Zilonda zam'mimba ndizozing'ono zooneka ngati nyemba zomwe zimapezeka padziko lonse lapansi. Iwo ndi mbali ya maselo a mitsempha, mtundu wofanana ndi womangamanga ku mitsempha ya mitsempha ya kayendedwe ka magazi. Mankhwala amtunduwu amakhala ngati kachilombo kakang'ono ka chitetezo cha mthupi, chophatikizidwa pamodzi ndi kayendedwe kamadzi komwe kumatulutsa madzi kuchokera kumatenda makamaka m'magawo a thupi.
Pamene maselo am'thupi amadziwika kuti retroperitoneum yowonjezereka, pali zifukwa zambiri zomwe zingayambitse, kuphatikizapo zotsatirazi:
- Matenda, monga chifuwa chachikulu
- Kutupa kuchokera ku zifukwa zosiyanasiyana, kuphatikizapo matenda monga sarcoidosis
- Khansara kuchokera kumalo akutali m'thupi lomwe limayambitsanso maseŵera olimbitsa thupi
- Mankhwala a khansa omwe amapezeka m'makina amaliseche kapena kufalikira ku maselo am'mimba
- Zina zomwe zimayambitsa
Pali nthawi zambiri zifukwa zosiyanasiyana zolimbitsira thupi, ndipo si onse omwe ali ndi khansa. Ndipotu, munthu akawona dokotala chifukwa cha ma lymph node, kutupa khansa si chifukwa chake. M'malo mwake, kachilombo ka HIV kamakhala kokayikitsa makamaka makamaka ngati mitsempha yotupa imakhala pamutu. Komabe, pali mitundu ina ya mitsempha ya mitsempha yomwe imakhala yosagwirizana ndi zinthu zowonongeka, monga kuwonana kwakukulu kwa maselo akuluakulu omwe amawoneka pamodzi pamodzi mu maphunziro a kujambula.
Lymph Node Zomwe Zidzatha Kukula Zingathe Kukulirakulira M'madera osiyanasiyana
Mapuloteni a retroperitoneal ali pamalo omwe sangathe kumvekedwa kapena kuzindikila pamene ayamba kuphulika, kotero madotolo angaphunzire za kukulitsa kwawo mwa njira yophunzirira zithunzi monga CT scan ya mimba ndi pelvis.
Nthawi zina ma retymperoneal lymph nodes amayamba kugwira ntchito kwambiri ndi matenda omwe amachititsa kuti zizindikiro ziziyenda bwino, monga momwe zimayambira pafupi. Nthaŵi zina, zizindikiro zingayambitse phunziro la kujambula lomwe limatulutsa kuthamanga kwa retroperitoneal lymph node. Komabe, chifukwa cha kutupa sikungakhale kosavuta kuwonetsa kuchokera ku zojambulajambula, ndipo chidziwitso cha mankhwala omwe amaphatikizidwa ndi ma lymph nodes nthawi zambiri amafunika.
Pankhani ya anthu omwe afooketsa chitetezo cha mthupi, zina mwazotheka kuti mitsempha ya retroperitoneal yowonjezereka ikhale: matenda a mtundu wina wa mabakiteriya wotchedwa Mycobacterium; Lymphoma, khansara yamagazi yomwe nthawi zambiri imayambira m'mimba yamagulu; ndi Kaposi's sarcoma, khansa imene imayamba kuchokera ku maselo omwe amatsitsa mitsempha kapena mitsempha ya magazi.
Pamene mitsempha yowonjezereka imawoneka mu gawo lina la thupi monga retroperitoneal dera, pamenepo imakhala ndi chithunzi pa nthawi, kotero pali mwayi wosiyana pa matenda omwe ali ndi udindo. Node zowonjezereka zikhoza kukhala chigawo choyamba cha matenda omwe pamapeto pake adzawonetsa kulumala kwa mitsempha m'madera osiyanasiyana a thupi kapena matenda opatsirana opatsirana amtundu wa lymphadenopathy.
Ngati pali maselo ambirimbiri omwe amapezeka mu retroperitoneum ndipo mawonekedwewo amasonyezanso chiwindi chofutukuka ndi nthata, izi zikhoza kukhala zowonjezera kwambiri za lymphoma , komabe palinso zina zotheka. Matenda a Castleman ndi matenda omwe sakhala ochepa omwe amachititsa kuti mitsempha yambiri ifike. Mayina ena ali ndi lymph node hyperplasia, ndi angiofollicular lymph node hyperplasia. Dr. Benjamin Castleman anayamba kufotokoza izi m'ma 1950.
Matenda a Castleman amaonedwa kuti ndi matenda a lymphoproliferative, kutanthauza kuti pali maselo ochuluka a maselo a lymph.
Ngakhale si khansa, ikhoza kukhala yofanana kwambiri ndi lymphoma, ndipo mitundu ina ikhoza kukhala lymphoma.
Retroperitoneum Ali Kuti, Nanga N'chifukwa Chiyani Kuli Kofunika?
Mankhwala aakulu amadziwika kuti dzina la maselo amenewa. Mitsempha yotchedwa Retroperitoneal lymph nodes ili m'kati mwa thupi, lotchedwa retroperitoneum. Retroperitoneum imafotokoza mbali ya mimba ya m'mimba-gawo la mimba lomwe nthawi zambiri limakhala pafupi ndi msana wako kusiyana ndi mimba yako ya m'mimba, kubwerera kumbuyo kwa matumbo.
Mitsempha ya retroperitoneal ndi imodzi mwa magulu amphamvu kwambiri omwe amapezeka kuzungulira thupi, monga momwe mndandandawu ukusonyezera:
- Matenda a retroperitoneal - omwe amapezeka mu retroperitoneum
- Mitsempha yamagulu a Inguinal - yomwe imapezeka kumapiri
- Zilonda zam'mimba zamtunduwu - zomwe zimapezeka m'makutu
- Zilonda zam'mimba zamkati zam'mimba zimapezeka mu chifuwa, pafupi ndi mtima
Lymph nodes ikhoza kutchulidwa ku dera lililonse la thupi kapena chiwalo china. Mwachitsanzo, pali mtundu winawake wamatenda omwe amapezeka pafupi ndi aorta. Lymph node imeneyi nthawi zambiri imatchedwa thoracic node. Kukhala wodalirika, ngati uli m'chipinda choyandikana ndi mtima, umathenso kukhala ngati mankhwala a m'mimba , kapenanso makamaka, ngati ili pambali pa aorta, mitsempha yambiri yomwe imakhala yolondola, koma zowonjezereka zingakhale zowona kwambiri.
Peritoneum ndi nembanemba yomwe imayika pamimba pamimba komanso imaphatikizapo ziwalo za m'mimba. Tangoganizirani ngati 'thumba lachiwiri la pulasitiki' lomwe limapangitsa kuti zonse zisawonongeke pakapita patsogolo. Ziwalo zina ndi intraperitoneal, kapena mkati mwa peritoneum, pamene ena ali kumbuyo, kapena retroperitoneal.
Mitundu ya Retroperitoneal
Chifukwa chokulitsa lymph node nthawi zina chimagwirizana ndi ziwalo zomwe ziri pafupi ndi node zofutukuka. Ziwalo zingapo zili mkati mwa peritoneum ndipo zina zimakhala pang'onopang'ono ndi pang'onopang'ono kunja kwa peritoneum. Ophunzira angagwiritse ntchito chipangizo chokumbukira chidziwitso kuti aphunzire ziwalo zomwe zimayambiranso:
S: suprarenal kapena adrenal gland
A: aorta / otsika vena cava
D: duodenum (gawo lachiwiri ndi lachitatu)
P: ziphuphu (kupatula mchira wa makoswe)
U: othawa
C: colon (kukwera ndi kutsika)
K: impso
E: esophagus
R: rectum
Ziwalo zotsatiridwa ndi abambo zimangokhala retroperitoneal. Nthawi zina matenda omwe amakhudza chimodzi mwa ziwalozi amakhudzanso mitsempha yambiri yomwe imayanjanitsidwa. Mwachitsanzo, otupa amanyamula mkodzo kuchokera ku impso kupita ku chikhodzodzo, ndipo misala m'derali ikhoza kuletsa ureter, kuchititsa zizindikiro za m'mimba. Nthawi zambiri matendawa amachititsa kuti munthu asatuluke m'mimba kapena kutsekedwa kwa mkodzo.
Retroperitoneal Lymph Nodes mu Lymphoma
Mafupa amtunduwu ndi gulu la khansa ya lymph system . Mankhwala am'mimba amayamba m'ziwalo zam'mimba, ndipo maselo am'mimba amatha kusokonezeka m'matumbo ambiri.
Pali mitundu iwiri ikuluikulu ya lymphoma:
1) Lymphoma ya Hodgkin, kapena HL - ndipo apa pali kugwirizana kwa Hodgkin's.
2) Non-Hodgkin's lymphoma, kapena NHL yomwe imakhala pafupifupi 90 peresenti ya mafupa onse, ili ndi mitundu yambiri kuposa Hodgkin's lymphoma.
Zonse ziwiri za HL ndi NHL zingayambitse kupatsirana m'mimba. Ngakhale kuti HL ndifalikira kufalikira, kuchokera ku gulu limodzi la nthendayi, NHL ikhoza kuwuka ndikubwera kuphatikizapo magulu osiyanasiyana a ma lymph nodes, kuphatikizapo retroperitoneal lymph nodes, panthawi yopereka.
Maselo a Retroperitoneal Lymph Nodes M'mayendedwe Ena
Mankhwala ena amatha kuchepetsa matendawa. Khansara imodzi ndi khansara yamatsenga. Khansara yamatsenga imafalikira m'njira yosayembekezereka kudzera m'matenda a retroperitoneal (RPLN), ndipo nthawi zina, opaleshoni yotchedwa retroperitoneal lymph node dissection (RPLND) yatha. Chinthu chimodzi chotheka chochita cha opaleshoni imeneyi ndi kubwezeretsa kukwera kwa madzi. Ngati dokotalayo akudula mitsempha panthawi ya opaleshoniyi, kuyamwa kumathabe, koma umuna umathera m'chikhodzodzo, ndipo kusabereka ndi vuto.
Mawu Ochokera
Pamene mitsempha yowonjezera mu retroperitoneum imadziwika, tanthauzo la kupeza izi kumadalira pa zonse zina, kuphatikizapo mbiri yachipatala ya munthuyo ndi node zofutukuka. Mbali imodzi yofunika kwambiri ya nodes yowonjezera pamalo ano ndi yakuti iwo ali kutali kwambiri ndi thupi lonse ndipo sazindikira mosavuta ngati maselo a mitsempha m'khosi, kupweteka kapena kubuula.
Nthawi zina maselo amphongo amakhala "okwera pamzere" pa mafano, kutanthauza kuti ndi aakulu kwambiri kuposa nthawi zonse, koma osati chifukwa chodetsa nkhaŵa. Pazochitikazi, pangakhale zojambula zotsatila zomwe zimachitika ndikuyerekezera ndi kafukufuku wakale kuti awone ngati pakhala palikulandila.
Nthawi zonse kambiranani ndi gulu lanu laumoyo ngati muli ndi mafunso okhudzana ndi zofukufuku monga zithukuta za retroperitoneal kapena mafunso okhudza kufunika kwa zotsatirazi.
Zotsatira:
Lymph Nodes. Lawrence M. Weiss. Cambridge University Press, Apr 28, 2008
Radiopaedia.org. Zizindikiro zobwezeretsa (mnemonic).
Mankhwala Osakhala a Hodgkin. James Armitage et al. Lippincott Williams & Wilkins, Aug 8, 2013.