Yala gɛlɛya dɔ bɛ aw farikolo la joli-sira-funu-kɔnɔ-fɛnw na wa? An ka kuma Lymphoproliferative Disorders (LPD) kan!

Yala aw delila k’a mɛn ko sɔrɔdasi fitininw bɛ an fari la minnu b’an tanga banaw ma wa? O sɔrɔdasiw bɛ wele ko joli kuru finmanw. O joli kuru finmanw cɛma, suguya kɛrɛnkɛrɛnnen dɔ bɛ yen min bɛ wele ko lymphocytes . U ka baara kunba ye ka an farikolo tangacogo barika bonya u kɛtɔ ka juguw kɛlɛ i n’a fɔ banakisɛw ni banakisɛw minnu bɛ don an fari la, ani hali ka kansɛribanakisɛw tiɲɛ. Nka, tuma dɔw la, o sɔgɔsɔgɔninjɛw bɛ baara dabila ka ɲɛ, walima u bɛ daminɛ ka caya kojugu. O waati de la an bɛ bana kulu dɔ wele min bɛ wele ko Lymphoproliferative Disorders (LPDs) . Nin ye bana ye min man teli ka sɔrɔ. An ka kuma o kan ka ɲɛ, tiɲɛ tɛ?

Banakisɛfagalanw (LPD) ye mun ye? Yala suguya dɔw bɛ yen wa?

N’an y’a fɔ cogo nɔgɔman na, LPDw ye bana kulu ye minnu bɛ sɔrɔ ni an ka farikolojidɛsɛbanakisɛw, n’u bɛ wele ko lanposotiw, olu tɛ baara kɛ ka ɲɛ walima ni u bɛ bonya cogo la min tɛ se ka kunbɛn. Olu bɛ se ka tila kuluba fila ye.

1. LPDw (Immunologic Disorders) minnu bɛ tali kɛ farikolo tangalanw na

Nin LPD suguya ninnu bɛ an farikolo tangacogo tiɲɛ jamana wɛrɛw ka binkannikɛlaw fɛ. nin bana ninnu bɛ mɔgɔ minnu na , olu ka kansɛri sɔrɔli farati ka bon i n' a fɔ sɔgɔsɔgɔninjɛ .

• X-linked lymphoproliferative disorder (XLP): Ni nin bana in bɛ mɔgɔ min na, o tigi ye Epstein-Barr banakisɛ sɔrɔ , a bɛ se ka taa ɲɛ ka kɛ lanpoma ye.
• Sindrom autoimmune lymphoproliferative syndrome (ALPS): O ye ni farikolojidɛsɛbanakisɛ caman bɛ lajɛ yɔrɔw la i n’a fɔ an ka ɲɛgɛnɛsiraw, an ka sɔgɔsɔgɔninjɛ, ani sugunɛ, o bɛ kɛ sababu ye k’o farikolo yɔrɔw funu. A bɛ iko an yɛrɛ ka seliw bɛ ka ɲɔgɔn lajɛ dɔrɔn yɔrɔw la minnu tɛ se ka kunbɛn.
• Ɲɛgɛnɛsiraw falenni kɔfɛ (PTLD): Nin ye bana ye min man teli ka sɔrɔ nka a ka jugu. A bɛ se ka kɛ farikolo yɔrɔ dɔw cili kɔfɛ (misali la, sugunɛ, sugunɛ) walima allojenikiw cili kɔfɛ. O bɛ kɛ kɛrɛnkɛrɛnnenya la ni aw walima mɔgɔ min ye farikolo yɔrɔ walima jirisunw di, olu ye Epstein-Barr banakisɛ sɔrɔ, o min bɛ B-cellw minɛ.

2. Kansɛri minnu bɛ sɔrɔ joli la

Ninnu ye bana juguw ye an bɛ minnu mɛn tuma caman na, i n’a fɔ jolidɛsɛ ni jolidɛsɛ . Min bɛ kɛ yan, o ye ko joli kuru finman minnu bɛ an kolotugudaw ni joli la, n’o ye B-cell, T-cell ani Natural killer cellules (NK cellules) ye, olu bɛ tiɲɛ.Mutations, cellules abnormales minnu bɛ caya cogo la min tɛ se ka kunbɛn. O farikolokisɛ minnu tɛ cogo la, olu bɛ joli kuru kɛnɛmanw degun. Hali ni o banaw bɛ se ka furakɛ tuma dɔw la, bana jugumanbaw don minnu bɛ se ka mɔgɔ ka ɲɛnamaya bila farati la.

Kansɛri minnu bɛ sɔrɔ B-cell fɛ

Hodgkin tɛ farikolojidɛsɛ suguya wɛrɛ minnu bɛ don nin kulu in na olu ye:

• B-cell belebeleba min bɛ jɛnsɛn
• Follicules lymphome (banakisɛfagalan min bɛ wele ko folliculaire).
• Manto selilɛriw ka lanpomisɛnni

B-cell jolidɛsɛ suguya dɔw fana bɛ yen:

• Jolidɛsɛ basigilen (CLL): Yan, kolotugudaw la, B-cell normales bɛ caya kojugu, ka joli kuru kɛnɛmanw ni joli segin furakisɛw degun.
• B-cell prolymphocytic leukemia : Yan fana, B-cell minnu tɛ cogo la, olu bɛ ɲɔgɔn sɔrɔ kolotugudaw la, ka selilu kɛnɛmanw degun.
• Sugunɛbilenni : I n’a fɔ a tɔgɔ b’a jira cogo min na, o joli kuru finmanw tɔgɔ dara barisa u bɛ i n’a fɔ kunsigiw ni u lajɛra ni mikroskɔpu ye. U fana bɛ Kɛ kolotugudaw la wa u bɛ caya kojugu.

Kansɛri minnu bɛ sɔrɔ T-cell fɛ

T-cell ni bana minnu bɛ sɔrɔ, olu tilalen don kosɛbɛ kulu fila ye:

• T-cell lymphomes systémiques : Olu bɛ se ka nɔ bila aw ka ɲɛgɛnɛsiraw, aw ka ɲɛgɛnɛsiraw, aw ka kolotugudaw, joli ani farikolo yɔrɔ wɛrɛw la.
• Farikolo T-cell lymphomes (T-cell lymphomes) : Olu bɛ fari de minɛ kosɛbɛ, nka a bɛ se ka kɛ sababu ye tuma dɔw la ɲɛgɛnɛsiralabanaw, joli, kolotugudaw ani kɔnɔnafɛnw.

T-cell lymphome (banakisɛfagalanw) suguya caman bɛ yen minnu bɛ sɔrɔ farikolo la. A suguya minnu ka ca kosɛbɛ olu dɔw ye:

• T-cell lymphome périphérique, min ma ɲɛfɔ cogo wɛrɛ la (PTCL NOS) .
• Angioimmunoblastique T-cell lymphome (AITL) .
• Anaplastique cellules grandes lymphome (banakisɛfagalan belebelebaw).

A suguya dɔw fana bɛ yen minnu man ca:

• Sugunɛbilenni T-cell lymphome (HSTCL) .
• T-cell lymphome (EATL) min bɛ sɔrɔ kɔnɔbara basigilen fɛ .

T-cell lymphomes systemiques dɔw fana bɛ wele ko T-cell leukemias chroniques . Misaliw:

• T-cell prolymphocytic leukemia (T-PLL) .
• T-cell granulaire lymphocytique leukemia (T-LGL) .

Farikolo T-cell lymphoma suguya fitinin fila bɛ yen:

• Mikozi fungoïdes (mikose fungoïdes).
• Sézary ka bana ye

NK-cell ni bana minnu bɛ tali kɛ ɲɔgɔn na

Olu man ca kosɛbɛ wa u bɛ nɔ bila NK selilɛriw la.

• Extranodal NK T-cell lymphome nugu suguya
• Jolidɛsɛ jugumanba (AKNL) .
• NK-cell granulaire lymphocytique leukemia (NK-LGL) .

Sisan aw bɛ se k’a ye ko cogoya suguya caman bɛ dafa LPDw kɔnɔ. Aw man kan ka taa ɲɛ u kelen-kelen bɛɛ la, nka a nafa ka bon aw k’a dɔn ko nin bana in bɛ yen.

LPD taamasiɲɛw ye jumɛnw ye? I b’u dɔn cogo di?

Nin LPD ninnu taamasiɲɛw bɛ se ka ɲɔgɔn ta kosɛbɛ, ka kɛɲɛ ni LPD suguya ye min bɛ aw la. Nka taamasiɲɛ dɔw bɛ yen minnu ka teli ka ye, aw bɛ se ka minnu ye. An k’a lajɛ u ye fɛn minnu ye:

• Sumaya kojugu su fɛ: A tɛ kɛ sumaya dɔrɔn ye, nka a bɛ sumaya fo ka se finiw bɛ ɲigi.
• Ɲɛgɛnɛsiraw, sugunɛ walima kɔkili fununen: Ni aw ye kurukuruw ye yɔrɔw la i n’a fɔ kɔ, kɔkili walima kɔkili, walima ni funu dɔ bɛ aw kɔnɔbara la min tɛ deli ka kɛ, aw ka kan ka hami.
• Joli ni kurukuru minnu tɛ deli ka kɛ walima minnu ka ca kojugu: Ni aw bɛ joli bɔ ka caya hali ni joginda misɛnni dɔ kɛra, walima ni joginda buluw bɛ aw fari yɔrɔ dɔw la dɔrɔn.
• Sɛgɛn min bɛ to ka kɛ: I bɛ sɛgɛn hali ni i mana sunɔgɔ cogo o cogo.
• Sumaya ka teli: Ni farigan basigilen bɛ aw la kun t’a la.
• Banakisɛfagalanw tali ka teli: K’a sababu kɛ farikolo tangacogo dɔgɔyali ye, banaw bɛ se ka to aw la i n’a fɔ farigan ni mura.
• Anorexie: Dumuni t’a fɛ dusukunnata min na.
• Farikolo girinya dɔgɔyali min ɲɛfɔlen tɛ: Ni aw bɛ barika dɔgɔya ka sɔrɔ aw ma dumuni kɛ walima ka farikoloɲɛnajɛ kɛ, o fana ye taamasiɲɛ ye min ka kan ka aw janto a la.

Nafama: Aw kana siran ni nin taamasiɲɛ kelen walima fila bɛ aw la. U bɛ se ka sɔrɔ fana sababu wɛrɛw fɛ minnu ka nɔgɔn. Nka, ni o taamasiɲɛw tora senna, a ka ɲi tuma bɛɛ ka taa dɔgɔtɔrɔso la walasa ka laadilikan sɔrɔ.

LPDw sababu ye mun ye?

A ka gɛlɛn ka sababu kelen jira LPD fanba la, nka fɛn suguya caman bɛ se ka kɛ sababu ye.

• Banakisɛw : LPD suguya dɔw bɛ se ka sɔrɔ banakisɛw fɛ i n’a fɔ Epstein-Barr banakisɛ walima H. ​​pylori banakisɛ . Miiri k’a filɛ, nin fɛnɲɛnama misɛnnin sugu minnu bɛ don an farikolo la, olu bɛ ka an ka selilɛriw tiɲɛ.
• Bana dɔw minnu bɛ sɔrɔ farikolo tangalanw fɛ: Rheumatoid arthritis, lupusBana dɔw bɛ mɔgɔ minnu na, farati bɛ olu la ka LPD suguya dɔw sɔrɔ (misali la, zone marginal lymphomes). O ye waati ye an farikolo farikolo tangalanw bɛ bin an yɛrɛ ka farikolokisɛw kan.
• Fura : Farikolo tangalan fura dɔw (misali la, fura minnu bɛ di walasa ka farikolo tangalanw bali farikolo yɔrɔw cili kɔfɛ) bɛ se ka bana dɔw lase mɔgɔ ma i n’a fɔ sugunɛbilenni T-cell lymphoma.
• Yɛlɛma dɔw: A man teli kosɛbɛ, i bɛ se ka fɛn dɔ ciyɛn ta min bɛ nin LPD suguya in bila mɔgɔ la. Misali la, X-linked lymphoproliferative disorder (XLP) bɛ mɔgɔ minnu na, fɛn caman bɛ ɲɔgɔn falen falen u ka jamu fila la. O b’a to u ka teli ka Epstein-Barr banakisɛ jaabi jugumanba sɔrɔ min tɛ deli ka kɛ ani ka ɲɛgɛnɛsiralabanaw sɔrɔ. Jɛnkulu jiginni minnu bɛ nɔ bila joli kuru finmanw falenni na, olu fana bɛ tali kɛ sɔgɔsɔgɔninjɛ ni jolidɛsɛ la.

Dɔgɔtɔrɔw bɛ LPDw sɛgɛsɛgɛ cogo di? (Sɛgɛsɛgɛli) .

Ikomi LPD suguya caman bɛ yen, ni u bɛ sɛgɛsɛgɛli kɛ, dɔgɔtɔrɔw bɛ fɔlɔ ka a lajɛ walasa ka a dɔn LPD suguya jumɛn de bɛ aw ka bana taamasiɲɛw bila mɔgɔ la.

Walasa ka o kɛ, dɔgɔtɔrɔ bɛna aw ka bana taamasiɲɛw jateminɛ, i n’a fɔ ɲɛgɛnɛsira funu, taamasiɲɛ minnu b’a jira ko aw ka sugunɛ walima aw ka sugunɛ ka bon ka tɛmɛ a cogo kɔrɔ kan, ani ka aw ɲininka aw ka furakɛli tɛmɛnenw na ani ni aw ka denbaya kɔnɔ mɔgɔ dɔ ye o bana suguw sɔrɔ.

O kɔfɛ, a bɛ se ka kɛ ka sɛgɛsɛgɛliw kɛ i n’a fɔ nin:

• Biyopisi : Kolotugudaw biyɔpisi bɛ se ka kɛ walasa ka joli kansɛri taamasiɲɛw lajɛ i n’a fɔ jolidɛsɛ walima jolidɛsɛ. O ye ka kolotuguda dɔɔni dɔ ta k’a sɛgɛsɛgɛ. Tuma dɔw la, ɲɛgɛnɛsira fununen yɔrɔ fitinin dɔ fana bɛ se ka ta.
• Joli sɛgɛsɛgɛliw : Joli hakɛ dafalen (CBC) , Panneau métabolique complète (CMP) , Epstein-Barr anticorps test, sugunɛbilenni sɛgɛsɛgɛli, sidabana sɛgɛsɛgɛli, Lactate dehydrogenase (LDH) sɛgɛsɛgɛli, a ɲɔgɔnnaw Ninnu bɛ se ka fɛn caman fɔ aw ye joli kuruw caman yeli kan, banakisɛw, ani sugunɛ ni sugunɛ baara.
• Jaa sɛgɛsɛgɛliw : Sɛgɛsɛgɛliw i n’a fɔ ɔridinatɛri tomografi (CT) ani positron emission tomography (PET) sɛgɛsɛgɛliw bɛ se ka kɛ. Olu bɛ se ka fɛnw lajɛ i n’a fɔ farikolo kɔnɔfɛnw, ɲɛgɛnɛsiraw cogoya, ani ni kansɛribanakisɛw jɛnsɛnna. A bɛ i n’a fɔ ka farikolo kɔnɔna ja ta.
• Laboratowari sɛgɛsɛgɛliw : Sɛgɛsɛgɛli kɛrɛnkɛrɛnnenw i n’a fɔ flow cytometry bɛ se ka dɛmɛ don ka LPD suguya kɛrɛnkɛrɛnnen dɔn.

LPDw bɛ furakɛ cogo di?

LPDw furakɛli bɛ bɔ LPD suguya kɛrɛnkɛrɛnnen na min bɛ aw la. Bɛɛ furakɛcogo tɛ kelen ye. Misali la, ni jolidɛsɛ walima jolidɛsɛ bɛ aw la, aw bɛ se ka furakɛli kɛ i n’a fɔ ninnu:

• Simifura: Fura minnu bɛ di walasa ka kansɛribanakisɛw tiɲɛ.
• Banakisɛfagalanw : Furakɛli min bɛ i yɛrɛ farikolo tangacogo lawuli walasa ka kansɛribanakisɛw kɛlɛ.
• Fiɲɛfura: Ka kansɛribanakisɛw tiɲɛ ni fanga caman bɛ minnu na.
• Sɔgɔsɔgɔninjɛ (kolokisɛ) cili : Tumu kɛnɛmanw cili walasa ka kolotuguda tiɲɛnenw bila u nɔ na.
• Furakɛli min ɲɛsinnen don a ma: Fura minnu bɛ fɛn kɛrɛnkɛrɛnnenw laɲini minnu bɛ kansɛribanakisɛw dɛmɛ u ka bonya ani ka balo.

Aw ye aw hakili to a la ko aw ka dɔgɔtɔrɔ bɛna furakɛli ɲuman latigɛ aw ye. Ale de bɛ i ka bana dɔn ka ɲɛ.

LPD bɛ mɔgɔ min na, o tigi ka ko kɛlen bɛ cogo di? Yala a bɛ se ka furakɛ wa?

Nin ye ɲininkali ye min jaabi ka gɛlɛn dɔɔni barisa LPD suguya caman bɛ yen, wa fɛn caman i n’a fɔ i ka kɛnɛya, i si hakɛ, ani bana in taabolo bɛ se ka nɔ bila a kɔlɔlɔ la.

LPD suguya dɔw bɛ se ka kɛnɛya pewu. Misali la, chimio-immunothérapie bɛ se ka joli-sira-funu suguya dɔw furakɛ, i n’a fɔ joli-sira-funu belebeleba ni Burkitt. Mɔgɔ min bɛ ni X-linked lymphoproliferative disorder (XLP) ye, o tigi bɛ se ka kɛnɛya ni stem cell transplantation ye.

Nka tuma dɔw la, furakɛli bɛ se ka farikolojidɛsɛ dɔw bila yafa la , o kɔrɔ ye ko a taamasiɲɛw bɛ tunu ani sɛgɛsɛgɛliw tɛ se ka bana in dɔn tuguni. Nka bana in tɛ kɛnɛya pewu. LPD dɔw bɛ se ka segin kalo walima san caman furakɛli bannen kɔfɛ.

Ni LPD bɛ aw la, n’a sɔrɔ aw bɛ aw yɛrɛ ɲininka ni a bɛ se ka furakɛ ani ni aw bɛ se ka ɲɛnamaya kɛ waati joli kɔnɔ. Aw bɛ se ka kunnafoni sɔrɔ o ko la yɔrɔ min ka fisa, o ye aw ka dɔgɔtɔrɔ ye. A bɛ aw ni aw ka bana dɔn ka ɲɛ. O la sa, aw kana siran ka ɲininkali o ɲininkali kɛ a la.

Ne bɛ se ka ne yɛrɛ ladon cogo di? (Yɛrɛladon) .

LPDw ye furakɛli bana jugumanw ye. Hali ni furakɛli bɛ se ka dɔ bɔ bana taamasiɲɛw la ani ka furakɛli kɛ yɛrɛ, gɛlɛyaw bɛ se ka sɔrɔ hali bi furakɛli senfɛ. Ladili dɔw filɛ nin ye minnu bɛ se k’aw dɛmɛ:

• Aw bɛ ɲininkali kɛ furakɛli kuntaalajan ko la: LPD bɛ mɔgɔ min na, o tigi bɛ se ka mago don dɛmɛ na walasa ka furakɛli taamasiɲɛw ni a kɔlɔlɔw kunbɛn. Furakɛcogo min bɛ mɔgɔ dusu sumaya, o ye ladonni suguya kɛrɛnkɛrɛnnen ye min bɛ mɔgɔ dɛmɛ ka a ka ɲɛnamaya kɛcogo ɲɛ ani ka dɔ bɔ dimi ni dusukasi wɛrɛw la, sanni ka a ɲini ka bana in furakɛ. Aw ka furakɛli kuntaalajan jɛkulu bɛ se ka laadilikan ɲumanw di aw ma.
• Aw bɛ dumuni kɛ ka ɲɛ: Aw bɛ se ka dumuni nege bɔ aw la ni aw bananen don walima ni aw bɛ furakɛli la. N’o don, aw bɛ taa balodɛsɛbagatɔ dɔ fɛ . A bɛna aw laadi dumuni ni minfɛn ɲumanw kan aw ye.
• Aw ye farikoloɲɛnajɛ dɔ kɛ: Farikoloɲɛnajɛ nɔgɔman bɛ se ka dɛmɛ don ka dɔ bɔ degun na min bɛ na ni bana juguman ye. Nka aw ye aw jija ka kuma dɔgɔtɔrɔ dɔ fɛ sani aw ka farikoloɲɛnajɛ porogaramu kura daminɛ.
• Aw bɛ aw tanga banakisɛw ma: Aw farikolo tangacogo bɛ se ka dɔgɔya bana walima furakɛli fɛ. O la, aw bɛ dɔgɔtɔrɔ ɲininka banakisɛw kunbɛncogo fɛɛrɛw la. Ka i yɛrɛ tanga yɔrɔw ma minnu falen don mɔgɔw la ani ka i tɛgɛ ko tuma caman, o nafa ka bon.

Tuma jumɛn na ne ka kan ka taa dɔgɔtɔrɔso la?

Ni aw bɛ furakɛli kɛ LPD la, aw bɛ dɔgɔtɔrɔ ɲininka taamasiɲɛ minnu b’a jira ko aw ka bana bɛ ka juguya (misali la, sumaya basigilen) walasa aw k’a dɔn aw ka kan ka taa a fɛ waati min na.

Ni dɔgɔtɔrɔ bɛ furakɛli kumasen fɔ min tɔgɔ ye ko "lymphoproliferation" walima "lymphoproliferative disorders (LPDs)", u bɛ kuma bana kulu dɔ kan minnu bɛ joli kuru finman kɛrɛnkɛrɛnnenw de kan minnu bɛ se ka nɔ bila i farikolo tangacogo la walima ka kɛ kansɛri ye.

Ni nin bana sugu dɔ bɛ aw la, aw bɛ se ka aw ka bana kɛrɛnkɛrɛnnenw dɔn ka tɛmɛ furakɛli daɲɛw kan. Nka n'i banana, dɔnniya ye fanga ye. O cogo la, n’i ye tɔgɔ in kɔrɔ dɔn, o bɛ se k’i dɛmɛ ka faamuyali ɲuman sɔrɔ min bɛ kɛ i farikolo kɔnɔ.

Misali la, LPDw taamasiɲɛw ni furakɛlicogo bɛ kɛ ɲɔgɔn fɛ. Nka u bɛɛ tɛ kelen ye. Ani fana, i ka ko kɛlen bɛ se ka kɛ danfara ye ni mɔgɔ wɛrɛw ta ye. Ni aw ka dɔgɔtɔrɔ bɛ baara kɛ ni nin kumasen ye min tɔgɔ ye ko "LPD), aw bɛ kunnafoni wɛrɛw ɲini aw ka bana kɛrɛnkɛrɛnnen kan. U bɛna nisɔndiya ka aw ka ɲininkaliw jaabi.

A laban na, cikan min bɛ taa ni i ye so:

Limfoproliferative Disorders (LPDs) ye bana gɛlɛnw kulu ye, minnu bɛ se ka juguya, minnu bɛ sɔrɔ farikolojidɛsɛbanakisɛw fɛ, olu minnu ye an farikolo lafasalifɛnw ye.

• Aw ye aw janto a taamasiɲɛw la: Aw kana kɛ sɛgɛnbagatɔ ye ni farigan basigilen bɛ aw la, ni aw bɛ sɛgɛn kojugu, ni aw girinya bɛ dɔgɔya, walima ni aw ka ɲɛgɛnɛsiraw fununen don.
• A nafa ka bon ka dɔgɔtɔrɔso laadilikan ɲini: Ni siga bɛ aw la, aw bɛ taa dɔgɔtɔrɔso la joona walasa ka a lajɛ. Ni bana in dɔnna joona, a ka ca a la furakɛli bɛ ɲɛ.
• LPD bɛɛ tɛ kelen ye: u suguya tɛ kelen ye, wa u kelen-kelen bɛɛ furakɛcogo tɛ kelen ye. Aw ka dɔgɔtɔrɔ bɛna a dɔn furakɛli min ka fisa aw ma.
• I kelen tɛ: Ni i bɛ nin ko sugu dɔ kunbɛn, i somɔgɔw, i teriw ani dɔgɔtɔrɔso baarakɛlaw ka dɛmɛ nafa ka bon kosɛbɛ.

Min nafa ka bon kosɛbɛ, o ye ka siran, ka to barika la, ka dɔgɔtɔrɔw ka laadilikanw labato. Ni furakɛli bɛnnen don ani ni hakili fanga ka ɲi, aw bɛ se ka se sɔrɔ o gɛlɛya kan.

` farikolojidɛsɛbanaw, LPDw, farikolojidɛsɛbanakisɛw, farikolojidɛsɛbanakisɛw, farikolo tangalanw, kansɛri, jolidɛsɛ, lanpomi