kluge. I-FDB PET ye-Therapy Monitoring eHodgkin nase-Non-Hodgkin Lymphomas. I-European Journal ye-Nuclear Medicine ne-Molecular Imaging . 2017 Apr 14. (Epub ngaphambi kokuphrinta).
> Berry, M. Ukuhlolwa kweMasses aseMidastinal. Kusesikhathini. Kubuyekezwe 09/28/16. http://www.uptodate.com/contents/pproach-to-the-adult-patient-with-a-mediastinal-mass
> Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. noB de Mol. Ukuphathwa Kwamasosha Omkhulu Omzimba: Ukucatshangelwa Nokuhlinzeka Ngokwezinzwa. I-Journal ye-Thoracic Disease . 2016. 8 (3): E175-84.
> I-Library Kazwelonke Kazwelonke Yezokwelapha. I-Medline Plus. Ama-Tumorinal Tumors. Kubuyekezwe 05/20/16. https://medlineplus.gov/ency/article/001086.htm