T-cell lymphomas: izinhlobo, izimpawu, uphethwe, ukwelashwa kanye Izibikezelo

T-cell lymphomas avame kutholakala iziguli ukuguga, kodwa intsha nezingane futhi othambekele sifo. Futhi amadoda uhlushwa ke kakhulu ukudlula abantu besifazane.

Uyini lymphomas T-cell

Lymphoma - okwahlonzwa lesion lymph izicubu kanye nezinye izitho. Endabeni T-cell-lymphoma, lesi sifo sihlasela isikhumba kanye izindlala zamanzi (ie wumumo epidermotropny). Izakhi eziyisisekelo abathintekayo okuvela neoplasms kukhona T-lymphocyte (amaseli ngokuvamile ukuhlinzeka amasosha omzimba). T-cell lymphoma (isithombe emelelwa ngezansi) zingase zimiswe ngenxa ekuqongeleleni izicubu sokugembula izakhi yeselula.

Izimbangela Nezingozi kunomthelela

• ufuzo
• Immunodeficiencies.
• Isikhathi eside ukuchayeka izici ezingezinhle: emisebe ye-UV, nolaka ejenti zamakhemikhali.
• Ubudala isici (ezigulini esezikhulile).
• Ukuba khona amagciwane e umzimba (HIV, Epstein-Barr, isifo sokusha kwesibindi kohlobo C, B, T-lymphocyte igciwane), isifo emathunjini.
• Ukuba khona ukuguquka kwezakhi zofuzo kwesimiso somzimba sokuzivikela, isitho nezicubu ukufakelwa kwezitho immunosuppressive yokwelapha aphoyintimenti.

Zonke lezi zici kungenzeka ukucasulwa (ngokulandelana, avuse ukuthuthukiswa isifo), ukucindezeleka, ukudla okungenawo umsoco, overloads sezinzwa, ukwehluleka ukuhambisana umbuso ukuphumula kanye nomsebenzi.

ngezigaba

• T-cell lymphoma isikhumba. lymphomas Okufanayo ngokuvamile ukuthuthukisa ngenxa yokwanda koshintsho ezihlukahlukene T lymphocyte, okuholela ukubuyabuyelela engalawuliwe wale mithandazo, futhi ngenxa yalokho, osebenza nabo ungqimba we epidermis. Libhekene ifomu abakhuthele of polymorph ukuqubuka nesenzakalo lymphomas (i-plaque, izimila, amabala, amanxeba okusha). Futhi iziguli lokuqala esekhala okuvela zibe maholoholo noma silume izindawo, ekugcineni aguqulayo ku zingcwecwe, futhi kamuva e-foci lwesimila.
• Neuropathy T-cell lymphoma. Lo mqondo kuhlanganisa zonke lymphomas ukuthi kukhona T-cell noma NK-cell umsuka (ngaphandle neoplasm of beya T-amaseli bese wegazi T-lymphoblastic). Kaningi, lezi lymphomas zenzeka ngegazi izilonda, isikhumba, umnkantsha futhi izitho zangaphakathi e-lymph, ekubhebhetselisa izinguquko infiltrative uyalandelwa.
• Angioimmunoblastic T-cell lymphoma. Kubonakaliswa njengoba uphawu lymph izicubu (ngesikhathi luhlolo histological of izindlala zamanzi) immunoblast plasma amaseli, kanye ukuguqulwa okwalandela ephelele isimo sawo futhi kumiswa imithambo yegazi ongaphilile.
• T-cell lymphoma lymphoblastic. Novobrazovanie, ogxile kwezinso-T cell. T cell musa abavuthiwe, i-nucleus yabo iba okungajwayelekile ukuma, basheshe futhi ezimathonsi iwe. Ibhekane lolu hlobo lymphoma akuvamile. Uma uhlangabezana efanayo iphethini umehluko ukuxilongwa, ene-leukemia oyingozi.
• Non-Hodgkin-T cell lymphoma. Limelela iqembu elikhulu izimila ukuthi yakhiwa ovuthiwe T-lymphocyte futhi Akakhulumi isifo Hodgkin sika (ngamanye amazwi, isifo Hodgkin sika). Fanele kuze lo xuku zinqunywa luhlolo histological (nge-chlamydia e Ukulungiselela Kutholwe yezici ezithile yeselula Berezovsky-Sternberg at lymphomas-non-Hodgkin sika anibona).

isigaba zentuthuko

1. Ukuhlulwa eyodwa lymph node.
2. Ukusabalala isimila ukuze ISIZINDA ezimbili lymph ukuthi zitholakala ngakolunye uhlangothi diaphragm.
3. Multiple lymph izakhiwo nhlangothi zombili diaphragm.
4. Lymph node kanye izitho zangaphakathi, khona metastases e izinso, umnkantsha, isibindi noma izinhlaka pheshana emathunjini.

izimpawu Jikelele

Ukuba khona noma ukungabi ukubonakaliswa ethile yomtholampilo incike uhlobo unesimila indawo yayo. Nokho, zikhona izimpawu ukuthi esivela cishe zonke T-cell lymphoma:

• Ukujuluka ebusuku.
• Rapid kwesisindo azinasisekelo.
• Mycosis fungoides.
• Low-grade ukusebenza nezinga lokushisa komzimba.
• ukukhathala njalo futhi singanakwa.

mycosis fungoides

Mycosis fungoides - omunye ukubonakaliswa esivamile agcwele T-cell lymphoma. Sitholakala amaphesenti angamashumi ayisikhombisa iziguli ezinalesi sifo, futhi izinhlobo ezintathu: classical, ikhanda kanye erythrodermic.

Classical mycosis fungoides sidlula izigaba ezintathu ukuthuthukiswa:

• Erythematous - kusukela izimpawu zokwelashwa efana psoriasis, eczema nokunye. Iziguli ukubika khona amabala kobujamo obusaqanda noma isiyingi, ne imiphetho ebukhali, lobehlukene, nge pink-violet umbala zibe maholoholo ebusweni. izakhi ezinjalo zivame esisogwini ubuso esifubeni, kancane kancane zandise izinto eliningi wedlula nezinye izingxenye. izilonda okunjalo ungaphenduli lokwelashwa azinakugcinwa isikhathi eside, noma kwenzeke ngokuphazima kweso zinyamalale. Ngaphezu kwalokho, amabala kungenziwa kuhlangene ukulunywa, okungasekelwe ime ngezindlela ezivamile.
• infiltrative Patchy - kwenzeka ngemva kweminyaka embalwa kuqala. Esikhundleni okungenhla amabala zingcwecwe nge imingcele obukhulu, oyindilinga noma nepravilnymi kodwa kucace, onsomi ne uyaxebuka phezu. At the site okushiwo umbhalo oshonile izindawo brown noma isikhumba yoma. inyuka ukulunywa, kuba ngaphezu kwamandla. Kukhona okusheshayo kwesisindo nomkhuhlane, lymphadenopathy kungase kube khona.
• Isimila - esakhiweni noma zingcwecwe esikhumbeni is akazange kwashintsha lapho ukubukeka aminyene red yellow kobuhlungu ifomu isimila eyindilinga noma kancane isicaba ukuma okufana isigqoko amakhowe. I ububanzi zokwakheka ezifana zokhahlamba kusuka kwangu omunye amabili, futhi nenombolo zingase zihluke. Lapho isimila uyabhujiswa, izilonda ezibuhlungu kwakhiwa endaweni yayo, ukujula ongatholakala ukufinyelela fascia noma ithambo. Ngokuvamile kuthinta ubende, izindlala zamanzi, amaphaphu isibindi. ukudakwa Narostaet nobuthakathaka. Iziguli yinhliziyo afe, amyloidosis, inyumoniya.

ifomu Eritrodermicheskoy libhekene ukuvela narostaet ubuhlungu ukulunywa, ububomvu nokuvuvukala, ukubukeka confluent erythematous-squamous izindawo, hyperkeratosis yamathe nezintende zezandla, kanye nezinwele. Khulisa zonke ISIZINDA lymph ku axillary, inguinal, femoral nezindawo cubital. Lapho ziseZwini plotnoelastichnye amaphakethe lymph palpation kobuhlungu hhayi soldered ezicutshini ezungeze (isikhumba). Lihodradka waphawula (kuze kube degrees 39), ukuncipha emzibeni, ukujuluka ebusuku futhi babekhathele kakhulu. umphumela Lethal kungenzeka uma bajoyina okwenza adakwe yokumelwa yinhliziyo.

Ephambi kwezinduna ifomu ikhanda esikhunjeni enempilo kukhona zingcwecwe amaningi, ekugcineni ezuza harater ebulalayo. Ukufa kwenzeka iziguli ungakapheli nonyaka.

ukubonakaliswa Clinical of lymphomas cutaneous

T-cell lymphoma kwesikhumba ngokuvamile kwenzeka ngokumelene okwenza yokuphathwa eside ezikhona nokungafanele izifo dermatological. Avuse ivela khona kungaba herpes amagciwane ngemisebe, yilanga nokunye. lymphomas Okufanayo iyokwenzeka ngezigaba ezimbili: oyinhloko (inqubo itholakala dermis), yesibili (lapho Izilonda zibangelwa lymphocyte kokuziphatha kwezitho zangaphakathi).

Izimpawu ezisemqoka:

• Polymorphic ukuqubuka kwesikhumba.
• Rising ukulunywa.
• Ukuba khona, izakhi ezincane flat ngefomu nodular.
• Ukubukeka zingcwecwe aphuzi, kamuva aguqulayo ku ekhukhwini hyperpigmentation futhi yoma (uma ifomu-plaque).
• Lwasemtholampilo isithombe efana psoriasis (at melkouzelkovoy uhlobo).
• Ukoma, ukuvuvukala, ububomvu nokuxebuka kwesikhumba (nge hlobo erythrodermic yesifo).

Symptomatology ka lymphomas neuropathy

Umtholampilo isifo kuncike esigabeni nohlobo inqubo sokugembula.

Libhekene nokwanda kokungabi lymphoid entanyeni, imbilapho kanye axillary izifunda.

Iziguli esekhala ukujuluka ngokweqile, ezinzima kwesisindo, ukungabi esesuthi, ubuthakathaka jikelele, imfiva, futhi zinikezwe uma kukhona ubende lakhulisiwe futhi isibindi (okuyinto kuvamile impela) - by iphika, ukukhwehlela yansukuzonke kanye nomuzwa ukusinda esiswini.

ukuhlola

• Ukuhlolwa, iqoqo izikhalazo kanye anamnesis oncologist.
• igazi Jikelele kanye nokuhlaziywa umchamo.
• Igazi-biochemistry, kanye yokuhlola amasosha amagciwane kwesibindi.
• A biopsy we ezilimele lymph node (okuyinto ikuvumela ukuba uqinisekise sitholakele T-cell lymphoma).
• US.
• MR.
• CT.
• umzimba Onkoskrining.
• cwaningo Immunofenotipirovannoe.
• cwaningo zofuzo Yamamolekhula.
• ukuhlaziywa Cytogenetic.

Ukwelapha

Ukwelashwa nokuvikelwa T-cell lymphoma incike kundlela futhi isigaba ohlelweni.

Ngokwesibonelo, i-erythematous mycosis esiteji fungoides yokwelapha anticancer ekhethekile akuyona ezimisiwe, kanti corticosteroids zangaphandle interferon isetshenziswa.

Le nqubo yokwelapha anti-isimila ukuba sifeze nokwelashwa ngamakhemikhali futhi welashwa ngemisebe.

Ngokuhambisana uhlobo lesi sifo (indolent, abe nolaka nolaka kakhulu) inqunywa obuphelele kanye nokwakheka ukwelashwa, kanye nokuvuselelwa.

lymphoma Indolent is hhayi ziphathwe, kodwa kuphela njalo waphawula uma inqubo iqhubeka, amacebo ukushintsha.

Ekwelapheni amafomu nolaka inhlanganisela ukusetshenziswa kwezidakamizwa chemotherapeutic futhi Rituximab (omzimba monoclonal).

Uma kuziwa lymphomas nolaka kakhulu, linqume izidakamizwa ezisetshenziswa ekwelapheni leukemias oyingozi.

Kaningi, amakhemikhali okwelapha kuhlangene lwama-stem cell ukufakelwa.

Nokho, ukwelashwa okuphumelelayo kakhulu lymphoma siwukuba aziphathe yokwelapha amathathu ngemisebe (njengoba kuchaziwe Elekta Synergy), futhi ngemva kokwamukela ejenti chemotherapeutic.

Izinkinga kokuthola ejenti chemotherapeutic kungabandakanya: wamaphaphu, webele, nokunye. ukwelashwa ngemisebe kungenzeka nzima ukuthuthukiswa isifo sokuqina kwemithambo yegazi yenhliziyo.

Ngemva yokwelashwa okuphumelelayo kuyinto nokuvuselelwa ayimpoqo.

T-cell lymphoma: umhlahlo

• Lapho ukuthola ngesikhathi esifanele lesi sifo (esigabeni sokuqala) nesabelo ezanele ukwelashwa oneminyaka emihlanu okusinda isilinganiso singamaphesenti angu-ayisishiyagalombili nanhlanu, futhi iziguli ezingane - ukuba amaphesenti ayisishiyagalolunye.
• Ngokuphathelene lymphoma angioimmunoblastic sezulu esidumazayo. Isikhathi esivamile okulindeleke ukuba in iziguli kokutshelwa ngokukhubazeka kwengane Mibili kuphela nengxenye - iminyaka emithathu. Izinga sokusinda kuphela-ingxenye eyodwa kwezintathu iziguli abe isikhathi esiyiminyaka emihlanu.
• Ephambi kwezinduna T-lymphoblastic ifomu Izibikezelo kuncike khona / ukungabikho lesion we umnkantsha. Uma umnkantsha asithinteki, umphumela ngokuvamile evumayo. Kungenjalo, ngcono amaphesenti amabili kuphela eziguli kungalindeleka.
• Izibikezelo futhi ungafi mushroom avium incike kundlela futhi isigaba ohlelweni. Ngakho, lapho ukusinda ibha ifomu - kuya kwezineminyaka eyishumi, kanye Izibikezelo okungekuhle esimweni ukubusa i-pneumonia, nokunye; ifomu eritrodermicheskoy sorovozhdaetsya ngokujoyina yezinkinga ezihlukahlukene eholela ekufeni kwenzeka ngaphakathi ezimbili - iminyaka emihlanu; ngenkathi ifomu Headless we Izibikezelo abampofu, abantu bayafa ungakapheli unyaka.