Mwachidule
Munthu amati ali ndi gawo lopanda mafupa kapena "discordant lymphoma" pamene mitundu iwiri ya lymphoma imapezeka mwa munthu yemweyo m'madera awiri osiyana thupi.
M'malo osakhala a Hodgkin's lymphoma, kapena NHL , kuphatikizapo mafupa osagwirizana ndi mafupa amapezeka makamaka pamene minofu yowopsa imapezeka m'mimba yamaliseche koma mitsempha yotchedwa indolent kapena slow-growing limpphoma imapezeka m'mafupa.
Zotsatira zake, ngati zilipo, za mgwirizano ndi kusagwirizana kwa mafupa omwe amapezeka mu lymphoma zikuwoneka kuti zimadalira mtundu wa lymphoma yomwe imapezeka komanso zina zomwe zimachitika pa matendawa. Kawirikawiri, kuganizira mozama zokhudzana ndi matendawa kumakhala kovuta chifukwa, nthawi zambiri, kutulutsa deta imene amadalira amadalira kwambiri.
Kuphatikizidwa kwa Maso a Maso
Zambiri zopanda malire kapena zopanda pang'onopang'ono za B-cell imymphomas zimakhala ndi mafupa omwe amayamba kugwira ntchito panthawi ya matenda. Ponena za kukula kwakukulu kwa B-cell lymphoma (DLBCL), yomwe ndi mtundu wankhanza wa non-Hodgkin's lymphoma , kafukufuku ambiri amanena kuti pafupifupi 10 mpaka 15 peresenti ya anthu omwe ali ndi mafupa amakhala nawo pamene akupezeka. Komabe, kuyesa fupa la fupa n'kofunika.
Kugwirizana ndi Kusamvana
Pamene kugwidwa kwa mnofu wamphongo kumachitika mu Hodgkin's lymphoma, kawirikawiri zimakhala kuti maselo a khansa m'magazi ali ofanana ndi maselo a khansa omwe amapezeka kumalo ena, monga m'magalasi - ndipo amadziwika kuti concordance .
Kusamvana kumatanthawuza kuti milandu ya lymphoma komwe kachipatala , kapena maonekedwe ndi maonekedwe a maselo a khansa, amasiyana mosiyana pakati pa fupa la mafupa ndi malo ena ogwira ntchito.
- Kusiyanitsa kuli kosiyana ndi gulu , lomwe limatanthawuza malo awiri kapena osiyana kwambiri a maselo a lymphoma omwe ali ndi mankhwala omwewo .
- Kulankhulana kumakhalanso kosiyana ndi kusintha , komwe kumatanthawuza lymphoma yomwe ikuyamba kukula mofulumira kapena yopanda phokoso koma kenako imasinthika kukhala lymphoma yoopsa (nthawi zambiri DLBCL) panthawi ya matendawa. Kusintha kwa Richter ndi chitsanzo cha kusintha komwe kumakhudza matenda aakulu a khansa ya m'magazi yomwe imasintha kukhala DLBCL kapena Hodgkin lymphoma.
Kusanthula, Chithandizo ndi Zotsatira
Palibenso mgwirizano wochuluka wokhudzana ndi momwe zimakhalire zovuta zogonana, momwe amachitira zogonana, kapena momwe angachitire bwino, mwatsoka. Deta zambiri zimachokera ku milandu imodzi yomwe yafotokozedwa muzinthu za sayansi ndi maphunziro ang'onoang'ono omwe amawonekera kumbuyo kuti ayese kufufuza machitidwe ndi mayanjano.
Concordant fupa la mfupa kutenga nawo mbali kwakhala likugwirizana ndi mbiri yakale ndi zotsatira zoipitsitsa kwambiri kwa odwala okhala ndi nodalular follicular lymphoma. Kupeza kumeneku kumayambitsa kukweza gawo la Ann Arbor la IV ndipo motero mapepala apamwamba pa ndondomeko yomwe amagwiritsidwa ntchito poyerekeza, chiwerengero cha FLIPI.
Nthenda yamphongo yosagwiritsidwa ntchito ikuoneka kuti imakhala yochepa pakati pa maimphine amakula mofulumira; Kusagwirizana mwachindunji kumachitika kuti pakati pa 40 ndi 70 peresenti ya odwala ali ndi follicular lymphoma.
Mphindi wosagwidwa ndi mafupa omwe amaphatikizidwa m'madera a m'mphepete mwa lymphoma amawoneka ngati ofanana.
Mfundo Yofunika Kwambiri
Malingana ndi olemba a nkhani ya 2016 yofalitsidwa mu "Magazi" - otchedwa 'Discordant bone furow involvement in non-Hodgkin's lymphoma,' - maphunziro ambiri ndi ziwerengero zazikulu amafunika kuti athe kufotokozera bwino momwe mgwirizano ndi kusiyana kwa njira zimakhudzira ambiri odwala okhala ndi lymphoma.
- Mphongo wamphongo womwe umagwirizanitsa ndi DLBCL umawoneka kuti umasonyeza zotsatira zoipirapo ndi kupitirirabe kwa moyo wonse poyerekezera ndi milandu yopanda kuphwanya mafupa.
- Mphuno wosagwirizana ndi mafupa osagwirizana ndi B-cell lymphoma yomwe imangoyamba kumene kupeza DLBCL sichikuoneka kuti imakhudzidwa molakwika ndi matenda.
Ndipo, ngakhale kuti FDG-PET ndi chithandizo chothandizira kugonana kwa concordant bone marrow ku DLBCL, ndizowona kuti ndizosamvetsetseka pozindikira kusagwirizana kokhala ndi mafupa osagwirizana.
Zotsatira
Brudno J, Tadmor T, Pittaluga S. Mphindi wosakanikirana wophatikizapo kuphatikizapo nthenda yotchedwa Hodgkin lymphoma. Magazi. 2016; 127 (8): 965-70.
Merli M, Arcaini L, Boveri E, et al. Kufufuza kwa fupa la mafupa kumalo a mafupa ena omwe si a Hodgkin: kuyerekezera pakati pa hertology ndi cytometry yothamanga. Eur J Haematol . 2010; 85 (5): 405-15.
Sehn LH, Scott DW, Chhanabhai M, et al. Zotsatira za mkodzo wamphongo wosagwirizana komanso wophatikizapo womwe umakhudzidwa ndi zotsatira za m "mimba yaikulu ya B-cell lymphoma yomwe imathandizidwa ndi R-CHOP. J Clin Oncol . 2011; 29 (11): 1452-7.