T-Sero lymphomas: mifananidzo, zviratidzo, chirwere, kurapwa uye fungidziro

T-sero lymphomas vanowanzobatwa chirwere Varwere pakukwegura, asi vari kuyaruka uye vana vari kuita chirwere. Uye varume vanotambura kakawanda kudarika vakadzi.

Chii chinonzi T-sero lymphomas

Rwekenza yelymphoma - munhu akaipa lesion lymphoid rinenge uye dzimwe nhengo. Kana ari T-sero rwekenza yelymphoma, chirwere chinobata ganda uye node nodes (kureva ndiro epidermotropny hunhu). The zvinokosha kuti vanobatanidzwa munyaya panowanikwa neoplasms vari T-lymphocytes (masero kuti kazhinji zvinopa yakakwana zvirwere response). T-sero rwekenza yelymphoma (mufananidzo anomirirwa pazasi) inogona kuumbwa somugumisiro kuunganidza pathological zvinyama cellular okunze.

Zvinokukonzera uye zvinokonzera

• nhodzera
• Immunodeficiencies.
• Mazhinji kugarotamba yaivhuvhuta zvinhu: UV nemwaranzi, hasha makemikari nevamiririri.
• Age chokuita (varwere vakwegura).
• Kuvapo nemavhairasi iri muviri (HIV, Epstein-Barr, hepatitis C, B, T-lymphocyte utachiona), intestinal chirwere.
• Kuvapo kunotouraya munyika, masoja emuviri nhengo uye zvinyama transplantation, immunosuppressive kurapa kugadzwa.

All izvi zvingakonzera kuti kuwedzerwa (azvaitwa, kutsamwisa kukura chirwere), kushushikana, kushaya zvokudya zvinovaka muviri, huta overloads, kukundikana kuteerera hurumende kuzorora uye basa.

kupatsanura

• T-sero rwekenza yelymphoma ganda. lymphomas Similar kazhinji kuva somugumisiro kunotouraya siyana T lymphocytes, zvichitungamirira ane inondimukira chokuwanziridza neyokupedzisira uye, naizvozvo, zvinoshanda navo marongera pakati Epiderme e. Dzinoratidzwa yezviri chimiro polymorph mapundu chiitiko lymphomas (Dombo, namamota, echitema, Maronda akasiyana). Uye varwere wokutanga chokunyunyuta pamusoro panowanikwa scaly kana itchy makwapa, pakupedzisira ndura plaques, uye zvadaro pane bundu foci.
• Peripheral T-sero rwekenza yelymphoma. Pfungwa iyi inosanganisira zvose lymphomas vari T-sero kana NK-sero mavambo (kunze neoplasm pamusoro saibva T-masero uye T-lymphoblastic neleukemia). Kazhinji, lymphomas izvi nokuitika maronda ropa, ganda, mwongo uye nhengo dzomukati, uye vari node nodes, diffuse infiltrative kuchinja kuchengetwa.
• Angioimmunoblastic T-sero rwekenza yelymphoma. It akaratidza sezvo rakavhara lymphoid rinenge (munguva histological kuongorora node nodes) immunoblast uye plasma masero, pamwe Zvakazoitwa wakakwana kusanduka yawo mamiriro uye paumbwe mwero tsinga.
• T-sero lymphoblastic rwekenza yelymphoma. Novobrazovanie, iyo yakavakirwa abnormalities T masero. T masero regai vachiyaruka, neerekitironi wavo anova vasingapindiwo chimiro, vakakurumidza uye zvisingadzorwi kuwa. Vasangana rwekenza yelymphoma uku hariwanikwi. Kana mukawana zvakafanana differential chirwere pamwe rikwanise neleukemia.
• Non-Hodgkin raMwari T-sero rwekenza yelymphoma. Rinomiririra guru boka anomera kuti akaumbwa vakura T-lymphocytes uye asingauyi chokuita Hodgkin chirwere (i.e., Hodgkin chirwere). Kuva boka iri takatsunga ne histological kuongororwa (pamwe chlamydia muna Preparation padzakacherechedza zvakananga cellular zvinhu Berezovsky-Sternberg panguva asiri Hodgkin vaMwari lymphomas vari hapana).

Makuriro Danho

1. The kukundwa imwe node raiva pedyo nebundu.
2. Kupararira bundu maviri node nodes kuti dziri rimwe divi diaphragm.
3. Multiple node hurongwa kumativi ose diaphragm.
4. Node nodes uye nhengo dzomukati, kuvapo metastases mu itsvo, mumwongo chiropa kana nhengo iri nemudumbu.

General zviratidzo

Kuvapo kana kusavapo kwemamwe kuratidzwa zvekuchipatara kunoenderana mhando bundu yayo nzvimbo. Zvisinei, pane zviratidzo kuti vari kuri mumashoko zvinenge zvose T-sero rwekenza yelymphoma:

• Vangadikitira usiku.
• Rapid kurasikirwa uremu iri groundless.
• Mycosis Fungoides.
• waivako Low-mugiredhi kupisa muviri.
• Kakawanda kuneta uye kusakendenga.

Mycosis Fungoides

Mycosis Fungoides - chimwe chezvinhu kakawanda kuratidzwa kuti zvaizobatsira T-sero rwekenza yelymphoma. Rinowanikwa makumi manomwe kubva muzana varwere nechirwere ichi, uye ane nhatu nezvimiro: chekare, musoro uye erythrodermic.

Classical Mycosis Fungoides ichipfuura zvinhanho zvitatu budiriro:

• Erythematous - kubva kurapwa zviratidzo zvakafanana psoriasis, eczema uye zvichingodaro. Varwere dzinoshuma kuvapo echitema denderedzwa kana dzeraundi chimiro, unopinza mativi, pamusoro inosiyana, pamwe Pink-Violet ruvara uye scaly pemvura. Kwakadaro zvinhu kazhinji iri pachiso uye mutumbi, zvishoma nezvishoma achiwedzera uwandu nokuregerera zvimwe zvikamu. maronda kwakadaro havapinduri kurapwa uye haigoni kuitwa kwenguva refu, kana pakarepo kunyangarika. Uyezve, echitema inogona pamwe kuvaviwa, usina nokupfuura kwakajairika nzira.
• Patchy infiltrative - kunoitika pashure pemakore mashomanana Pazvinotanga. Panzvimbo pamusoro echitema plaques ane gobvu, woita kana nepravilnymi asi yakajeka miganhu, yepepuru pamwe peeling pamusoro pemvura. At nzvimbo zvisipo plaques muri nzvimbo shava kana ganda atrophy. Kuvaviwa kuwedzera, zvinova sabvumika. Pane nokukurumidza uremu uye fivha, lymphadenopathy vangave.
• Bundu - on-nzvimbo kana plaques paganda hakuna akachinjwa chitarisiko gobvu tsvuku yellow nyarara bundu fomu idenderedzwa kana zvishoma flattened chimiro, akafanana howa hat. The dhayamita kuti idzodzo akadaro anoda kubva imwe makumi maviri millimeters, uye nhamba angava akasiyana. Kana bundu raparadzwa, dzinorwadza nemaronda kuumbwa panzvimbo yayo, kudzama zvinogona kusvika fascia kana pfupa. Kakawanda rinokanganisa chirwatata, node nodes, mapapu uye chiropa. Narostaet kudhaka uye kushaya simba. Varwere vanofa mwoyo kukundikana, amyloidosis, mabayo.

Eritrodermicheskoy chimiro kunoratidzwa ne kwaita narostaet kunorwadza kuvaviwa, akatsvuka uye kuzvimba, pakuonekwa confluent erythematous-squamous makwapa, hyperkeratosis pakati inotsika nemichindwe, uyewo kurasikirwa bvudzi. Kurisa zvose node nodes vari axillary, inguinal, femoral uye cubital munzvimbo. Pavanenge zvinowanika plotnoelastichnye nyarara palpation node omumasherufu haana soldered kuti dzakapoteredza munyama (ganda). Lihodradka kuchengetwa (kusvika madhigirii 39), uremu, usiku sweats uye kuneta. Zvinouraya Mugumisiro zvinogoneka kana kubatana achitowedzera kudhaka uye mwoyo nokukundikana.

In pamberi musoro chimiro paganda utano mune plaques kakawanda, pakupedzisira kuwana akaipa harater. Rufu kunoitika muna varwere mukati pagore.

Clinical kuratidzwa cutaneous lymphomas

T-Sero rwekenza yelymphoma ganda rinowanzoberekera pamusoro colour ari refu-yaivapo uye kukodzera vabatwe dermatological zvirwere. Kutsamwisa chiitiko chacho unogona herpes nemavhairasi, mwaranzi, sunburn uye zvichingodaro. lymphomas Similar kuitika mumatanho maviri: chikuru (kwacho iri mupasi ari dermis), yechipiri (kana ganda maronda ndiwo mugumisiro lymphocyte infiltration pakati zvomukati).

Huru zviratidzo ndiwo:

• Polymorphic ganda nekumhanyirira.
• Achifumira kuvaviwa.
• Kuvapo duku, flat masangano ari nodular chimiro.
• Chitarisiko yellowish plaques, vakabva ndura muhomwe hyperpigmentation uye atrophy (kana Dombo fomu).
• The kunotoda mufananidzo chakatodzana psoriasis (pa melkouzelkovoy mhando).
• Kuoma, kuzvimba, akatsvuka uye peeling ganda (pamwe erythrodermic Chirwere).

Symptomatology pamusoro peripheral lymphomas

Clinic chirwere zvinoenderana pachikuva uye mhando pathological kwacho.

Dzinoratidzwa kuwedzera lymphoid zvinyama zviri pamutsipa, groin uye axillary kumatunhu.

Varwere vanotsutsumwa wokunzwa vangadikitira, zvikuru uremu, kushaya kudya, vakawanda simba, nefivhiri, uye pamberi yakawedzerwa chirwatata uye chiropa (ndiro zvakajairika mazuva) - ne kupfupika mweya, idzokororo chikosoro uye kunzwa waziya mudumbu.

Diagnostics

• Inspection, muunganidzwa zvichemo anamnesis oncologist.
• General ropa uye weti kuongorora.
• Ropa nemakemikari omuviri, uyewo muedzo antibodies kuti chiropa wanda.
• A biopsy of dzaparadzwa node raiva pedyo nebundu (izvo unokubvumira ritsigire nechirwere T-sero rwekenza yelymphoma).
• US.
• MR.
• CT.
• Onkoskrining muviri.
• Immunofenotipirovannoe kudzidza.
• Molecular nemagene Analyses.
• Cytogenetic ongororo.

kurapa

Mabatirwo T-sero rwekenza yelymphoma kunobva chimiro uye pavaipfuura kwacho.

Somuenzaniso, nokuti erythematous Danho Mycosis Fungoides inokosha anticancer kurapa harigadzwi, uye dzokunze corticosteroids uye interferon inoshandiswa.

Anti-bundu kurapwa ndiko kuita mishonga uye radiotherapy.

Maererano muchimiro chacho (usimbe, hasha, uye zvikuru zvechisimba) kunotemwa nokureba uye Kuronga kurapwa, uye kunaya.

Usimbe rwekenza yelymphoma haina kurapwa, asi chete kugara kwakacherechedzwa kana kwacho mberi, mazano kuchinja.

In pakurapa hasha siyana pamwe kushandisa zvinodhaka chemotherapeutic uye Rituximab (monoclonal antibody).

Kana totaura zvikuru nehasha lymphomas, kushandisa mishonga inoshandiswa pakurapa chakasimba leukemias.

Kazhinji, mishonga pamwe hunde sero transplantation.

Zvisinei, chinonyanya inobudirira pakurapa rwekenza yelymphoma ndiko kuitisa matatu nemwaranzi kurapa (sezvinorondedzerwa Elekta Mubatanidzwa), uye pashure pakugamuchira chemotherapeutic nevamiririri.

Matambudziko kugamuchira chemotherapeutic yomuchipatara zvingasanganisira: zvemapapu, zamu, uye zvichingodaro. Radiation mushonga anogona kuva kwakaoma nokuda kukura coronary atherosclerosis.

Pashure inobudirira kurapa chinhu zvairayirwa vapore.

T-Sero rwekenza yelymphoma: kushurudzira

• Kana nenguva kuonekwa chirwere (kutanga kwekupwanyiwa) uye basa zvakakwana kurapwa kwemakore mashanu wokurarama ndiyo-masere nezvishanu kubva muzana, uye varwere chiremba - kusvika makumi mapfumbamwe kubva muzana.
• Achitaura angioimmunoblastic rwekenza yelymphoma ramangwana mwoyo. Avhareji youpenyu hunotarisira pavarwere vane chirwere akadaro maviri chete nehafu - makore matatu. Wokurarama chete mumwe pavatatu varwere vane kwemakore mashanu.
• In pamberi T-lymphoblastic chimiro fungidziro kunobva kuvapo / pasina lesion pakati mumwongo. Kana mumwongo isina kukanganiswa, mugumisiro uri kazhinji zvakanaka. Zvikasadaro, kuvandudzika muzana chete maviri wevarwere zvinogona kutarisirwa.
• Fungidziro uye Kupona howa avium kunobva chimiro uye pavaipfuura kwacho. Saka, kana kupona bhaa fomu - kusvika makore gumi, uye zvisingafadzi. fungidziro panyaya accession nemabayo, nezvimwewo; eritrodermicheskoy fomu sorovozhdaetsya kubatana nemamwe matambudziko akasiyana-siyana zvichikonzera rufu kunoitika mukati maviri - namashanu; asi vasina musoro chimiro murombo fungidziro, rufu kunoitika mukati gore.