Munyori: Monica Porter
Zuva Rekusika: 17 Kurume 2021
Gadziridza Zuva: 18 Mbudzi 2024
Anonim
Lecture-83: Cutaneous B-cell lymphomas
Vhidhiyo: Lecture-83: Cutaneous B-cell lymphomas

Zvemukati

Mhedziso

Lymphoma imhando yekenza inotanga muma lymphocyte. MaLymphocyte ndiwo masero mune immune system. Hodgkin's uye isiri-Hodgkin's lymphoma ndiwo maviri makuru marudzi e lymphoma.

T-cell lymphoma uye B-cell lymphoma marudzi maviri easina-Hodgkin's lymphoma. Iko kune zvakare isingawanzo mhando inonzi NK-cell lymphoma.

Pakati pevanhu vasina-Hodgkin lymphoma, vangangoita 85 muzana vane B-cell lymphoma.

Kurapa kweB-cell lymphomas kunoenderana neyakajeka chikamu uye nhanho yechirwere.

Ndeapi madiki eB-cell lymphoma?

Kune akawanda madiki eB-cell lymphoma, ese anokura zvishoma (indolent) uye anokurumidza kukura (ane hukasha), kusanganisira:

B-sero chikamuHunhu
Kuparadzira yakakura B-cell lymphoma (DLBCL)Iyi ndiyo mhando yakajairika yeiyo isiri-Hodgkin's lymphoma. Iyo kenza ine hukasha asi inorapika iyo inogona kusanganisira lymph node uye dzimwe nhengo.
Follicular lymphomaIyi ndiyo yechipiri mhando yakajairika pane isiri-Hodgkin's lymphoma. Inononoka kukura uye kazhinji inotanga mune ma lymph node.
Mantel cell lymphomaKazhinji zvinosanganisira lymph node, mapfupa emapfupa, spleen, uye nemudumbu.
Chirwere lymphocytic leukemia (CLL) / Diki lymphocytic lymphoma (SLL)Rudzi urwu rwunonamira uye rwunowanzo kukanganisa ropa uye mwongo wemapfupa (CLL), kana lymph node uye spleen (SLL).
Primary central nervous system lymphomaRudzi urwu runowanzo tangira muuropi kana musana. Iyo inosangana nematambudziko ekudzivirira anokonzerwa neAIDS kana mishonga yekurwisa-kurambwa inoshandiswa zvichitevera kuisirwa nhengo.
Splenic marginal zone B-cell lymphomaIyi ndiyo mhando inokura zvishoma-zvishoma iyo inotanga mu spleen nemongo wemapfupa.
Extranodal marginal zone B-cell lymphoma yeMALTRudzi urwu kazhinji runosanganisira dumbu. Iyo inogona zvakare kuitika mumapapu, ganda, thyroid, salivary gland, kana ziso.
Nodal marginal zone B-cell lymphomaIchi chinhu chisingawanzo, chinononoka-kukura chinowanikwa kunyanya mune ma lymph node.
Burkitt lymphomaUrwu ndirwo rudzi runokurumidza kukura runowanzoitika muvana.
Bvudzi sero leukemiaIyi mhando inononoka kukura iyo inobata spleen, lymph node, uye ropa.
Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia)Ichi hachiwanzoitika, inononoka kukura lymphoma yemongo wemapfupa, spleen, uye lymph node.
Primary effusion lymphomaIchi chinhu chisingawanzoitika, chine hukasha chinowanzoitika muvanhu vane immune system isina kusimba.

Stage

Gomarara rakaiswa zvinoenderana nekuti rakapararira zvakadii kubva panzvimbo yekutanga. Non-Hodgkin's lymphoma yakarongedzwa kubva pa1 kusvika pa4, uye ina iri yepamusoro.


Ndezvipi zviratidzo?

Zviratidzo zvinosiyana zvichienderana nerudzi rweB-cell lymphoma uye nekufambira mberi kwayo. Izvi ndizvo zvimwe zvezviratidzo zvikuru.

  • kuzvimba lymph node mumutsipa mako, muhapwa, kana kugomera
  • kurwadziwa mumimba kana kuzvimba
  • kurwadziwa pachipfuva
  • kukosora
  • kufema kunetseka
  • kupisa muviri uye kudikitira usiku
  • kuonda
  • kuneta

Inorapwa sei?

Mamwe marudzi e lymphoma ayo asymptomatic uye ane husimbe haadi kurapwa. Chiremba wako angakurudzira izvo zvinozivikanwa seku "kumirira wakangwarira." Izvi zvinoreva kuti iwe unozoteedzera yega yega mwedzi mishoma kuti uve nechokwadi chekuti cancer haina kufambira mberi. Mune zvimwe zviitiko, izvi zvinogona kuenderera kwemakore.

Kurapa kunogona kutanga kana zviratidzo zvikaonekwa kana paine zviratidzo zvekuwedzera kwechirwere. B-cell lymphoma kazhinji inosanganisira musanganiswa wemishonga, iyo inogona kuchinja nekufamba kwenguva.

Radiation

Kushandisa matanda emagetsi ane simba-zhinji, kurapa nemwaranzi kunoshandiswa kuuraya maseru egomarara uye kudzikira mamota. Zvinoda kuti urare wakanyarara patafura nepo iwo matanda achinongedzwa kune chaiyo nhanho pamuviri wako.


Nekukurumidza-kukura, kunoitwa munzvimbo ine lymphoma, kurapwa kwemwaranzi kunogona kuve zvese zvaunoda.

Mhedzisiro inogona kusanganisira kuneta uye kutsamwa kweganda.

Chemotherapy

Chemotherapy inzira yekurapa inogona kupihwa nemuromo kana mukati. Zvimwe zvechisimba B-cell lymphomas zvinogona kurapwa nekemotherapy, kunyanya mukutanga kwechirwere chirwere.

DLBCL iri inokurumidza kukura mhando iyo inogona kurapwa nechemotherapy regimen inonzi CHOP (cyclophosphamide, doxorubicin, vincristine, uye prednisone). Kana ikapihwa pamwe chete ne monoclonal antibody rituximab (Rituxan), inonzi R-CHOP. Inowanzo kupihwa mumatunhu masvondo akati wandei akaparadzana. Zvakaoma pamoyo, saka hazvisi sarudzo kana uine matambudziko emoyo asati avepo.

Zvimwe zvinokanganisa chemotherapy zvinogona kusanganisira kushungurudza, kuneta, uye kurasikirwa nevhudzi.

Kurapa immune

Biologic zvinodhaka zvinobatsira immune system yako kurwisa cancer. Rituximab inotarisa mapuroteni ari pamusoro peB-maseru, zvichiita kuti zvive nyore kuti immune system izive nekuvaparadza. Nekuderedza huwandu hweacancer uye ane hutano B-maseru, mushonga unokurudzira muviri wako kuburitsa itsva B-maseru ane hutano. Izvi zvinoita kuti zvive zvishoma kuti gomarara ridzokezve.


Radioimmunotherapy mishonga, senge ibritumomab tiuxetan (Zevalin), inogadzirwa nema monoclonal antibodies anotakura radioactive isotopes. Mushonga unobatsira maantibhakitiriya anonamira kumasero ekenza kutakura kwakatenderedza radiation.

Mhedzisiro yemhedzisiro yekurapa immune inogona kusanganisira yakachena chena masero eropa kuverenga, kuneta, uye hutachiona.

Stem cell kuisirwa

Iyo stem cell transplant inosanganisira kutsiva mapfupa ako nemongo kubva kune anopa zvakanaka. Kutanga, iwe uchazoda yakakwira-dose chemotherapy kana radiation kuti udzvanyise immune system yako, kuparadza cancer maseru, uye kugadzira nzvimbo yemongo mutsva. Kuti uve unokodzera, unofanirwa kuve uine hutano hwakakwana kuti utsungirire kurapwa uku.

Zvimwe zvinokanganisa zvinogona kusanganisira kutapukirwa, kupererwa neropa, uye kurambwa kwemupfupa mutsva.

Pane zvinganetsa here?

Lymphomas inonetesa immune system yako, ichikuita kuti utapurike kubatwa nezvirwere. Mimwe mishonga ye lymphoma inogona kukonzera matambudziko akadai se:

  • kushaya mbereko
  • mwoyo, mapapu, itsvo, uye chirwere chetachiona
  • chirwere cheshuga
  • kanzura yechipiri

B-cell lymphomas inogona kukura nekupararira kunhengo dziri kure.

Kudzoreka kwakaita sei?

Dzimwe mhando dzeB-cell lymphomas dzinogona kurapwa. Kurapa kunogona kunonoka kufambira mberi mune vamwe. Kana pasina chiratidzo chekenza mushure mekurapwa kwako kwekutanga, zvinoreva kuti uri mukuregererwa. Iwe unenge uchiri kuda kuteedzera kweanoverengeka makore kuti uongorore kwekudzokorora.

Outlook

Iyo yakazara-makore mashanu ane hukama kupona kweiyo isiri-Hodgkin's lymphoma ndeye 70 muzana. Izvi zvinosiyana zvakanyanya zvichienderana nerudzi rweB-cell lymphoma uye nhanho pakuongororwa. Zvimwe zvekufunga zera rako uye hutano hwakazara.

Semuenzaniso, DLBCL inorapika muhafu yenguva yevanhu vanayo. Avo vanotanga kurapwa mumatanho ekutanga vane maonero ari nani pane avo vane chirwere chekupedzisira.

Chiremba wako anogona kukupa iwe kufungidzira kwako pachako zvichienderana nehutano hwako hwakazara.

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