Pheochromocytoma

I-pheochromocytoma (fee-o-kroe-moe-sy-TOE-muh) iwumdlavuza omningi ongapheliyo ekhula esinweni se-adrenal. Ngokuvamile, lo mdlavuza awuyona i-kensi. Uma umdlavuza ungeyona i-kensi, ubizwa ngokuthi ungcolile. Unamasinweni amabili e-adrenal - omunye phezulu kwenyawo ngalinye. Amasinweni e-adrenal enza ama-homoni asisiza ukulawula izinqubo ezibalulekile emzimbeni, njengengcindezi yegazi. Ngokuvamile, i-pheochromocytoma yakha esinweni esisodwa se-adrenal. Kodwa imidlavuza ingakhula kuwo womabili amasimu e-adrenal. Ngo-pheochromocytoma, umdlavuza ukhulula ama-homoni angabangela izimpawu ezahlukene. Zihlanganisa ukuphakama kwegazi, ikhanda, ukukhishwa ukweluka nokuqala kwezinkinga zokukhathazeka. Uma i-pheochromocytoma ingaphathwa, ukulimala okukhulu noma okusongela impilo kwamanye amasimu omzimba kungenzeka. Ukuhlinzwa kokususa i-pheochromocytoma kuvame ukubuyisela ingcindezi yegazi kububanzi obuphilile.

I-pheochromocytoma ivame ikhiqiza izimpawu ezilandelayo: Izinga eliphezulu legesi. Ukuhlunguluka kwekhanda. Ukubila okukhulu. Ukushushumbisa okusheshayo. Abanye abantu abane-pheochromocytomas banesimpawu ezifana nalezi: Ukuxhaphaza okukhathazayo. Isikumba esiguqula umbala olukhanyayo, okuthiwa futhi i-pallor. Ukuqina komoya. Izimpawu ezifana nezehlakalo zokukhathazeka, ezingabandakanya ukwesaba okukhulu ngokuzumayo. Ukukhathazeka noma umuzwa wokuphela. Izinkinga zobuso. I-constipation. Ukulahlekelwa isisindo. Abanye abantu abane-pheochromocytomas abanasimpawu. Abaqapheli ukuthi banaleli-tumor kuze kube yilapho ukuhlolwa komfanekiso kuthola. Ngokuvamile, izimpawu ze-pheochromocytoma ziya futhi ziye. Uma ziqala ngokuzumayo futhi ziqhubeka zibuyela, zaziwa njenge-spells noma ukuhlaselwa. Lezi spells zingaba khona noma zingabi khona i-trigger engatholakala. Imisebenzi ethile noma izimo zingadala i-spell, ezifana nalezi: Umsebenzi onzima womzimba. Ukukhathazeka noma ukucindezeleka. Ukushintsha kwesimo somzimba, njengokuguqa, noma ukuphuma ekuhlaleni noma ekuphumuleni ukuya ekuma. Ukubeletha nokubeletha. Ukuhlinzwa neyethu elikwenza ube sesimweni sokulala ngesikhathi sokuhlinzwa, okuthiwa yi-anesthetic. Ukudla okunama-tyramine aphezulu, into ethonya izinga legesi, kungadala i-spells. I-Tyramine ivame ukuba ekudleni okuphekiwe, okudala, okugayiwe, okuphekwe, okuphelelwe yisikhathi noma okonakele. Lokhu kudla kufaka phakathi: Amanye ama-cheese. Amanye ama-beers namawayini. Ama-soybeans noma imikhiqizo eyenziwe nge-soy. I-chocolate. Inyama eyomile noma ebilisiwe. Imithi ethile neziyobisi ezingadala i-spells zifaka phakathi: Imithi yokucindezeleka ebizwa ngokuthi yi-tricyclic antidepressants. Ezinye izibonelo ze-tricyclic antidepressants yi-amitriptyline ne-desipramine (Norpramin). Imithi yokucindezeleka ebizwa ngokuthi yi-monoamine oxidase inhibitors (MAOIs), njenge-phenelzine (Nardil), i-tranylcypromine (Parnate) ne-isocarboxazid (Marplan). Ingozi ye-spells iphakeme kakhulu uma le mi thi ithathwa ngokudla noma iziphuzo ezineminyaka eminingi. Izithuthukisi ezifana ne-caffeine, i-amphetamines noma i-cocaine. Izinga eliphezulu legesi ingenye yezimpawu eziyinhloko ze-pheochromocytoma. Kodwa abantu abaningi abanokucindezeleka okuphezulu abanalo i-adrenal tumor. Khuluma nodokotela wakho uma ezinye zalezi zinto zikuthinta: I-spells yezimpawu ezihlobene ne-pheochromocytoma, njengokuhlunguluka kwekhanda, ukubila nokubetha okusheshayo, okukhulu. Ubunzima bokulawula izinga eliphezulu legesi ngokwelashwa kwakho kwamanje. Izinga eliphezulu legesi eliqala ngaphambi kweminyaka engu-20. Ukuphindaphinda kokunyuka okukhulu kwezinga legesi. Umlando womndeni we-pheochromocytoma. Umlando womndeni wesimo se-genetic esihlobene. Lokhu kufaka phakathi i-multiple endocrine neoplasia, uhlobo 2 (MEN 2), isifo se-von Hippel-Lindau, izimpawu ze-paraganglioma ezidluliselwa ezizukulwaneni kanye ne-neurofibromatosis 1.

Ukuphakama kwegazi kuyinye yezimpawu eziyinhloko ze-pheochromocytoma. Kodwa abantu abaningi abanokuphakama kwegazi abanawo i-adrenal tumor. Xoxa nodokotela wakho uma ezinye zalezi zinto zikuthinta: Izikhathi zezimpawu ezihlobene ne-pheochromocytoma, ezifana nokuhlunguluka kwekhanda, ukukhishwa lukhulu lwesweti kanye nokushaya kwenhliziyo okusheshayo, okuqatha. Ukuphazamiseka ekulawuleni ukuphakama kwegazi ngokwelashwa kwakho kwamanje. Ukuphakama kwegazi okuqala ngaphambi kweminyaka engama-20. Ukuphindaphinda kokunyuka okukhulu kwegazi. Umlando womndeni we-pheochromocytoma. Umlando womndeni wesimo sezofuzo esihambelanayo. Lokhu kuhlanganisa i-multiple endocrine neoplasia, uhlobo 2 (MEN 2), isifo se-von Hippel-Lindau, izimpawu ze-paraganglioma ezifuywe, ne-neurofibromatosis 1.

Abaphandi abaziqondi ngokucacile ukuthi yini ebangela ipheochromocytoma. I-tumor yakha ezicellulwini ebizwa ngokuthi yi-chromaffin cells. Lezi zicellu zitholakala ebukhoneni be-adrenal gland. Zikhulula ama-hormone athile, ikakhulukazi i-adrenaline ne-noradrenaline. La ma-hormone ayaluza ukusebenza kwamandla omzimba amaningi, njengokuthinta kwentliziyo, ukucindezeleka kwegazi kanye noshukela egazini. I-adrenaline ne-noradrenaline kuqalisa ukulwa noma ukubaleka komzimba. Lokho kuphendula kwenzeka lapho umzimba ucabanga ukuthi kukhona usongo. Ama-hormone abangela ukucindezeleka kwegazi ukuphakama kanye nentliziyo ukushaya ngokushesha. Zilungiselela nezinye izinhlelo zomzimba ukuze ukwazi ukuphendula ngokushesha. Ipheochromocytoma ibangela ukukhululwa okuningi kwala ma-hormone. Futhi kubangela ukuba akhululwe lapho ungekho esimweni esisongela. Iningi le-chromaffin cells lise-adrenal glands. Kodwa amaqembu amancane ala ma-cellu atholakala nentliziyweni, ekhanda, entanyeni, esibindini, endaweni yesisu kanye nohlangothini lwomgogodla. I-chromaffin cell tumors etholakala ngaphandle kwe-adrenal glands ibizwa ngokuthi yi-paragangliomas. Zingabangela imiphumela efanayo emzimbeni njengepheochromocytoma.

Abantu abane-MEN 2B banemikhuhlane yemisipha emaphethelweni, emlonyeni, emehlweni nasemgogweni wokugaya. Bangase futhi babe nomkhuhlane esigxotsheni se-adrenal, okuthiwa yi-pheochromocytoma, kanye nomdlavuza we-thyroid medullary.

Ubudala bomuntu nezinye izimo zezokwelapha zingandisa ingozi ye-pheochromocytoma.

I-pheochromocytomas eningi itholakala kubantu abaneminyaka ephakathi kwama-20 nama-50. Kodwa umkhuhlane ungakha kunoma yiliphi iminyaka.

Abantu abanemibandela ethile yofuzo elingavamile banengozi enkulu ye-pheochromocytomas. Imikhuhlane ingaba yiyona, okusho ukuthi ayilona umdlavuza. Noma ingaba yiyona, okusho ukuthi umdlavuza. Ngokuvamile, imikhuhlane enhle ehlobene nalezi zimo zofuzo yakha ezindaweni zombili ze-adrenal. Isimo sofuzo esihlangene ne-pheochromocytoma sifaka:

• I-neoplasia ephindwe kakhulu, uhlobo 2 (MEN 2). Lesi simo singabangela imikhuhlane engaphezu kwesinye isigaba sesistimu yokwenza ama-hormone omzimba, okuthiwa yi-endocrine system. Kunezinhlobo ezimbili ze-MEN 2 - uhlobo 2A nohlobo 2B. Zombili zingabandakanya i-pheochromocytomas. Eminye imikhuhlane ehlobene naleli simo ingabonakala kwezinye izingxenye zomzimba. Lezi zingxenye zomzimba zifaka i-thyroid, amagxotsheni e-parathyroid, izindebe, umlomo kanye nesistimu yokugaya.
• I-Von Hippel-Lindau disease. Lesi simo singabangela imikhuhlane ezingxenyeni eziningi zomzimba. Izindawo ezingase zibandakanye ubuchopho nomgogodla, uhlelo lwe-endocrine, i-pancreas kanye namakilogremu.
• I-Neurofibromatosis 1. Lesi simo sibangela imikhuhlane esikhunjeni okuthiwa yi-neurofibromas. Futhi singabangela imikhuhlane yemisipha ngemuva kweliso ehlanganisa ubuchopho, okuthiwa yi-optic nerve.
• I-Hereditary paraganglioma syndromes. Lezi zimo zidluliselwa emindenini. Zingabangela i-pheochromocytomas noma i-paragangliomas.

• Isifo senhliziyo.
• Isikhubekiso.
• Ukuhluleka kwesibindi.
• Ukwehluleka kobona.

Ngesikhathi esingavamile, ipheochromocytoma iyomdlavuza, futhi amangqamuzana omdlavuza asakazeka kwenye ingxenye yomzimba. Amangqamuzana omdlavuza asuka epheochromocytoma noma iparaganglioma ngokuvamile aya ohlelweni lwe-lymph, amathambo, isibindi noma amaphaphu.

Ukuthola ukuthi ukhona yini i-pheochromocytoma, ochwepheshe bakho bezempilo cishe bayokukhipha izilingo ezahlukene.

Lezi zilingo zilinganisa amazinga e-hormone adrenaline ne-noradrenaline, kanye nezinto ezingase zivela kulawo ma-hormone okuthiwa yi-metanephrines. Amazinga aphezulu e-metanephrines avame kakhulu lapho umuntu enesifo se-pheochromocytoma. Amazinga e-metanephrine cishe awaphezulu lapho umuntu enezimpawu ezingabangelwa yinto engaphandle kwe-pheochromocytoma.

• Uvivinyo lwegazi. Ochwepheshe bezempilo bathatha isampula legazi ukuze lihlolwe elabhoratri.

Kokubili izinhlobo zezilingo, buza ochwepheshe bakho bezempilo uma udinga ukwenza noma yini yokulungiselela. Isibonelo, ungase ucelwe ukuba ungadli isikhathi esithile ngaphambi kokuhlolwa. Lokhu kubizwa ngokuthi ukudla okulula. Noma ungase ucelwe ukuba ulahle ukusebenzisa imithi ethile. Ungalahli umthamo wemithi ngaphandle kokuthi ilungu leqembu lakho lezempilo likutshele ukuba wenze kanjalo futhi likunikeze imiyalo.

Uma imiphumela yokuhlolwa kwelebhu ithola izimpawu ze-pheochromocytoma, kuyadingeka ukuhlolwa kwezithombe. Ochwepheshe bakho bezempilo cishe bayokukhipha okukodwa noma ngaphezulu kwalawa ma-test ukuze bathole ukuthi une-tumor yini. Lezi zilingo zingafaka:

• I-CT scan, ehlanganisa uchungechunge lwemifanekiso ye-X-ray ethathwe emakhoneni ahlukene emzimbeni wakho.
• I-MRI, esebenzisa amaza omsakazo nendlela yamagnethi ukwenza imifanekiso eningiliziwe.
• I-M-iodobenzylguanidine (MIBG) imaging, isikhombisi esingatholakala amazinga amancane e-compound eradioactive eyongezwe. I-compound ithathwa yi-pheochromocytomas.
• I-Positron emission tomography (PET), isikhombisi esingatholakala futhi ama-compound eradioactive athathwe yi-tumor.

I-tumor e-adrenal gland ingatholakala ngesikhathi sezifundo zezithombe ezenziwe ngezizathu ezihlukene. Uma lokho kwenzeka, ochwepheshe bezempilo bavame ukukhipha izilingo eziningi ukuze bathole ukuthi i-tumor idinga ukwelashwa yini.

Ochwepheshe bakho bezempilo bangase bancoma izilingo ze-genetic ukuze babone ukuthi i-pheochromocytoma ihlobene yini nesimo se-genetic. Ulwazi mayelana nezici ezingase zibe yi-genetic lungabaluleka ngezizathu eziningi:

• Ezinye izimo ze-genetic zingabangela inkinga eyodwa yezokwelapha. Ngakho-ke, imiphumela yokuhlolwa ingase iphakamise isidingo sokuhlola ezinye izimo zezokwelapha.
• Ezinye izimo ze-genetic zivame kakhulu ukwenzeka futhi zibe yimpukane. Ngakho-ke, imiphumela yakho yokuhlolwa ingase ithonye izinqumo zokwelapha noma izinhlelo zesikhathi eside zokulandelela impilo yakho.
• Imiphumela yezilingo ingase iphakamise ukuthi amalungu omndeni afanele ahlolwe i-pheochromocytoma noma izimo ezihlobene.

Ukuqondisa nge-genetic kungakusiza ukuqonda imiphumela yokuhlolwa kwakho kwe-genetic. Kungasiza nomndeni wakho ukuphatha noma yiziphi izinkinga zempilo yengqondo ezihlobene nokucindezeleka kokuhlolwa kwe-genetic.