Chordoma

Chordoma

ʻO ka chordoma kahi ʻano maʻamau ʻole o ka maʻi kanesa iwi e loaʻa pinepine ana i nā iwi o ke kua a i ʻole ke poʻo. Hoʻomaka pinepine ia ma kahi e noho ai ke poʻo ma luna o ke kua (kumu poʻo) a i ʻole ma lalo o ke kua (sacrum).

Hoʻomaka ka chordoma i nā sela i hana mua i kahi hui o nā sela i loko o ka embryo e ulu ana e lilo i nā diski o ke kua. Poina ka hapa nui o kēia mau sela i ka wā e hānau ai ʻoe a i ʻole ma hope koke. Akā i kekahi manawa, noho kekahi o kēia mau sela a, maʻamau ʻole, hiki iā lākou ke lilo i kanesa.

Loaʻa pinepine ka chordoma i nā mākua ma waena o 40 a me 60, ʻoiai hiki ke loaʻa i kēlā me kēia makahiki.

ʻO ka chordoma ka ulu mālie pinepine. Hiki ke paʻakikī ke mālama no ka mea ua waiho pinepine ʻia kokoke loa i ke kaula kua a me nā ʻano koʻikoʻi ʻē aʻe, e like me nā arteries, nā nerves a i ʻole ka lolo.

ʻO nā hoʻokolohua a me nā kaʻina hana i hoʻohana ʻia e ʻike i ka chordoma e komo pū ana:

• Ke wehe ʻana i kahi laʻana o nā sela no ka hoʻokolohua hale hana (biopsy). He kaʻina hana ka biopsy e wehe ai i kahi laʻana o nā sela kānalua no ka hoʻokolohua hale hana. I loko o ka hale hana, nānā nā kauka i aʻo ʻia i kapa ʻia ʻo pathologists i nā sela ma lalo o nā microscope e hoʻoholo ai inā aia nā sela kanesa.

  ʻO ka hoʻoholo ʻana i ke ʻano o ka biopsy e pono ai ka hoʻolālā akahele e ka hui lapaʻau. Pono nā kauka e hana i ka biopsy ma ke ʻano ʻaʻole e hoʻopilikia i ka ʻoki kino e hiki mai ana e wehe i ka maʻi kanesa. No kēia kumu, e noi i kāu kauka no kahi kuhikuhi i kahi hui o nā loea me ka ʻike nui i ka mālama ʻana i ka chordoma.

• Ke loaʻa ʻana o nā kiʻi kikoʻī hou aku. Hiki i kāu kauka ke ʻōlelo aku i nā hoʻokolohua kiʻi e kōkua i ka ʻike ʻana i kāu chordoma a hoʻoholo ai inā ua pālahalaha aku ma mua o ke kua a i ʻole ke kumu poʻo. Hiki i nā hoʻokolohua ke komo pū me ka MRI a i ʻole CT scan.

Ke wehe ʻana i kahi laʻana o nā sela no ka hoʻokolohua hale hana (biopsy). He kaʻina hana ka biopsy e wehe ai i kahi laʻana o nā sela kānalua no ka hoʻokolohua hale hana. I loko o ka hale hana, nānā nā kauka i aʻo ʻia i kapa ʻia ʻo pathologists i nā sela ma lalo o nā microscope e hoʻoholo ai inā aia nā sela kanesa.

ʻO ka hoʻoholo ʻana i ke ʻano o ka biopsy e pono ai ka hoʻolālā akahele e ka hui lapaʻau. Pono nā kauka e hana i ka biopsy ma ke ʻano ʻaʻole e hoʻopilikia i ka ʻoki kino e hiki mai ana e wehe i ka maʻi kanesa. No kēia kumu, e noi i kāu kauka no kahi kuhikuhi i kahi hui o nā loea me ka ʻike nui i ka mālama ʻana i ka chordoma.

Ma hope o kou loaʻa ʻana i kahi ʻike o ka chordoma, e hoʻomohala kāu kauka i kahi hoʻolālā mālama i kūpono i kou mau pono ma ke kūkākūkā ʻana me nā loea i ka lāʻau lapaʻau pepeiao, ihu a me ka ʻāʻī (otolaryngology), kanesa (oncology), a me ka radiation therapy (radiation oncology) a i ʻole ka ʻoki kino. Hiki i kāu hui mālama ke komo pū me nā loea i ka endocrinology, ophthalmology a me ka hoʻōla hou, e like me ka pono.

ʻO ka mālama ʻana i ka chordoma e hilinaʻi ana i ka nui a me kahi o ka maʻi kanesa, a me ka mea i komo i nā nerves a i ʻole nā ​​mea ʻē aʻe. Hiki i nā koho ke komo pū me ka ʻoki kino, ka radiation therapy, ka radiosurgery a me nā therapies i hoʻonohonoho ʻia.

Inā hoʻopilikia ka chordoma i ka ʻāpana lalo o ke kua (sacrum), hiki i nā koho mālama ke komo pū me:

• ʻOki kino. ʻO ka pahuhopu o ka ʻoki kino no ka maʻi kanesa sacral spine ka wehe ʻana i ka maʻi kanesa a pau a me kekahi o nā mea ola maikaʻi e hoʻopuni ana iā ia. Hiki ke paʻakikī ke hana i ka ʻoki kino no ka mea kokoke ka maʻi kanesa i nā ʻano koʻikoʻi, e like me nā nerves a me nā kīʻaha koko. I ka wā hiki ʻole ke wehe piha i ka maʻi kanesa, hiki i nā kauka ʻoki ke ho'āʻo e wehe i ka nui e hiki ai.

• Radiation therapy. Hoʻohana ka radiation therapy i nā kukuna kiʻekiʻe, e like me nā X-rays a i ʻole nā ​​proton, e pepehi i nā sela kanesa. I ka wā o ka radiation therapy, moe ʻoe ma kahi papa e like me ka neʻe ʻana o ka mīkini a puni ʻoe, e kuhikuhi ana i nā kukuna radiation i nā wahi kūpono ma kou kino.

  Hiki ke hoʻohana ʻia ka radiation therapy ma mua o ka ʻoki kino e hoʻemi i ka maʻi kanesa a hoʻomaʻalahi i ka wehe ʻana. Hiki nō hoʻi ke hoʻohana ʻia ma hope o ka ʻoki kino e pepehi i nā sela kanesa i koe. Inā ʻaʻole he koho ka ʻoki kino, hiki ke ʻōlelo ʻia ka radiation therapy ma kahi.

  ʻO ka mālama ʻana me nā ʻano hou o ka mālama radiation, e like me ka proton therapy, e ʻae i nā kauka e hoʻohana i nā nui kiʻekiʻe o ka radiation ʻoiai e pale ana i nā mea ola maikaʻi, ka mea e ʻoi aku ka maikaʻi i ka mālama ʻana i ka chordoma.

• Radiosurgery. Hoʻohana ka stereotactic radiosurgery i nā kukuna radiation he nui e pepehi i nā sela kanesa i kahi liʻiliʻi loa. ʻAʻole ikaika loa kēlā me kēia kukuna radiation, akā ʻo ka wahi e hui pū ai nā kukuna a pau - ma ka chordoma - loaʻa ka nui o ka radiation e pepehi i nā sela kanesa. Hiki ke hoʻohana ʻia ka radiosurgery ma mua a i ʻole ma hope o ka ʻoki kino no ka chordoma. Inā ʻaʻole he koho ka ʻoki kino, hiki ke ʻōlelo ʻia ka radiosurgery ma kahi.

• Targeted therapy. Hoʻohana ka targeted therapy i nā lāʻau e kau i nā hemahema kūikawā i loaʻa i loko o nā sela kanesa. Ma ke kau ʻana i kēia mau hemahema, hiki i nā lāʻau lapaʻau i hoʻonohonoho ʻia ke kumu i ka make ʻana o nā sela kanesa. Hoʻohana ʻia kekahi manawa ka targeted therapy e mālama i ka chordoma e pālahalaha i nā wahi ʻē aʻe o ke kino.

Radiation therapy. Hoʻohana ka radiation therapy i nā kukuna kiʻekiʻe, e like me nā X-rays a i ʻole nā ​​proton, e pepehi i nā sela kanesa. I ka wā o ka radiation therapy, moe ʻoe ma kahi papa e like me ka neʻe ʻana o ka mīkini a puni ʻoe, e kuhikuhi ana i nā kukuna radiation i nā wahi kūpono ma kou kino.

Hiki ke hoʻohana ʻia ka radiation therapy ma mua o ka ʻoki kino e hoʻemi i ka maʻi kanesa a hoʻomaʻalahi i ka wehe ʻana. Hiki nō hoʻi ke hoʻohana ʻia ma hope o ka ʻoki kino e pepehi i nā sela kanesa i koe. Inā ʻaʻole he koho ka ʻoki kino, hiki ke ʻōlelo ʻia ka radiation therapy ma kahi.

ʻO ka mālama ʻana me nā ʻano hou o ka mālama radiation, e like me ka proton therapy, e ʻae i nā kauka e hoʻohana i nā nui kiʻekiʻe o ka radiation ʻoiai e pale ana i nā mea ola maikaʻi, ka mea e ʻoi aku ka maikaʻi i ka mālama ʻana i ka chordoma.

Hoʻohana ʻia kahi tube lōʻihi, lahilahi (endoscope) e wehe i kahi tumor ma o ka ihu, me ka ʻole o nā ʻoki ʻili.

Inā hoʻopilikia ka chordoma i kahi e hui pū ai ke kua me ke poʻo (kumu poʻo), hiki i nā koho mālama ke komo pū me:

• ʻOki kino. Hoʻomaka pinepine ka mālama ʻana me kahi hana e wehe ai i ka nui o ka maʻi kanesa e hiki ai me ka ʻole o ka hōʻino ʻana i nā mea ola maikaʻi kokoke a i ʻole ke kumu i nā pilikia hou, e like me ka hōʻino ʻana i ka lolo a i ʻole ke kaula kua. Hiki ʻole ke wehe piha inā kokoke ka maʻi kanesa i nā ʻano koʻikoʻi, e like me ka carotid artery.

  I kekahi mau kūlana, hiki i nā kauka ʻoki ke hoʻohana i nā ʻano hana kūikawā, e like me ka endoscopic surgery e komo i ka maʻi kanesa. ʻO ka endoscopic skull base surgery kahi ʻano hana liʻiliʻi e komo pū ana i ka hoʻohana ʻana i kahi tube lōʻihi, lahilahi (endoscope) i hoʻokomo ʻia ma o ka ihu e komo i ka maʻi kanesa. Hiki ke hoʻoili ʻia nā mea hana kūikawā ma o ka tube e wehe i ka maʻi kanesa.

  Maʻamau ʻole, hiki i nā kauka ʻoki ke ʻōlelo aku i kahi hana hou e wehe ai i ka nui o ka maʻi kanesa e hiki ai a i ʻole e hoʻopaʻa i kahi i loaʻa ai ka maʻi kanesa.

• Radiation therapy. Hoʻohana ka radiation therapy i nā kukuna kiʻekiʻe, e like me nā X-rays a i ʻole nā ​​proton, e pepehi i nā sela kanesa. Hoʻomaopopo pinepine ʻia ka radiation therapy ma hope o ka ʻoki kino no ka skull base chordoma e pepehi i nā sela kanesa i koe. Inā ʻaʻole he koho ka ʻoki kino, hiki ke ʻōlelo ʻia ka radiation therapy ma kahi.

  ʻO nā ʻano hana radiation therapy e hoʻonohonoho pono i ka mālama ʻana e ʻae i nā kauka e hoʻohana i nā nui radiation kiʻekiʻe, ka mea e ʻoi aku ka maikaʻi no ka chordoma. ʻO kēia mau mea e komo pū ana i ka proton therapy a me ka stereotactic radiosurgery.

• Nā mālama hou. Ke aʻo nei nā hoʻokolohua klinika i nā mālama hou no ka skull base chordoma, e komo pū ana i nā mālama hou e hoʻonohonoho i nā nāwaliwali kūikawā i nā sela chordoma. Inā makemake ʻoe e ho'āʻo i kēia mau mālama hou, e kūkākūkā i nā koho me kāu kauka.

ʻOki kino. Hoʻomaka pinepine ka mālama ʻana me kahi hana e wehe ai i ka nui o ka maʻi kanesa e hiki ai me ka ʻole o ka hōʻino ʻana i nā mea ola maikaʻi kokoke a i ʻole ke kumu i nā pilikia hou, e like me ka hōʻino ʻana i ka lolo a i ʻole ke kaula kua. Hiki ʻole ke wehe piha inā kokoke ka maʻi kanesa i nā ʻano koʻikoʻi, e like me ka carotid artery.

I kekahi mau kūlana, hiki i nā kauka ʻoki ke hoʻohana i nā ʻano hana kūikawā, e like me ka endoscopic surgery e komo i ka maʻi kanesa. ʻO ka endoscopic skull base surgery kahi ʻano hana liʻiliʻi e komo pū ana i ka hoʻohana ʻana i kahi tube lōʻihi, lahilahi (endoscope) i hoʻokomo ʻia ma o ka ihu e komo i ka maʻi kanesa. Hiki ke hoʻoili ʻia nā mea hana kūikawā ma o ka tube e wehe i ka maʻi kanesa.

Maʻamau ʻole, hiki i nā kauka ʻoki ke ʻōlelo aku i kahi hana hou e wehe ai i ka nui o ka maʻi kanesa e hiki ai a i ʻole e hoʻopaʻa i kahi i loaʻa ai ka maʻi kanesa.

Radiation therapy. Hoʻohana ka radiation therapy i nā kukuna kiʻekiʻe, e like me nā X-rays a i ʻole nā ​​proton, e pepehi i nā sela kanesa. Hoʻomaopopo pinepine ʻia ka radiation therapy ma hope o ka ʻoki kino no ka skull base chordoma e pepehi i nā sela kanesa i koe. Inā ʻaʻole he koho ka ʻoki kino, hiki ke ʻōlelo ʻia ka radiation therapy ma kahi.

ʻO nā ʻano hana radiation therapy e hoʻonohonoho pono i ka mālama ʻana e ʻae i nā kauka e hoʻohana i nā nui radiation kiʻekiʻe, ka mea e ʻoi aku ka maikaʻi no ka chordoma. ʻO kēia mau mea e komo pū ana i ka proton therapy a me ka stereotactic radiosurgery.

Hiki i nā pōʻino o ke kōpū kuamoʻo ke hoʻokumu i nā hōʻailona a me nā hōʻailona like ʻole, ʻoi aku hoʻi i ka ulu ʻana o nā pōʻino. Hiki i nā pōʻino ke hoʻopilikia i kou kōpū kuamoʻo a i ʻole nā ​​aʻa o nā aʻalolo, nā kīʻaha koko a i ʻole nā ​​iwi o kou kua. Hiki i nā hōʻailona a me nā hōʻailona ke komo pū me: ʻEha ma kahi o ka pōʻino ma muli o ka ulu ʻana o ka pōʻino ʻEha kua, pinepine e pālahalaha ana i nā ʻāpana ʻē aʻe o kou kino ʻOi aku ka liʻiliʻi o ka ʻike i ka ʻeha, ka wela a me ke anu Nalo o ka hana o ka ʻōpū a i ʻole ka ʻōpū Paʻakikī ke hele, i kekahi manawa e alakaʻi ai i ka hāʻule ʻEha kua e ʻoi aku ka ʻino i ka pō Nalo o ka manaʻo a i ʻole ka nāwaliwali o nā ʻiʻo, ʻoi aku hoʻi i kou mau lima a i ʻole nā ​​wāwae Nāwaliwali o nā ʻiʻo, hiki ke māmā a i ʻole koʻikoʻi, ma nā ʻāpana like ʻole o ke kino ʻO ka ʻeha kua kahi hōʻailona mua maʻamau o nā pōʻino o ke kōpū kuamoʻo. Hiki nō hoʻi ke pālahalaha aku ka ʻeha ma mua o kou kua i kou mau hāhā, nā wāwae, nā wāwae a i ʻole nā ​​lima a hiki ke ʻoi aku ka ʻino ma mua o ka manawa - ʻoiai me ka mālama ʻana. Ke holomua nei nā pōʻino o ke kōpū kuamoʻo ma nā wikiwiki like ʻole ma muli o ke ʻano o ka pōʻino. He nui nā kumu o ka ʻeha kua, a ʻaʻole i hana ʻia ka hapa nui o ka ʻeha kua e kahi pōʻino. Akā, no ka mea he mea nui ka ʻike mua ʻana a me ka mālama ʻana i nā pōʻino o ke kōpū kuamoʻo, e ʻike i kāu kauka e pili ana i kou ʻeha kua inā: He mau a holomua ia ʻAʻole pili ia i ka hana Ke ʻoi aku ka ʻino i ka pō Loaʻa iā ʻoe ka mōʻaukala o ka maʻi kanesa a hoʻomohala i ka ʻeha kua hou Loaʻa iā ʻoe nā hōʻailona ʻē aʻe o ka maʻi kanesa, e like me ka luaʻi, ka luaʻi a i ʻole ka dizziness E ʻimi koke i ka mālama lapaʻau inā ʻike ʻoe: Ke holomua nei ka nāwaliwali o nā ʻiʻo a i ʻole ka numbness i kou mau wāwae a i ʻole nā ​​lima Hoʻololi i ka hana o ka ʻōpū a i ʻole ka ʻōpū

He nui nā kumu o ka ʻeha kua, a ʻo ka hapa nui o ka ʻeha kua ʻaʻole ia i hana ʻia e ka ʻaʻai. Akā, no ka mea he mea nui ka ʻike mua ʻana a me ka mālama ʻana i nā ʻaʻai o ke kua, e ʻike i kāu kauka e pili ana i kou ʻeha kua inā: He mau a holomua ia ʻAʻole pili ia i ka hana Ke ʻoi aku ka ʻino i ka pō Loaʻa iā ʻoe kahi moʻolelo o ka maʻi kanesa a hoʻomohala i ka ʻeha kua hou Loaʻa iā ʻoe nā hōʻailona ʻē aʻe o ka maʻi kanesa, e like me ka luaʻi, ka luaʻi ʻana a i ʻole ka luhi E ʻimi koke i ka mālama lapaʻau inā ʻike ʻoe i: Ka nāwaliwali o nā ʻiʻo a i ʻole ka ʻeha ʻole i kou mau wāwae a i ʻole nā lima Loli i ka hana o ka ʻōpū a i ʻole ka ʻōpū

ʻAʻole maopopo ke kumu o ka hapa nui o nā ʻōpū o ke kua. Manaʻo nā loea he kuleana ko nā gene hemahema. Akā ʻaʻole maopopo pinepine inā ua hoʻoilina ʻia kēlā mau hemahema genetic a i ʻole ua ulu wale ma mua o ka manawa. Hiki paha iā lākou ke kumu ʻia e kekahi mea i loko o ke kaiapuni, e like me ka hōʻike ʻia ʻana i kekahi mau kemika. I kekahi mau hihia, eia naʻe, pili nā ʻōpū o ke kaula kua i nā maʻi hoʻoilina i ʻike ʻia, e like me ka neurofibromatosis 2 a me ka maʻi von Hippel-Lindau.

ʻOi aku ka nui o nā maʻi ʻaʻai o ka iwi kuamoʻo i nā kānaka me: Neurofibromatosis 2. I kēia maʻi hoʻoilina, ulu nā maʻi ʻaʻai maikaʻi ʻole ma luna a i ʻole kokoke i nā aʻalolo e pili ana i ka lohe. Hiki paha kēia ke alakaʻi i ka emi ʻana o ka lohe ma kekahi pepeiao a i ʻole nā ​​pepeiao ʻelua. Hoʻomohala kekahi poʻe me ka neurofibromatosis 2 i nā maʻi ʻaʻai o ka ʻōpū kuamoʻo. Maʻi Von Hippel-Lindau. Hoʻopili ʻia kēia maʻi ʻano maʻamau, multisystem me nā maʻi ʻaʻai o nā kīʻaha koko (hemangioblastomas) i ka lolo, retina a me ka iwi kuamoʻo a me nā ʻano maʻi ʻaʻai ʻē aʻe i nā puʻupaʻa a i ʻole nā ​​glands adrenal.

Hiki i nā ʻōpū o ke kua ke kāomi i nā aʻalolo o ke kua, e alakaʻi ana i ka nalowale o ka neʻe ʻana a i ʻole ka manaʻo ma lalo o kahi o ka ʻōpū. Hiki i kēia ke hoʻololi i ke ʻano o ka ʻōpū a me ka ʻeke. Hiki paha ke mau loa ka poino o ka aʻalolo. Eia naʻe, inā loaʻa koke a mālama ʻia me ka ikaika, hiki paha ke pale aku i ka nalowale hou aku o ka hana a hoʻihoʻi hou i ka hana o ka aʻalolo. Ma muli o kona wahi, hiki i kahi ʻōpū e kāomi ana i ke kua o ke kua ke hoʻoweliweli i ke ola.

ʻO ka manawa kekahi, hiki ke nānā ʻole ʻia nā ʻōpū o ke kua no ka mea ʻaʻole lākou he mea maʻamau a ua like ko lākou mau hōʻailona me nā kūlana maʻamau. No kēlā kumu, he mea nui loa ia e ʻike kāu kauka i kāu moʻolelo lapaʻau piha a hana i nā hoʻokolohua kino maʻamau a me nā hoʻokolohua neurological.

Inā manaʻo kāu kauka he ʻōpū o ke kua, hiki i kēia mau hoʻokolohua ke kōkua i ka hōʻoia ʻana i ka maʻi a me ka kuhikuhi ʻana i ka wahi o ka ʻōpū:

• Kiʻi resonance magnetic o ke kua (MRI). Hoʻohana ka MRI i kahi kahua magnetic ikaika a me nā nalu radio e hana i nā kiʻi pololei o kou kua, ke kaula kua a me nā aʻalolo. ʻO ka MRI ka hoʻokolohua maʻamau i makemake ʻia e ʻike i nā ʻōpū o ke kaula kua a me nā pūnaewele a puni. Hiki ke hoʻokomo ʻia i loko o kahi vein ma kou lima a i ʻole lima hema kahi mea hoʻohui e kōkua ana i ka hoʻomālamalama ʻana i kekahi mau pūnaewele a me nā ʻano i ka wā o ka hoʻokolohua.

Hiki i kekahi poʻe ke manaʻo claustrophobic i loko o ka mīkini MRI a i ʻole e ʻike i ka leo nui e hoʻopilikia ana. Akā, maʻamau ʻoe e loaʻa i nā earplugs e kōkua i ka walaʻau, a ua hoʻolako ʻia kekahi mau mīkini me nā kīwī a i ʻole nā ​​headphones. Inā hopohopo nui ʻoe, e nīnau e pili ana i kahi sedative māmā e kōkua i ka mālie ʻana iā ʻoe. I kekahi mau kūlana, pono paha kahi anesthetic maʻamau.

Kiʻi resonance magnetic o ke kua (MRI). Hoʻohana ka MRI i kahi kahua magnetic ikaika a me nā nalu radio e hana i nā kiʻi pololei o kou kua, ke kaula kua a me nā aʻalolo. ʻO ka MRI ka hoʻokolohua maʻamau i makemake ʻia e ʻike i nā ʻōpū o ke kaula kua a me nā pūnaewele a puni. Hiki ke hoʻokomo ʻia i loko o kahi vein ma kou lima a i ʻole lima hema kahi mea hoʻohui e kōkua ana i ka hoʻomālamalama ʻana i kekahi mau pūnaewele a me nā ʻano i ka wā o ka hoʻokolohua.

Hiki i kekahi poʻe ke manaʻo claustrophobic i loko o ka mīkini MRI a i ʻole e ʻike i ka leo nui e hoʻopilikia ana. Akā, maʻamau ʻoe e loaʻa i nā earplugs e kōkua i ka walaʻau, a ua hoʻolako ʻia kekahi mau mīkini me nā kīwī a i ʻole nā ​​headphones. Inā hopohopo nui ʻoe, e nīnau e pili ana i kahi sedative māmā e kōkua i ka mālie ʻana iā ʻoe. I kekahi mau kūlana, pono paha kahi anesthetic maʻamau.

• Computerized tomography (CT). Hoʻohana kēia hoʻokolohua i kahi kukuna radiation lahilahi e hana i nā kiʻi kikoʻī o kou kua. I kekahi manawa, hui pū ʻia me kahi kala hoʻohui e hoʻomaʻalahi i ka ʻike ʻana i nā loli ʻole i loko o ke kahawai kua a i ʻole ke kaula kua. Hoʻohana wale ʻia ka CT scan e kōkua i ka ʻike ʻana i nā ʻōpū o ke kua.
• Biopsy. ʻO ke ala wale nō e hoʻoholo ai i ke ʻano pololei o kahi ʻōpū o ke kua, ʻo ia ka nānā ʻana i kahi laʻana liʻiliʻi o ka pūnaewele (biopsy) ma lalo o ka microscope. E kōkua nā hopena biopsy i ka hoʻoholo ʻana i nā koho mālama.