Adenoma we ndlala salivary: izimbangela, izimpawu kanye zokwelapha

Bambalwa cabanga lapho indlala salivary. Nakuba yena njalo wenza imisebenzi yayo futhi akabubangeli ukungakhululeki, awusebenzi unake kakhulu. Adenoma we nezindlala salivary kungahluka isakhiwo sabo histological kanye morphological. Bona, njengabanye neziqu kukhona okubulalayo nokuhlala kungavamile ukuba ingozi. izimila Benign ukuthuthukisa kunalokho kancane, futhi ungabonisi ngokwabo kabi noma okunye ukugula. izimila ebulalayo ukhule ngokushesha, ukunikeza Ukuhlola e kwezitho nezicubu eziseduze, okubangela ubuhlungu ebusweni emsipheni ukulimala.

definition

Likuphi indlala salivary? Ngokuyinhloko-ke Kuyaphawuleka ukuthi lesi pair alveolar umzimba serous, etholakala ngaphansi kwesikhumba futhi phansi phambi indlebe. Umsebenzi wayo eyinhloko uketshezi kanye ekuqongeleleni ngamathe. Inani elikhulu ketshezi sodium ne-potassium chloride, kanye Amylase. Lwenza emlonyeni naphakathi esidi nge pH ngaphansana 6. Ngoba usuku kokubili nezindlala ungakwazi ukwaba kuze kube isigamu ilitha ngamathe.

Salivary indlala adenoma - a neoplasms kungavamile ukuba ingozi, liletha abulalayo, okuyinto akhiwa ka ncane nezindlala salivary. Phakathi kwazo zonke izinqubo neoplastic at ucezu nezindlala salivary akhawunti eyodwa amaphesenti. Lena sibalo kunalokho okusezingeni eliphezulu. Izinguquko usungaqala ngasiphi yobudala, kodwa ngokuvamile kakhulu lokhu kwenzeka kweminyaka yobudala emaphakathi futhi ubudala (iminyaka 40-60), kanye nabesifazane kabili njengoba ngokuvamile kunabantu.

Neoplasms zithambekele umdlavuza, Ukuphinda futhi Ukudlulela ke, kuyathakazelisa ukuthi odokotela bamazinyo kanye odokotela abahlinzayo ngomlomo.

izizathu

Kungani kukhona adenoma we ndlala salivary, kuze kube sekupheleni alwaziwa. Ngo nokucabanga yezokwelapha kungenjongo ukubukeka izimila abayohlanganiswa nokuhlukumezeka endaweni ezibalwe ngenhla noma okungeke Izifo ukuvuvukala, kanye mumps (mumps). Kodwa akubona bonke iziguli kwakufanele umlando amacala afanayo.

Ezinye izazi bagcizelele ukuthi imbangela salivary izimila indlala kungenzeka azalwa naso dystopia kwezicubu. Futhi, enganciphisa la magciwane oncogenic like Epstein - uBarr igciwane, cytomegalovirus (ikakhulukazi 16, 18, 31 no-32 ekilasini th) kanye herpes simplex virus.

Kodwa akunjalo zonke izimo, lapho kungase ukuthuthukisa salivary ndlala adenoma. Izizathu kumele wafuna ngesimo ukuphila komuntu (ugwayi ohlafunwayo noma ukusetshenziswa kwezidakamizwa), endaweni yawo kanye umsebenzi (ukuzichaya elangeni, ukuchayeka njalo we ikhanda nentamo ukwelashwa ngemisebe ku-thymus noma yegilo isifo). Kukholakala ukuthi zokugula okuhlobene ne-cholesterol kakhudlwana, ukuntuleka kwamavithamini ekudleni neziyaluyalu hormone.

Kukholakala ukuthi abasebenzi engozini ukhuni, steel namakhemikhali umkhakha (sebethule esindayo zensimbi), abalungisa izinwele.

TNM ngezigaba

Ukuze kube lula in the ukuxilongwa kanye nokwelashwa of adenoma we ndlala salivary isetshenziswa ngezigaba international ukuthi kusiza definition isigaba ohlelweni:

1. T (isimila) - usayizi isimila:
   - T0 - ukuhlonza adenomas bahluleka;
   - T1 - neoplasms ububanzi esingaphansi 2 cm;
   - T2 - ububanzi 4 cm, kodwa hhayi ngale zokuphuma indlala;
   - I-T3 - isixazululo 4 kuya ku-6 cm, emsipheni ebusweni akuyona wamshaya;
   - T4 - ububanzi ezingaphezu kuka 6 cm, lasakazekela izicubu eduze, ithinta imizwa cranial.
2. N (nodes) - lesifunda lymph node:
   - N0 - akukho metastases;
   - u-N1 - washaya omunye node ukuvuvukala kuya ku-3 cm;
   - N2 - wamshaya ISIZINDA eziningana, usayizi isimila - kusuka 3 kuya ku-6 cm;
   - Umgwaqo uN3 - wamshaya ISIZINDA eziningi, izimila ubukhulu - ezingaphezu kuka-6 cm.
3. M (Ukudlulela) - metastases:
   - M0 - Cha metastases elikude;
   - M1 - kukhona metastases ezikude.

Lolu hlelo wakwazi lula ukuxilongwa kanye Izibikezelo lesi sifo. Futhi ikhodi alphanumeric kwenza kube nokwenzeka ukuyisebenzisa kunoma yiliphi izwe emhlabeni.

ngezigaba morphological

Adenoma of indlala parotid kuyinto ngezinhlobo eziningi, zehlukene isakhiwo histological kanye morphological:

1. isimila EPITHELIAL. Kungaba ukuthuthukisa ezicutshini zomzimba kokubili ezinkulu nezincane salivary nezindlala. Libhekene ekukhuleni epithelium e mafutha anciphisa isikhala esingaphakathi we Amapayipi ngesimo papillae, kribroznyh futhi ijabulise izakhiwo.
2. adenoma Monomorphic. izimila Benign sakhiwa izicubu yezindlala. Utfutfukisa kungaqashelwa, ikakhulukazi amadoda amadala. It has a round noma kobujamo obusaqanda ukungaguquguquki nokunwebeka.
3. Adenolymphoma sekulandela morphology monomorphic adenoma, kodwa ngaphakathi nezindlala futhi iqukethe lymph.
4. adenoma Sebaceous - is icaciswe isimila kwakhiwa Slots eziningana amaseli fibrosis sebaceous. Kungaba ukuthuthukisa ngasiphi yobudala. Buhlungu, uba nombala aphuzi. Ngemva ukususwa ningalokothi nikhathale Ukudlulela.
5. adenoma Canalicular yakhiwa amaseli prismatic EPITHELIAL, okuyinto ziqoqwa zibe izinyanda. Isilinganiso sobudala kweziguli lolu hlobo lwesimila - engu-65. Ngaphezu adenoma salivary indlala awupheleli lip engenhla futhi esihlathini.
6. Basal cell adenoma. Benign ehlanganisa basal cell. Ngokuvamile, inkampani encane Friend ifindo emhlophe. Akukona ziyabuya futhi azibe maligneziruetsya.
7. Sikwazi ukukhula adenoma Pleomorphic we nezindlala salivary ube usayizi esikhulu, inamagquma futhi obukhulu. Ngokuvamile kungavamile ukuba ingozi, kodwa izigaba kamuva zingavela amaseli ebulalayo. Ngaphakathi ngokwayo iqukethe liquid fibroblasts. Amenable ekwelashweni kuhlinzwa, kodwa ngenxa ukusondela ukuba ebusweni emsipheni odokotela abahlinzayo kungenzeka nobunzima.

izimpawu

adenoma Benign we ndlala parotid eba kancane kakhulu, kwesinye isikhathi iminyaka. It akubangi imizwa subjective, kodwa lungenza kube nomuntu isikhathi engalingani. Lona isizathu uya kudokotela. Ngemva ukususwa izimila ezinjalo zingase ziphinde zenzeke amaphesenti 6 amacala. Uma isimila itholakala eduze pharyngeal Scion parotid ndlala kungabangela ukuhlukumeza ukugwinya, ubuhlungu indlebe nemisipha lockjaw ukuhlafuna.

ingabe i adenoma Lesisemkhatsini we salivary indlala kanjani? Izimpawu zayo zifana futhi ngesikhathi esifanayo e izimila benign nesibulalayo. It libhekene Ukwanda okusheshayo infiltrative, ubhubhisa lesi izicubu elibazungezile. Kungaba ziyabuya futhi ukunikeza metastases ezikude emaphashini futhi bone.

izimila ebulalayo kwenzeke kokubili ngokuzimela futhi emva ukuguqulwa abulalayo izimila ingozi. Khulisa ngokushesha ukungena nezicubu eziseduze. Isikhumba phezu isimila obomvu, kushisa futhi ukhandlekile. Ingahle sasigcwala izilonda. Libhekene ubuhlungu, ukuphazamiseka kwemisipha masticatory, ukwandisa engumakhelwane lymph node kanye khona metastases.

ukuhlola

Salivary izimila indlala wathola impela nje. Ukuze wenze lokhu, kudingeka ahlole wamazinyo wakho futhi oncologist, ukuqoqa izikhalazo futhi uthole umlando sifo. Ngokukhethekile kufanele kukhokhelwe morphology yesimila, usayizi waso, ukungaguquguquki ehlanganisa nokuya nomaphi.

Kusukela nophenyo wezinsimbi eyenziwa skull esimweni, ultrasound salivary nezindlala ptyalography (bheka indlala ductal patency) kanye sialostsintigrafiya (ngoba ukuthola metastases ezikude). Indlela onokwethenjelwa kunayo ubhekwa lubhoboze indlala kulandele smear nezicubu biopsy sesifundo somuntu histological futhi sokugembula.

Ukuze sicacise nokudlanga inqubo kungase kudingeke CT salivary ndlala esifubeni X-ray noma amathambo ngabanye.

Ukwelashwa izimila Benign

Uma isiguli sekutholakele ukuthi sine- izimila benign we nezindlala salivary, yena umgwaqo ngqo nodokotela ohlinzayo. Sekuyisikhathi eside ithuthukiswe inqubo "husking" lolu hlobo izimila. A imbobo encane capsule we ethintekile indlala adenoma is luphumelele futhi zisuswe. Udokotela ngesikhathi esifanayo uzama ilimaze okuqukethwe yesimila. ukuphazamiseka okunjalo kwezinkolo kubizwa ngokuthi "ekskholeatsiya".

Ukususwa kwezicubu edingekayo ukunikeza ngesikhathi luhlolo macro- futhi ezincane ukuqinisekisa uphethwe. Emsipheni ebusweni akakaze isuswe, njengoba kuyaqabukela hit. Uma isimila eba nezindlala submandibular, kuba ekhishiwe nezintsha ukukhula, nensimbi.

Ukwelashwa izimila ebulalayo

Inxanxathela ukwelashwa kuhlangene kudinga abulalayo salivary ndlala adenoma. is ukuhlinzwa lwenziwa kanjani? Ngisho nangaphambi kokuba kokungenela kuyadingeka ukwenza inkambo gamma-therapy ukunqinda yesimila, kanye ukuvimbela ukuvela metastases kwesifunda futhi ezikude. Ukuhlinzwa wenziwa ngqo emva kwenyanga ngemva radiotherapy.

Abanye abalobi ukuncoma ukwenza ukususwa ephelele nezindlala parotid, kanye amagatsha emsipheni ebusweni yokuhlala ebhkisini olulodwa, ne extirpation ka lesifunda zamanzi. Uma ukuhlolwa wathola ukuthi unesimila ikhule ibe ithambo umhlathi ongezansi, lesi sigaba futhi kudingeka resect. Kodwa ngaphambi ukusebenza kubalulekile ukucabangela indlela yokugqugquzela lonke ithambo.

Ezimweni ezimbi kakhulu, kutuswa radiotherapy okuthuthukisa kuphela, kusukela Ithumba Akumelwe zisuswe ngenxa izicubu okuxekethile kakhulu.

ukuba nombono ongafani ngeke

Ukuze izimila ingozi ngemva kuhlinzwa ukwelashwa Izibikezelo ukuphila nempilo evumayo. Amathuba sokuphinda ongaphakeme, eyodwa kuphela kanti amaphesenti angu-isigamu. izimila ebulalayo futhi zenzeka ezingezinhle kakhulu. Yelaphani isiguli can amabili kuphela amaphesenti amacala, futhi ngisho nangalesosikhathi kunengozi ukuthi isimila kuyabuya. Ukudlulela kwezinye izitho ezitholakala cishe ingxenye amacala.