Uma utshelwe ukuthi une-nodule yamaphaphu noma amaphaphu amaphaphu ku-x ray, cishe usaba kakhulu. Iziphi ezinye izimbangela? Bangaki abantu abanamahlumela amaphaphu? Futhi yiziphi amathuba ukuthi umdlavuza wamaphaphu ?
Kubalulekile ukusho masinyane ukuthi iningi- okungenani amaphesenti angu-60 emaphaphu aqhubezela jikelele-awawona umdlavuza. Sizokukhuluma ngalezi zimbangela, kodwa kubalulekile ukuthi uqaphele ukuthi uma i-nodule ingumdlavuza wamaphaphu kusekhona ithuba lokuthi lingelashwa.
I-nodule, ngencazelo, ingaphansi kwamamentimitha amathathu ububanzi, futhi ngalesi sayizi, amaningi kancane yamaphaphu aphiliswa kakhulu. Kodwa ngisho nangomdlavuza wamaphaphu omkhulu, ukwelashwa kanye nezindleko zokusinda komdlavuza wamaphaphu kuye kwaba ngcono kakhulu eminyakeni embalwa edlule.
Iphuzu lokugcina ngaphambi kokuqala ukuphawula ukuthi ukulandela ukuthola ukuxilongwa kubalulekile ngisho noma ungakaze upheze. Ngesikhathi samanje, kunabaningi ababhemayo ngaphambili futhi abasoze baphuza abakha umdlavuza wamaphaphu , kunabantu ababhema.
Yiziphi Ama-Nodules Amangqamuzana?
I-nodule yamaphaphu ichazwa ngokuthi "indawo" emaphaphu amamitha ayizigaba ezintathu (cishe ama-1.5 amasentimitha) ububanzi noma ngaphansi. Lezi zinhlayiya zivame ukubhekwa ngokuthi "izilonda zemali" uma kuchazwe ekuhlolweni kwesithombe. Uma ukungabonakali kubonakala ku-x-ray yamaphaphu kunkulu kunezingamamitha amathathu, kubhekwa njengama-" mass mass " esikhundleni se-nodule futhi kungenzeka ukuba nomdlavuza.
Ama-nodules ama-lung ngokuvamile kudingeka abe okungenani amentimitha eyodwa ngosayizi ngaphambi kokuba abonakale e-x-ray yesifuba, kanti ama-nodules njengamancane amamitha amabili angabonwa nge-CT scan.
Ukuvama
Ama-nodules ama-lung ajwayelekile futhi atholakala kwelinye lama-x-rays angu-500, futhi eyodwa ku-100 ucwaningo lwe-CT lwesifuba.
Cishe amaphesenti angu-150,000 amaphaphu atholakala kubantu base-United States unyaka ngamunye. Cishe ingxenye yabantu abangaphezu kweminyaka engama-50 abashaya ubusi bazoba nesigxobo se-CT scan esifubeni sabo.
Uma i-nodule engase ibe khona iyabonakala e-x-ray yesifuba, kubalulekile ukuba ne-CT scan. Amakhansela amancane angaphuthelwa kwi-x-ray yesifuba .
Izimpawu
Amapayipi amaningi amancane ayabangeli noma yimaphi izimpawu futhi atholakala "ngengozi" noma "ngephutha" uma i-x-ray yesifuba isenzelwe esinye isizathu. Uma izimpawu zikhona, zingabandakanya ukukhwehlela, ukukhwehlela igazi, ukushaya umoya, ukuphefumula, noma izifo zokuphefumula uma ama-nodule (s) eseduze nomgwaqo omkhulu.
Izimbangela
Ama-nodules ama-lung angaba yinhle (angewona umdlavuza) noma anonya (umdlavuza). Izimbangela ezivame kakhulu zihlanganisa ama- granulomas (ama-clumps wezicubu ezivuthayo ngenxa yesifo noma ukuvuvukala) kanye ne-hamartomas (izicubu ze-lung acid). Isizathu esivame kakhulu sezinambuzane zamaphaphu ezinonya kuhlanganisa nomdlavuza wamaphaphu noma umdlavuza wezinye izifunda zomzimba osakaze emaphashini ( umdlavuza we-metastatic ).
Ama-neodules angahle aphulwe abe yizigaba ezimbalwa ezinkulu.
- Izifo - Izimbangela ezithathelwanayo zezifo ezinama-nodules zingabandakanya ukutheleleka kwebhaktheriya njengosifo sofuba kanye nezinye izifo ezithathelwana nge-mycobacterial, ukutheleleka kwe-fungal efana ne-histoplasmosis, i-blastomycosis, i-aspergillosis, ne-coccidiomycosis, nezifo ezinjenge-ascariasis (ama-roundworms,) ama-echinococcus (i-hydatid cysts) kanye ne-paragonimous (isibindi ukuphefumula.) Uma amasosha omzimba "edonga" izindawo zokutheleleka ngokuvamile udala ama-granulomas.
- Ukuvuvukala - Izimo ezinjenge- arthritis ye-rheumatoid , i- sarcoidosis , ne-wegener's granulomatosis, kanye nama-pneumoconioses afana ne-silicosis nawo angabangela ama-granulomas.
- Izicubu zomzimba - Amathumba we-Benign amathanga afana ne- hamartomas (i-bladomas, i-fibromas, i-blastomas, neurofibromas, ne-hemangiomas). angabonisa njenge-nodule emaphashini ku-ray ray.
- Izicubu ezimbi - Amanqamu angase avele njengamaqhubu omzimba ahlanganisa umdlavuza wamaphaphu, i- lymphomas , i-sarcomas, nezicubu ze-carcinoid.
- Ama- metastases - Amagundane angamafutha angase abe ngenxa yezinsalela ezivela kwezinye izifo zomdlavuza ezifana nomdlavuza webele, umdlavuza we-colon, umdlavuza wesibeletho, nomdlavuza wesi-prostate.
- Amanye ama-nodules ezinobuthi - Iziphazamisi zamapulmonary (izindawo zamapayipi amaphaphu alahlekelwe yigazi,) izitsha zegazi ezingavamile (i-AV malformations,) i- atelectasis (ukuwa kwezingxenye zamaphaphu,) i -fibrosis yamaphaphu , kanye ne- amyloidosis yizo zonke ezinye izimbangela zamaphaphu i-nodule.
Ukuxilongwa
Okokuqala udokotela wakho uzofuna ukukwenza uma ebona isigqomo samaphaphu ku-x ray yakho ukuthola noma yikuphi ama-x-rays owawunayo futhi uwaqhathanise. Uma i-nodule noma ama-nodules ekhona isikhathi eside, ukuhlolwa okungeziwe kungase kungadingeki. Uma i-nodule isisha noma ungenayo i-x-ray ngaphambi kokuqhathanisa, ukuphanga okuqhubekayo kungadingeka.
Uma i-nodule itholakala e-x-ray yesifuba, isinyathelo sokuqala ngokuvamile siyokwenza iskena se-CT esifubeni sakho. Okunye ukuhlolwa okufana ne-MRI kungadingeka.
Ngalesi sikhathi, udokotela wakho uzofuna ukwazi umlando wakho kanye nanoma yiziphi izinto ezinobungozi onakho nganoma yiluphi uhlobo lwamaphaphu amaphaphu (bheka ngezansi.) Isibonelo, uma usanda kuhamba, ukutheleleka kwefungal kungase kwenzeke kanti uma ziye zabhema, isisu esinonya singase senzeke. Izici ze-tumor njengoba kuboniswe ku-CT yakho scan nazo zizohlolwa.
Ngezinye izikhathi ukuhlolwa kwe-PET kuyasiza ekuchazeni ngokuqhubekayo i-nodule. Ngokungafani nokuhlola kwe-CT noMRI kukhona "ukuhlolwa kwesakhiwo". Bangathola izilonda emaphashini kodwa banganiki ngempela ukuthi kwenzekani ku -nodule. Ngesisindo se-PET, inani elincane le-ushukela omsakazo lujojowe emzimbeni wakho wegazi. Izikhumba ezikhulayo zithatha ngaphezulu ushukela okhanyisa ekuhlolweni. Lokhu kungaba usizo ekuhlukaniseni isisu esilalayo esicukeni esibuhlungu njengoba isisu esikhulayo sizothatha ushukela. Lokhu kuyasiza kakhulu kulabo abaye babhekana nemisebe yesifuba esidlule, izifo zamaphaphu noma ukuhlinzwa okungabangela izicubu ezibomvu.
Uma i-nodule ingabonakali iyakhula noma inezici zesifo esibuhlungu, (sinomqondo ophansi wokuba nomdlavuza) indlela "yokulinda nokubuka" ngezinye izikhathi ingathathwa nge-CT scan ephindaphindiwe ngemva kwesikhathi esithile. Ama-nodules ayingqayizivele ayengaguquki isikhathi seminyaka emibili noma ngaphezulu ayidingi ngokuqhubekayo ukuphanga.
Ukuphikisana kwamaNodules wokuPulmonary
Ngeshwa, i- biopsy yamaphaphu ivame ukudingeka ukuze wazi ngokuqinisekile ukuthi yini ebangela ukuqhuma. Ngokuthakazelisayo, izindlela ezintsha ezintsha zokungazitholi izicubu zesampula manje zivame ukutholakala. Lokhu kungabalulekile ngisho noma udokotela wakho eqiniseke ukuthi yini ebangela i-nodule noma ama-nodules.
Isibonelo lapho ama-nodules ecatshangwa ukuthi abe ngumdlavuza we-metastatic kusuka kwesinye isisu esinjengomdlavuza webele. Ucwaningo lwakamuva lubonisa ukuthi ngisho nangesikhathi isiguli samaphaphu sitholakala kumuntu okungenzeka kulindeleke ukuthi abe namaphasastase wamaphaphu, isigamu kuphela sezinqamuzana zaziyi-metastases uma zihlanganisiwe. Kuze kube ngamaphesenti angu-25, kunalokho, kwakuwumdlavuza wesibili wamaphaphu oyinhloko.
Kuye ngokuthi indawo ye-nodule, inaliti ye-nicophile enhle ingenziwa kanjani. Ngezinye izikhathi i-endobronchial ultrasound ne-biopsy ingenziwa njengengxenye ye-bronchoscopy. Ngezinye izikhathi i-biopsy evulekile ingadingeka. Ngisho noma kunjalo, amasu amasha, njengokuhlinzeka nge-thoracoscopic (VATS) okusizwa ngevidiyo kungenziwa kaningi esikhundleni se-thoracotomy.
Benign vs. Nodules Malignant
Ngokuvamile, amathuba okuthi umkhuhlane wamaphaphu ngumdlavuza ngamaphesenti angama-40, kodwa ingozi yokuba nomswakama we-lung lungumdlavuza uhluka kakhulu kuye ngezici eziningana. Kubantu abangaphansi kweminyaka engama-35 ubudala, ithuba lokuthi umkhuhlane wamaphaphu unomdlavuza ungaphansi kwephesenti eyodwa, kanti ingxenye yesifo samaphaphu kubantu abaneminyaka engaphezu kwengu-50 yingozi (umdlavuza).
Ezinye izici eziphakamisa noma ezinciphisa ingozi yokuthi isifo samaphaphu ngumdlavuza sihlanganisa:
- Usayizi - ama-nodules amakhulu kakhulu amathuba okuba nomdlavuza kunezincane.
- Ukubhema - Ababhemayo bamanje nabangaphambili banamathuba amaningi okuba nomdlavuza wamaphaphu kunomuntu ongabhemi. Funda iphesenti lababhemayo abathola umdlavuza wamaphaphu.
- Umsebenzi - Okunye ukuvezwa komsebenzi kuphakamisa amathuba okuthi i-nodule ingumdlavuza.
- Umlando wezokwelapha - Ukuba nomlando womdlavuza kwandisa amathuba okuthi i-nodule ingaba yingozi.
- Umlando wendabuko y - Labo abanama-nodules nomlando womndeni womdlavuza wamaphaphu cishe amathuba okuba nomdlavuza womdlavuza kunabo abangenawo umlando womndeni.
- Izimpawu - Ikhono lokuthi udonsa lungumdlavuza wamaphaphu mkhulu uma ezinye izimpawu noma izimpawu zomdlavuza wamaphaphu zikhona.
- Ukubunjwa / ukubonakala kwe-nodule - I-Smooth, i-nodules nxazonke kungenzeka ukuba ibe yinhlonipho, kuyilapho "ama-nodules" atholakala, noma ngemingcele engavamile noma ebulalayo ingase ibe nomdlavuza.
- Okuqinile / okungewona oqinile - Ama-Nodules ayingxenye eqinile kunokuba eqinile kungenzeka ukuba abe nomdlavuza
- Ukwanda - I-Cancerous lung lungules ikhula ngokusheshisa ngesikhathi sokuphindaphinda kabili cishe izinyanga ezine, kanti ama-nodules ezinobungozi avame ukuhlala ngobukhulu obufanayo ngokuhamba kwesikhathi.
- Ukubalwa - Ama- nodule ama- Lung ahlanganisiwe cishe angabhekana.
- I-Cavitation - I-Nodules echazwe ngokuthi "i-cavitary," okusho ukuthi ingaphakathi langaphakathi le-nodule ibonakala liluhlaza kuma-x-rays, amathuba okuba angabonakali.
- I-Ground glass nodules - Ama-Nodules ahlongozwa njengokuba nokubukeka kweglasi ingaphansi kwenselele futhi ingaba yinhle noma ayingozi. Ngenxa yale nkinga, i-biopsy yalezi zilonda ngokuvamile idinga.
- Isibalo sama-nodules - Labo abanama-nodules amaningi kungenzeka banomdlavuza kunelabo abanezinhlanzi ezincane noma ezimbalwa kuphela.
- Indawo yama-nodules - I-Lobules e-lobes engakwesokudla noma kwesobunxele noma i-lobe ephakathi yamaphaphu ayinamathuba okuba nomdlavuza kunelawo angaphansi kwesobunxele noma kwesokudla.
- Ubuhlanga nobuzwe - Uma uye ngaphesheya kwe-United States, i-nodule yamaphaphu cishe inobungozi. Ngokwesibonelo, ucwaningo lwe-ecent luye lwathola ukuthi ama-nodules amaphaphu ngenxa ye-schistosomiasis, ukutheleleka kwe-parasitic, ajwayelekile kubantu abafuduka e-Afrika. Ngokufanayo, ama-nodules ahlobene nokutheleleka kwamafungula, njenge-coccidiomycosis ajwayelekile eNingizimu-ntshonalanga.
Ama-Nodules angama-Lung angenayo
Inombolo yamaphaphu amaphaphu afundwa ama-radiologists ngokuthi "indeterminate" yanda ngokufika kokuhlolwa komdlavuza wamaphaphu. Ukuzwa ukuthi ama-nodule wakho noma ama-nodules angakunqamuki angase adideke. Akusobala yini? Ngeshwa, kunezikhathi lapho kungenakwenzeka ekucabangeni ukuhlolwa okuwukuphela kokwazi ukuthi i-nodule iyingozi-ngisho nangemva kokucubungula zonke izici ezingenhla. Ukuze uphendule lo mbuzo, i-biopsy kufanele yenziwe. Ngokuthakazelisayo, ama-radiologists, odokotela abahlinzayo nabahlengikazi ndawonye bafumana izindlela ezincane zokuhlasela zesisindo. Ukuze uqonde kangcono ukuthi kungani lo mbuzo kunzima kakhulu, ungase ufise ukufunda kabanzi mayelana nokwahlukana phakathi kwezicubu ezinobuthi nezilimazayo .
Ukuhlolwa kwesifo somdlavuza
Ukuhlolwa komdlavuza we-Lung kubantu abafanele kuye kwatholakala ukunciphisa izinga lokufa komdlavuza wamaphaphu ngamaphesenti angu-20. Kodwa njengoba kunoma yikuphi ukuhlolwa kokuhlola, kukhona ingozi yamaphutha amanga, futhi kuvamile ukuthola ama-nodules ekuhlolweni kwe-CT. Kodwa ukuthola ama-nodules akusho njalo umdlavuza. Eqinisweni, izifundo ezize kube manje zilinganisela ukuthi kuphela amaphesenti amahlanu angama-nodules atholakele ekuhlolweni kokuqala kwe-CT lungumdlavuza.
Ukwelapha
Ukwelashwa kwamapulazi emaphaphu kuyahlukahluka ngokuya ngesibangela, kungakhathaliseki ukuthi kuhlobene nezifo, ukuvuvukala, umdlavuza, noma ezinye izimo. Amapayipi amaningi abhekene nesibindi, ikakhulukazi lawo akhona futhi awazange ashintshe esikhathini esiyiminyaka embalwa, angashiywa yedwa.
Izwi elivela
Uma uzwile ukuthi wena noma othandekayo unesigqoko samaphaphu cishe uyingxenye yokwethuka nokuphazamiseka. Kunamathuba amaningi kakhulu futhi amanye alawa asabisa. Kungasiza kancane ukuba ucabange ukuthi iningi lama-nodules awunomdlavuza, futhi ngisho nalawo angase aphuluke ngokuhlinzwa.
Uma unquma ukucwaninga ama-nodule wakho emgqeni kubalulekile ukuqaphela ukuthi isayensi ishintsha ngokushesha. Amasu amasha okuhlola aqala ukutholakala kanye nokwelapha okusha ngonyaka. Njengoba imithi ishintsha ngokushesha, Kubalulekile ukuba ngummeli wakho ekunakekelweni kwezokwelapha. Uma ungatholi izimpendulo, cela imibuzo eminye. Cabanga ukuthola umbono wesibili kungakhathaliseki ukuthi uzwa ngani. Okokugcina, finyelela emndenini nakubangane. Uma umkhonto wakho uphendukela ekubeni ngumdlavuza wamaphaphu kukhona umphakathi osebenzayo womdlavuza wamaphaphu ozokukwamukela.
> Imithombo:
> Gould, M., uDonington, J., uLynch, W. et al. Ukuhlolwa Kwabantu Abanye Nama-Nodules Emapulmonary: Ngabe I-Cancer Lung? . Isifuba. 2013. 143 (S Suppl): e93S-e120S.
> McWilliams, A., Tammemagi, M., Mayo, J. et al. Amathuba weKhansela Emidlalweni Yamapulmonary Ebonakalayo Ekuhlolweni Kwokuqala kwe-CT. I-New England Journal of Medicine. 2013. 369: 910-919S.
> Wang, Y., Gong, J., Suzuki, K., noS S. Morcos. Amaqhinga okuCatshangelwa okuSuselwa ekuSebenzisweni kweSolitary Pulmonary Nodule. I-Journal ye-Thoracic Disease. 2014. 6 (7): 872-87.
> Yang, W., Jiang, H., Khan, A. et al. I-Transthoracic Isinxephezelo Isaluka ku-Solitary Pulmonary Nodule. Ucwaningo lwe-Cancer Research. 2017. 6 (1): 76-85.
> Yao, Y., Lv, T., no-Y. Ingoma. Indlela Yokuthola I-Nodules Yamapulmonary: Ukusuka Ekuhlolweni Kwokuthola Ukwelapha. Ucwaningo lwe-Cancer Research. 2017. 6 (1): 3-5.