Paraganglioma

I-paraganglioma uhlobo lokukhula kwamaselula okungahle kwenzeke ezindaweni ezahlukene emzimbeni. Lokhu kukhula, okubizwa ngokuthi i-tumor, kuvela ohlotsheni olukhulu lweselula yethumbu elisekhona emzimbeni wonke. I-Paragangliomas iqala kakhulu ekhanda, entanyeni, endaweni yesisu noma emathangeni.

I-paraganglioma iyinto engavamile. Futhi ngokuvamile, akuyona i-cancer. Uma i-tumor ingelona i-cancer, kubizwa ngokuthi i-benign. Ngezinye izikhathi i-paraganglioma iyona i-cancer. I-tumor ye-cancer ingasakazeka kwezinye izingxenye zomzimba.

I-Paragangliomas ngokuvamile ayinazizathu ezicacile. Ezinye i-paragangliomas zibangelwa ukuguqulwa kwe-DNA okuvela kubazali kubantwana.

I-Paragangliomas ingakha kunoma iyiphi iminyaka. Ochwepheshe bezempilo bavame ukuyithola kubantu abadala abaneminyaka engama-20 kuya kwengu-50.

Ukuphathwa kwe-Paraganglioma ngokuvamile kuhilela ukuhlinzwa kokususa i-tumor. Uma i-paraganglioma iyona i-cancer futhi isakazeka kwezinye izingxenye zomzimba, kungase kudingeke ukwelashwa okwengeziwe.

Amasimptomu e-paraganglioma angase ahluke kuye ngokuthi isibopho siqala kuphi. I-Paragangliomas iqala kakhulu ekhanda, entanyeni, endaweni yesisu noma emathangeni. Amasimptomu e-paraganglioma ekhanda noma entanyeni angafaka: umsindo ophefumula noma ophefumula ngendlela ephindaphindayo ezindlebeni, okuthiwa yi-pulsatile tinnitus. Ubunzima bokuginya. Izwi elihlwithiwe. Ukwehluleka kokuzwa. Ukubona okungacaci. Ukuqina. Amasimptomu e-paraganglioma endaweni yekhanda nentanyeni angase enzeke njengoba isibopho sikhuphuka. Isibopho singacindezela izakhiwo eziseduze. Uma i-paragangliomas yenzeka kwezinye izindawo emzimbeni, amasimptomu anethuba elikhulu lokuba abangelwe yi-hormones eyenziwa yi-paraganglioma. I-hormones, ebizwa ngokuthi yi-catecholamines, idlala indima endleleni umzimba uphendula ngayo ekuhluphekeni. Ihlanganisa i-adrenaline, eyaziwa nangokuthi yi-hormone yokulwa-noma-ukubaleka. Amasimptomu e-paragangliomas ezenza i-hormones afaka: Ukuphindaphindiwe kwegazi. Ukuzizwa kokuba nenhliziyo eshaya ngokushesha, ehlwitha noma eshaya. Ukulahlekelwa kwesikhathi esisheshayo kombala ebusweni. Ukukhishwa. I-Headache. Ukuxubha okungenakulawulwa ezandleni noma ezingalweni. Ubuthakathaka obukhulu. La masimptomu angase eze futhi ahambe. Abanye abantu abane-paragangliomas abanamasimptomu. Bangase bafunde ukuthi banezi-tumors uma ukuhlolwa kwezithombe okwenziwe ngezizathu ezingezona zabo kuqaphela i-tumors. Yenza i-aphoyintimenti nodokotela noma omunye ochwepheshe wezempilo uma ukhathazekile ukuthi ungase ube namasiptomu e-paraganglioma. Lokhu kubalulekile uma unemasimptomu amaningi e-paraganglioma ngesikhathi esifanayo. Khuluma nochwepheshe wakho wezempilo ngengozi yakho ye-paraganglioma uma unegazi eliphezulu elikhathazayo ukulawula. Lokhu kuhlanganisa ukucindezeleka kwegazi okudinga ukwelashwa ngemithi engaphezu kwesisodwa. Khuluma nochwepheshe wakho wezempilo uma ukucindezeleka kwegazi kwakho kuphakama ngezikhathi ezithile lapho wena noma ochwepheshe wezempilo ukulinganisa.

Bopha i-aphoyintimenti nodokotela noma omunye ochwepheshe wezempilo uma ukhathazekile ukuthi ungase ube nezimpawu ze-paraganglioma. Lokhu kubalulekile uma unezimpawu eziningi ze-paraganglioma ngesikhathi esifanayo. Khuluma nochwepheshe wakho wezempilo ngengozi yakho ye-paraganglioma uma une-high blood pressure okunzima ukuyilawula. Lokhu kuhlanganisa i-high blood pressure edinga ukwelashwa ngemithi engaphezu kwemithi eyodwa. Khuluma futhi nochwepheshe wakho wezempilo uma izinga lakho le-blood pressure likhuphuka ngezikhathi ezithile lapho wena noma ochwepheshe wezempilo elikala.

Ama-paraganglioma avame ukungabi naso isizathu esicacile. Ngezinye izikhathi lezi zinhlobo zemikhuhlane zidlulela emindenini. Zingabangelwa yizinguquko ze-DNA ezidluliselwa kubazali kubantwana. Kodwa abantu abaningi abane-paraganglioma abanawo umlando womndeni walezi zinhlobo zemikhuhlane futhi isizathu asiwaziwa. I-paraganglioma iwukukhula kwamaselula. Yakhiwa uhlobo lweselula yethumbu ebizwa ngokuthi iselula ye-chromaffin. Amashejuli e-chromaffin aqeda imisebenzi ebalulekile emzimbeni, okuhlanganisa nokulawula ukucindezeleka kwegazi. I-paraganglioma iqala lapho amasselula e-chromaffin ehlanganisa izinguquko ku-DNA yawo. I-DNA yeselula igcina imiyalo eyalela iselula ukuthi yenze ini. Emashejuli aphilile, i-DNA inikeza imiyalo yokukhula nokukhulisa ngesivinini esibekiwe. Imiyalo iphinde iyalela amasselula ukuthi afe ngesikhathi esibekiwe. Emashejuli e-paraganglioma, izinguquko ze-DNA zinikeza imiyalo ehlukile. Izingqungquthela ziyalela amasselula e-paraganglioma ukuba enze amasselula amaningi ngokushesha. Amashejuli aqhubeka ephila lapho amasselula aphilile efa. Lokhu kubangela ukukhula kwamaselula okuthiwa yi-tumor. Ama-paraganglioma amaningi ahlala lapho aqale khona. Awasabeli ezingxenyeni eziningi zomzimba. Kodwa ngezinye izikhathi amasselula angaphula ukusuka kwi-paraganglioma futhi asakazeke. Uma lokhu kwenzeka, kubizwa ngokuthi i-paraganglioma e-metastatic. Uma i-paraganglioma isakazeka, ivame ukusakazeka kuma-lymph nodes aseduze. Ingasakazeka nasemiphungeni, e-liver nasemathanjeni. I-paraganglioma ihlobene eduze ne-tumor enye eyingqayizivele ebizwa ngokuthi i-pheochromocytoma. I-pheochromocytoma iwumkhuhlane oqala e-chromaffin cells e-adrenal glands. I-adrenal glands yizitho ezimbili ezihlala phezulu kwezinso.

Ingozi yokuba ne-paraganglioma iphakeme kubantu abanemlando womndeni walolu hlobo lwesihlungu. Ezinye i-paragangliomas zibangelwa yizinguquko ze-DNA ezivela kubazali ziye kubantwana. Ukuba nomlando womndeni we-paraganglioma kungaba uphawu lokuthi izinguquko ezithile ze-DNA zikhona emndenini wakho.

Ezinye izimo zezempilo ezingelwe yizinguquko ze-DNA ezivela kubazali ziye kubantwana zikhuphula ingozi ye-paragangliomas. Lezi zimo zihlanganisa:

• I-Multiple endocrine neoplasia, uhlobo 2. I-Multiple endocrine neoplasia, uhlobo 2, ebizwa nangokuthi yi-MEN 2, ingabangela izihlungu kwenye noma ngaphezulu kwezinye izicubu ezakha ama-hormone, kuhlanganise ne-thyroid ne-parathyroid glands. Kukhona izinhlobo ezimbili ze-MEN 2 — uhlobo 2A nohlobo 2B. Zombili zikhuphula ingozi ye-paragangliomas.
• I-Von Hippel-Lindau disease. I-Von Hippel-Lindau disease ingabangela ukuba kube khona izihlungu ne-cysts eziningi emzimbeni. Izindawo ezingase zibe khona zihlanganisa ubuchopho, i-spinal cord nezinso.
• I-Neurofibromatosis 1. I-Neurofibromatosis 1 ibangela izihlungu ezibizwa ngokuthi yi-neurofibromas ezikhula esikhunwini. Lesi simo singabangela nezihlungu ze-optic nerve. I-optic nerve yintombiyane esemva kwamehlo ehlanganisa nobuchopho.
• I-Hereditary paraganglioma syndromes. I-Hereditary paraganglioma syndromes ingabangela i-pheochromocytomas noma i-paragangliomas. Abantu abanesimo esinjalo bavame ukuba ne-paraganglioma engaphezu kwesinye.
• I-Carney-Stratakis dyad. I-Carney-Stratakis dyad ibangela izihlungu zesisu ne-paragangliomas.

Ukuxilongwa kwe-paraganglioma kuqala ngokuvamile ngezivivinyo zegazi nezinye ze-urine. Lezi zivivinyo zingabukela izimpawu zokuthi i-tumor yenza ama-hormone engeziwe. Ezinye izivivinyo zingafaka izivivinyo ze-imaging nezivivinyo ze-genetic.

Izivivinyo zegazi nezinye ze-urine zingalinganisa amazinga ama-hormone emzimbeni. Zingase zithole ama-hormone engeziwe e-catecholamine enziwe yi-paraganglioma. Noma zingase zithole ezinye izimpawu ze-paraganglioma njengopuroteni oluthiwa yi-chromogranin A.

Uchwepheshe wakho wezokunakekelwa kwezempilo angase akukhuthaze izivivinyo ze-imaging uma izimpawu zakho, umlando womndeni, noma izivivinyo zegazi nezinye ze-urine zikhomba ukuthi ungase ube ne-paraganglioma. Lezi zithombe zingabonisa indawo nobukhulu be-tumor. Zingase futhi zisize ukuqondisa izinketho zakho zokwelashwa.

Lezi zivivinyo ze-imaging zilandelayo zingase zisetshenziswe ku-paraganglioma:

• Magnetic resonance imaging, ebizwa nangokuthi yi-MRI, isebenzisa amaza omsakazo nensimu yama-magnetic ukwenza izithombe ezinemininingwane.
• I-Computerized tomography scan, ebizwa nangokuthi yi-CT scan, ihlanganisa uchungechunge lwezithombe ze-X-ray ezithathwe emakhoneni ahlukahlukene emzimbeni.
• I-Metaiodobenzylguanidine scan, ebizwa nangokuthi yi-MIBG scan, ithola i-tracer eradioactive eyongezwe ephuzwe yi-paragangliomas.
• I-Positron emission tomography scan, ebizwa nangokuthi yi-PET scan, nayo ithola i-tracer eradioactive ephuzwe yi-tumor.

Ezinye izinguquko ze-DNA ezidluliselwe kubazali kubantwana zenza i-paragangliomas kube lula ukwakha. Uma une-paraganglioma, uchwepheshe wakho wezokunakekelwa kwezempilo angase akukhuthaze ukuhlolwa kwe-genetic ukubukela lezi zinguquko ze-DNA emzimbeni wakho. Imiphumela yokuhlolwa kwe-genetic ingasiza ukubikezela amathuba e-tumor yakho ukubuya ngemuva kokwelashwa.

Abazali bakho, abantwana bakho noma abazalwane bakho bangahlolwa futhi ngezinguquko ze-DNA ezandisa ingozi ye-paragangliomas. Iqembu lakho lokunakekelwa kwezempilo lingase likukhombe kuconsultant we-genetic noma omunye uchwepheshe wezokunakekelwa kwezempilo oqeqeshwe e-genetics. Lo muntu angakusiza wena nabathandekayo bakho ukuba unqume ukuthi uzothola yini ukuhlolwa kwe-genetic.

Ngokuvamile, ukwelashwa kwe-paraganglioma kuhilela ukuhlinzwa kokususa isibopho. Uma isibopho lenza ama-hormone, ochwepheshe bezempilo bavame ukusebenzisa imithi ukuvimba ama-hormone kuqala. Uma i-paraganglioma ingasuswa ngokuhlinzwa noma isakazeka, ungase udinga ezinye izindlela zokwelapha. Izinketho zakho zokwelapha ze-paraganglioma ziyahlukahluka kuye ngezinto eziningi. Lezi zihlanganisa: Indawo lapho isibopho sikhona khona. Uma singumdlavuza futhi sisakazeke kwezinye izingxenye zomzimba. Uma yenza ama-hormone engeziwe abangela izimpawu. Izinketho zokwelapha zihlanganisa: Izindlela zokwelapha zokulawula ama-hormone enziwa yisibopho Uma i-paraganglioma yakho yenza ama-catecholamines engeziwe, cishe uzodinga izindlela zokwelapha zokuvimba imiphumela noma ukunciphisa amazinga ala ma-hormone. Lezi zindlela zokwelapha zinciphisa ukucindezeleka kwegazi eliphezulu futhi zilawula ezinye izimpawu. Kubalulekile ukuthi ukucindezeleka kwegazi kanye nezimpawu zibe ngaphansi kolawulo ngaphambi kokuba ukwelashwa kwe-paraganglioma kuqale. Lokho kungenxa yokuthi ukwelashwa kungabangela isibopho ukukhulula inani elikhulu kakhulu lama-catecholamines futhi lokho kungabangela izinkinga ezinkulu. Imithi esetshenziswa ukulawula imiphumela ye-catecholamine ihlanganisa eminye imithi yokucindezeleka kwegazi. Le mithi ihlanganisa abaqaphi be-alpha, abaqaphi be-beta kanye nabaqaphi be-calcium channel. Ezinye izindlela zingase zihlanganise ukudla ukudla okunosadium eliphezulu nokuphakelwa amanzi amaningi. Ukuhlinzwa Ukuhlinzwa kungenziwa ukususa i-paraganglioma. Ngisho noma i-paraganglioma ingasuswa ngokuphelele, ochwepheshe bakho bezempilo bangase bancoma ukuhlinzwa ukususa ingxenye enkulu yesibopho. Uhlobo lokuhlinzwa olusetshenziswa ukususa i-paraganglioma luyahlukahluka kuye ngokuthi likuphi. Indawo yesibopho iphinde inqamule uhlobo lochwepheshe oqondene nokuhlinzwa. Isibonelo: Izibopho ezikumakhanda nasezintamini zingase ziphathwe ochwepheshe bemakhanda nezintamini. Izibopho ezithinta ubuchopho, umgogodla nezinzwa zingase ziphathwe ochwepheshe bezinso. Izibopho ezithinta amagciwane akhiqiza ama-hormone zingase ziphathwe ochwepheshe bezinto ezikhiqiza ama-hormone. Izibopho ezithinta imithambo yegazi zingase ziphathwe ochwepheshe bemithambo yegazi. Ngezinye izikhathi ochwepheshe bokuhlinzwa abavela ezinhlotsheni ezahlukene basebenzisana ngesikhathi sokuhlinzwa kwe-paraganglioma. Ukwelashwa ngomgogodla Ukwelashwa ngomgogodla kusebenzisa imisebe yamandla enamandla ukwelapha izibopho. Amandla angase avela kuma-X-rays, amaprotons noma ezinye imithombo. Ochwepheshe bakho bezempilo bangase bancome ukwelashwa ngomgogodla uma i-paraganglioma yakho ingasuswa ngokuphelele ngokuhlinzwa. Ukwelashwa ngomgogodla kungasiza futhi ekuqedeni ubuhlungu obubangelwa yi-paraganglioma esakazeke kwezinye izingxenye zomzimba. Ngezinye izikhathi uhlobo oluhlukile lokwelashwa ngomgogodla oluthiwa yi-stereotactic radiosurgery lusetshenziswa ukwelapha ama-paragangliomas ekhanda nasezintamini. Lolu hlobo lokwelashwa luqondisa imisebe eminingi yamandla esibophweni. Umsebe ngamunye awunamandla kakhulu. Kodwa indawo lapho imisebe ihlangana khona ithola inani elikhulu lokwelashwa ngomgogodla ukubulala amakhemikhali esibopho. Ukwelashwa kwe-ablation Ukwelashwa kwe-ablation kusebenzisa ukushisa noma ukuqandisa ukubulala amakhemikhali esibopho nokulawula ukukhula kwe-paraganglioma. Lokhu kungase kube yisinqumo uma i-paraganglioma isakazeke kwezinye izingxenye zomzimba. Ukwelashwa kwe-radiofrequency ablation kusebenzisa amandla kagesi ukushisa amakhemikhali esibopho. Olunye uhlobo lokwelashwa oluthiwa yi-cryoablation lusebenzisa igesi ebandayo ukuqandisa amakhemikhali esibopho. Ukwelashwa nge-chemotherapy Ukwelashwa nge-chemotherapy kuyindlela yokwelapha esebenzisa imithi enamandla. Uma i-paraganglioma yakho isakazeke, ochwepheshe bakho bezempilo bangase bancome i-chemotherapy ukusiza ukunciphisa izibopho. Uma i-paraganglioma yakho yenza ama-hormone engeziwe, uthola imithi yokulawula amazinga e-hormone ngaphambi kokuqala i-chemotherapy. Ukwelashwa okuqondiswe Ukwelashwa okuqondiswe kusebenzisa imithi ehlasela amakhemikhali athile kumakhemikhali esibopho. Ngokuvimba lawa makhemikhali, izindlela zokwelapha eziqondiswe zingabangela ukuba amakhemikhali esibopho afe. Nge-paraganglioma, imithi yokwelapha eqondiswe ingase isetshenziswe uma ukuhlinzwa kungelona isikhethi. Ukwelashwa okuqondiswe kungase futhi kusetshenziswe uma isibopho sisakazeka kwezinye izingxenye zomzimba. Ukwelashwa kwe-peptide receptor radionuclide Ukwelashwa kwe-peptide receptor radionuclide, okuthiwa yi-PRRT, kusebenzisa imithi ukunika ukwelashwa ngomgogodla ngqo kumakhemikhali esibopho. Imithi ihlanganisa into ethola amakhemikhali esibopho kanye nento enomgogodla. Imithi inikezwa ngomthambo. Imithi iyahamba emzimbeni futhi inamathela kumaseli e-paraganglioma. Ezinsukwini kuya emavikini, imithi inikeza ukwelashwa ngomgogodla ngqo kumakhemikhali esibopho. Imithi eyenza ngale ndlela yi-lutetium Lu 177 dotatate (Lutathera). Ingase isetshenziswe uma ukuhlinzwa kungelona isikhethi noma uma i-paraganglioma isakazeka kwezinye izingxenye zomzimba. Izivivinyo zeklinikhi Izivivinyo zeklinikhi ziyizifundo zezindlela zokwelapha ezintsha noma izindlela ezintsha zokusebenzisa izindlela zokwelapha ezindala. Uma unesithakazelo ezivivinyweni zeklinikhi ze-paraganglioma, xoxa nochwepheshe bakho bezempilo ngezinketho zakho. Ndingasebenzisana nawe ukuqhathanisa izinzuzo nezingozi zezindlela zokwelapha ezihlolwa abacwaningi. Ukulinda okuqaphayo Ngezinye izikhathi, ochwepheshe bezempilo bancoma ukungaqali ukwelashwa kwe-paraganglioma ngokushesha. Esikhundleni salokho, bangase bakhethe ukubuka isimo sakho eduze ngokuhlola impilo njalo. Lokhu kuwaziwa ngokuthi ukulinda okuqaphayo. Isibonelo, ukulinda okuqaphayo kungase kube yisinqumo uma i-paraganglioma ikhula kancane futhi ayibangeli izimpawu. Ulwazi Olwengeziwe Ukwelashwa kwe-ablation Ukwelashwa ngomgogodla Cela i-aphoyintimenti