Matenda a mitsempha yambiri

Lymph node biopsy ndikuchotsa kwa ma lymph node minofu kuti iwunikidwe ndi microscope.

Ma lymph node ndi tiziwalo ting'onoting'ono tomwe timapanga ma cell oyera (ma lymphocyte), omwe amalimbana ndi matenda. Ma lymph node amatha kutengera tizilombo tomwe timayambitsa matenda. Khansa imafalikira ku ma lymph node.

Chidziwitso cha lymph node nthawi zambiri chimachitidwa m'chipinda chogwiritsira ntchito kuchipatala kapena kuchipatala. Zolembazo zitha kuchitidwa m'njira zosiyanasiyana.

Biopsy yotseguka ndi opareshoni yochotsa zonse kapena gawo la ma lymph node. Izi zimachitika kawirikawiri ngati pali ma lymph node omwe amatha kumveka poyesa. Izi zitha kuchitika ndi mankhwala oletsa ululu am'deralo (jekeseni wamankhwala) omwe amalowetsedwa m'deralo, kapena pansi pa dzanzi. Njirayi imachitika motere:

• Mumagona pagome lofufuzira. Mutha kupatsidwa mankhwala okutonthozani ndikukupangitsani kugona kapena mungakhale ndi anesthesia, zomwe zikutanthauza kuti mukugona komanso simumva kuwawa.
• Tsamba la biopsy limatsukidwa.
• Kudula kocheperako (incision) kumapangidwa. Nthenda yam'mimba kapena gawo lake limachotsedwa.
• Chombocho chimatsekedwa ndi timitengo ndipo bandeji kapena zomatira zamadzi zimagwiritsidwa ntchito.
• Tsamba lotseguka limatha kutenga mphindi 30 mpaka 45.

Kwa khansa zina, njira yapadera yopezera ma lymph node ku biopsy imagwiritsidwa ntchito. Izi zimatchedwa sentinel lymph node biopsy, ndipo zimaphatikizapo:

Kamtengo kakang'ono ka tracer, kaya kama radioactive tracer (radioisotope) kapena utoto wabuluu kapena onse awiri, amabayidwa pamalo otupa kapena m'chigawo cha chotupacho.

Chotsalacho kapena utoto umadutsa munjira yapafupi (yapafupi) kapena mfundo. Nambala izi zimatchedwa sentinel node. Ma sentinel nodes ndi ma lymph node oyamba omwe khansa imafalikira.

Ma sentinel kapena mfundo zachotsedwa.

Zilonda zam'mimba m'mimba zimatha kuchotsedwa ndi laparoscope. Ichi ndi chubu chaching'ono chokhala ndi kuwala ndi kamera yomwe imayikidwa kudzera pang'amba kakang'ono m'mimba. Chimodzi mwazinthu zingapo zidzapangidwa ndipo zida zidzaikidwa kuti zithandizire kuchotsa mfundozo. Lymph node ilipo ndipo gawo kapena yonse imachotsedwa. Izi nthawi zambiri zimachitidwa pansi pa anesthesia, zomwe zikutanthauza kuti munthu amene ali ndi njirayi amakhala akugona komanso wopanda ululu.

Chotsulocho chikachotsedwa, chimatumizidwa ku labotale kukayesedwa.

Chigoba cha singano chimaphatikizapo kuyika singano mu lymph node. Biopsy yamtunduwu itha kuchitidwa ndi radiologist wokhala ndi anesthesia wamba, pogwiritsa ntchito ultrasound kapena CT scan kuti apeze mfundo.

Uzani wothandizira wanu:

• Ngati muli ndi pakati
• Ngati muli ndi ziwengo zilizonse
• Ngati muli ndi mavuto otaya magazi
• Ndi mankhwala ati omwe mukumwa (kuphatikiza zowonjezera zilizonse kapena mankhwala azitsamba)

Wopereka wanu akhoza kukupemphani kuti:

• Lekani kumwa zochotsa magazi zilizonse, monga aspirin, heparin, warfarin (Coumadin), kapena clopidogrel (Plavix) monga mwalamulidwa
• Osadya kapena kumwa chilichonse pakapita nthawi isanachitike
• Fikani pa nthawi inayake kuti muchite izi

Pamene mankhwala oletsa ululu am'deralo abayidwa, mudzamva kuwawa ndi kubaya pang'ono. Tsamba la biopsy lidzakhala lowawa kwa masiku angapo mayeso atayesedwa.

Pambuyo pa biopsy yotseguka kapena ya laparoscopic, kupweteka kumakhala kofatsa ndipo mutha kuyisamalira mosavuta ndi mankhwala opweteka owonjezera. Muthanso kuwona kuvulala kapena kutuluka kwamadzimadzi kwamasiku ochepa. Tsatirani malangizo osamalira thupilo. Ngakhale kutsekeka kukuchiritsa, pewani mtundu uliwonse wa zolimbitsa thupi kapena kunyamula zolemetsa zomwe zimapweteka kapena kusokoneza. Funsani omwe akukuthandizani kuti akupatseni malangizo pazomwe mungachite.

Chiyesocho chimagwiritsidwa ntchito pozindikira khansa, sarcoidosis, kapena matenda (monga chifuwa chachikulu):

• Pamene inu kapena wothandizira wanu mumamva zotupa ndipo sizichoka
• Pamene ma lymph node osadziwika amapezeka pamammogram, ultrasound, CT, kapena MRI scan
• Kwa anthu ena omwe ali ndi khansa, monga khansa ya m'mawere kapena khansa ya m'mimba, kuti awone ngati khansara yafalikira (sentinel lymph node biopsy kapena singano biopsy ndi radiologist)

Zotsatira za biopsy zimathandiza wothandizirayo kusankha mayesero ena ndi chithandizo.

Ngati ma lymph node biopsy sakuwonetsa zizindikiro zilizonse za khansa, ndizotheka kuti ma lymph node ena apafupi nawonso alibe khansa. Izi zitha kuthandiza othandizira kuti athe kusankha mayesero ena ndi chithandizo chake.

Zotsatira zachilendo zitha kukhala chifukwa cha zinthu zosiyanasiyana, kuyambira matenda ofatsa mpaka khansa.

Mwachitsanzo, ma lymph node owonjezera atha kukhala chifukwa cha:

• Khansa (m'mawere, m'mapapo, m'kamwa)
• HIV
• Khansa yamatenda am'mimba (Hodgkin kapena non-Hodgkin lymphoma)
• Matenda (chifuwa chachikulu, matenda amphaka)
• Kutupa kwa ma lymph node ndi ziwalo zina ndi minofu (sarcoidosis)

Lymph node biopsy itha kubweretsa izi:

• Magazi
• Matenda (nthawi zambiri, bala limatha kutenga kachilomboka ndipo mungafunike kumwa maantibayotiki)
• Kuvulala kwamitsempha ngati biopsy yachitika pa mwanabele wam'mimba pafupi ndi mitsempha (dzanzi limatha miyezi ingapo)

Biopsy - mwanabele; Tsegulani zamitsempha zam'mimba; Chabwino singano kukhumba biopsy; Sentinel lymph node chidziwitso

• Makina amitsempha
• Matenda amtundu wa metastases, CT scan

Chernecky CC, Berger BJ. Zosintha, zatsatanetsatane - tsamba. Mu: Chernecky CC, Berger BJ, olemba., Eds. Kuyesa Kwantchito ndi Njira Zakuzindikira. Lachisanu ndi chimodzi. St Louis, MO: Elsevier Saunders; 2013: 199-202.

Chung A, Giuliano AE. Mapu amitsempha yam'mimba ndi sentinel lymphadenectomy ya khansa ya m'mawere. Mu: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, olemba. Chifuwa: Kusamalira kwathunthu kwa matenda a Benign ndi Malignant. 5th ed. Philadelphia, PA: Elsevier; 2018: mutu 42.

Tsamba la National Cancer Institute. Sentinel lymph node chidziwitso. www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet. Idasinthidwa pa June 25, 2019. Idapezeka pa Julayi 13, 2020.

Achinyamata NA, Dulaimi E, Al-Saleem T. Lymph node: cytomorphology ndi flow cytometry. Mu: Bibbo M, Wilbur DC, olemba. Cytopathology Yokwanira. Wolemba 4. Philadelphia, PA: Elsevier Saunders; 2015: chap 25.