Lymphoma ndi kansa yamagazi yomwe imakhudza ma lymphocytes, mtundu wa selo loyera la magazi. Mitundu ikuluikulu ya lymphoma ndi Hodgkin's lymphoma ndipo si ya Hodgkin's lymphoma, kapena NHL. Ngakhale kuti ma lymphomas amayamba m'ziwalo zam'mimba , amatha kufika paliponse m'thupi. Akamakhala kunja kwa maselo am'mimba, amatchedwa lymphomas extranodal.
Primary bone lymphoma ndi yachilendo extranodal lymphoma . Pamene lymphoma imayamba kunja kwa maselo am'mimba, zimakhala zofala kwambiri kuti chiwindi chiyambire m'mimba m'mimba kusiyana ndi mafupa.
Mwachidule
Primary bone lymphoma ndi chinthu chosowa kwambiri chomwe chimayamba kumayambitsa mafupa. Matendawa amachititsa pafupifupi 1 mpaka 2 peresenti ya milandu yonse ya non-Hodgkin lymphoma , yomwe imakhala ndi ana atatu kapena 9 peresenti yambiri kwa ana ndi achinyamata. Khansara yomwe imayambira kwinakwake ndikufalikira mafupa imakhala yowonjezereka kwambiri kuposa yoyamba fupa lymphoma.
Ndani Amakhudzidwa ?
Mafupa akuluakulu a mafupa akuluakulu amakhudza makamaka anthu akuluakulu. Amuna ambiri amakhudzidwa kwambiri kuposa akazi. Ambiri ndi maselo amphamvu omwe si a Hodgkin a mtundu waukulu wa B-cell , omwe chiwerengero chawo chimakwera pakati pa zaka 45 ndi 60. Komabe, pofika pansi pa msana pa sacrum kapena tailbone, primary bone lymphoma ili ndi nsonga chiwerengero cha achinyamata ndi makumi awiri.
Ndipo kawirikawiri matenda amapezeka kwa ana okhala ndi zaka 12.
Zizindikiro
Anthu ambiri omwe amavutika ndi mafupa oyambirira a mfupa amayamba kumva kupweteka m'mapfupa awo. Kawirikawiri ululu umamveka ngakhale kupumula. Izi zingapitirire kwa miyezi isanafike zizindikiro zina. Pamene lymphoma imakula, imatha kupweteka kwa chiwalo ndi kuchepetsa kusuntha kwa mkono kapena mwendo.
Zizindikiro zina za lymphoma monga fever ndi kutaya thupi si zachilendo.
Mayesero
Zithunzi zojambulidwa, X-rays, ndi zikopa za fupa , zimathandizira kuzindikira chachikulu cha fupa la mthemphama. Chifuwa cha fupa chimasonyeza kusintha kumasintha pa mafupa a MRI kapena CT. Pakhoza kukhala kudyedwa kwa njenjete ya mafupa m'madera omwe amavutika ndi lymphoma.
Kuti mudziwe mtundu wa chotupacho, biopsy ya fupa lapangidwa. Izi zikhoza kuchitiridwa opaleshoni, mwa kutenga pang'onopang'ono khungu lophatikizapo fupa kuti liyesedwe kakang'ono. Mayesero ena amathandiza kudziwa ngati chotupacho chafalikira kapena chochepa ku fupa. PET / CT ya chifuwa, mimba ndi mapepala angagwiritsidwe ntchito kuti azindikire kuchuluka kwa momwe thupi limakhudzidwira ndi kukhalapo kwa matenda akutali.
Mitundu
Kawirikawiri, primary bone lymphoma si Hodgkin lymphoma kapena NHL. Hodgkin lymphoma ya fupa sichinthu chochepa kwambiri. Pakati pa mitundu yosiyanasiyana ya NHL, yofala kwambiri ya B-cell lymphoma kapena DLBCL, ndiyo yowopsa kwambiri ya mafupa a mitsempha. Mtundu wa lymphoma umatsogolera zokhudzana ndi mtundu wa chithandizo chomwe chingachitike.
Chithandizo
Chifukwa chachikulu cha fupa la mthemphama sichimachilendo, regimen simunakhazikitsidwe. Zochitika zamakono zamakono nthawi zambiri zimakhala ndi mankhwala a chemotherapy kwa kanthawi kochepa kuphatikizapo mankhwala othandizira mpweya ku fupa.
Chithandizo pa zigawo zosiyanasiyana zosiyana, kapena mankhwala othandizira anthu ambiri, amavomereza, komabe, machitidwe a radiation ndi chemotherapy amasiyana m'mapoti ofalitsidwa. Nthawi zambiri zimakhala bwino kusiyana ndi mitundu ina ya mafinya omwe si a Hodgkin.
Yunivesite ya Miami inanena kuti anthu oposa 80 peresenti ya anthu omwe amachiritsidwa kuti ayambe kudwala matendawa amayamba kupitirira zaka 4 pambuyo pake - adapeza kupulumuka kwapadera kwa 83 peresenti, kapena PFS pofufuza odwala 53. Palibe kusiyana pakati pa odwala ndi chemotherapy kapena chemotherapy kuphatikizapo kuwala kwa dzuwa.
Komabe, panali chizoloŵezi cha kusintha kwa PFS kwa odwala omwe ali ndi DLBCL ochiritsidwa ndi rituximab plus chemotherapy.
Kutsiliza
Pambuyo pa chithandizo, PET / CT mayeso angakhale othandiza kwambiri poyesa momwe angayankhire mankhwala. Phunziro la kujambulira chithandizo pambuyo pa mankhwala ndi PET / CT scan, lomwe limathandiza kusiyanitsa matenda opatsirana ku fibrosis. Odwala ayenera kuyang'ananso kuti ayambirenso nthawi yaitali. Bone lymphoma imakhala yochepa kwambiri kwa kubwerera kwawo komweko ndipo nthawi zambiri imabwerera kumadera akutali kuchokera ku matenda oyambirira.
Zotsatira
Kuti mudziwe zambiri pa mutu uwu, fufuzani zotsatirazi:
Alencar A, Pitcher D, Byrne G, et al. Primary bone lymphoma - maphunziro a University of Miami. Khansa ya m'magazi ndi Lymphoma . 2010; 41 (1): 39-49.
Thornton E, Krajewski KM, O'Regan KN ndi al. Kujambula kumaphatikizapo zotupa zapachiyambi ndi zapachibale zosautsa za sacrum. British Journal of Radiology . 2012; 85 (1011): 279-284.
Kujambula Mfupa Zopweteka ndi Zilonda Zopweteka: Njira ndi Mapulogalamu; A. Mark Davies, Murali Sundaram, Steven J. James. Springer Science & Business Media, 2009.
Malamulo ndi Machitidwe a Mafilimu Oncology 4th Ed. Okonza: Carlos A Perez, Luther W Brady, Edward C Halperin, ndi Rupert K Schmidt-Ullrich. Lippincott Williams & Wilkins, 2003.
Nkhumba K, Allen L, Yahalom J. Primary Bone Lymphoma: Zotsatira za mankhwala ndi zizindikiro zotsutsa zomwe zikutsatiridwa ndi odwala 82. Khansara , 2006; 106 (12).
O'Connor AR, Birchall JD, O'Connor SR et al. Mtengo wa 99mTc-MDP fupa lofukula pakhosi pamayendedwe oyamba a lymphoma a fupa. Nuclear Medicine Communications. 2007; 28 (7): 529-31.
Swerdlow SH, Campo E, Harris NL, ndi al, eds. Kafukufuku wa WHO wa Matenda a Haematopoietic ndi Matenda a Lymphoid. 4th ed. Geneva, Switzerland: Press IARC; 2008.