Aia kekahi puʻupuʻu e like me kēia i loko o kou kino? E aʻo maʻalahi kākou e pili ana iā ia (Adrenal Adenoma)!

Ua manaʻo paha ʻoe i kekahi manawa ke hana mākou i kahi mea e like me ka 'scan' no kekahi maʻi ʻē aʻe, hiki iā mākou ke loaʻa i kahi mea i hūnā ʻia i loko o ke kino a mākou i ʻike ʻole ai? Pēlā i ʻike ʻia ai kēia ʻano i kapa ʻia ʻo "Adrenal Adenoma". He ʻōpū liʻiliʻi kēia, ʻaʻole maʻi kanesa, ʻaʻole weliweli e hana ʻia ana i loko o kāu mau kelepa adrenal. E kamaʻilio hou aku kākou e pili ana i kēia?

He aha maoli ka adenoma adrenal?

ʻAe, e nānā mua kākou i ke ʻano o nā kelepa adrenal. Aia kēia mau kelepa ʻelua ma luna o kou mau puʻupaʻa, e like me ʻelua mau pāpale liʻiliʻi. ʻO kēia nā mea e hana ai i kekahi mau ʻano hormones he mea nui loa no ko mākou kino. E noʻonoʻo, pehea ka pane a kou kino ke manaʻo koke ʻoe i ka makaʻu nui a i ʻole ka hopohopo? ʻO nā hormones e kōkua ana i kēlā mai kēia mau kelepa. ʻAʻole wale ia, akā kōkua pū kēia mau hormones i ka hoʻomalu ʻana i nā mea he nui e like me kou pae kō koko, ke koko, a me ka ʻōnaehana pale.

ʻElua ʻāpana nui o ka ʻōpū adrenal: ʻo ka ʻaoʻao waho i kapa ʻia ʻo ka adrenal cortex, a ʻo ka ʻaoʻao o loko i kapa ʻia ʻo ka adrenal medulla. Hoʻopuka ka adrenal cortex i nā hormones e like me (Cortisol) a me (Aldosterone). Hoʻopuka ka adrenal medulla i nā hormones e like me (Dopamine), (Epinephrine) a me (Norepinephrine). Aia i loko o ka adrenal cortex kahi e ulu ai nā puʻupuʻu a mākou e kamaʻilio nei, i kapa ʻia ʻo adrenal adenoma.

ʻO ka hapa nui o ka manawa, ʻaʻole kēia mau adenomas e hōʻike i nā hōʻailona nui a ʻaʻole pono e mālama ʻia. Eia nō naʻe, i kekahi manawa, hiki i kēia mau puʻupuʻu ke hana i nā nui ma mua o ka maʻamau o hoʻokahi a ʻoi aku paha mau hormones adrenal.

Aia kekahi mau ʻano o ka adenoma adrenal?

ʻAe, ʻelua ʻano nui.

• Nā adenomas hana/hana: Hoʻopuka kēia ʻano puʻupuʻu i nā hormones adrenal gland ma mua o ka maʻamau . Hiki i kēia ke hana i nā hōʻailona a pono paha e mālama ʻia.
• ʻAdenomas Hana ʻole/Hana ʻole: ʻAʻole kēia mau mea e hana i nā hormones keu. Hāʻule ka hapa nui o nā adenomas adrenal i loko o kēia māhele. ʻAʻole lākou e hana i nā hōʻailona a pono paha e mālama ʻia.

ʻO ka mea nui, ʻo ka likelika o kēlā me kēia ʻano e lilo i maʻi kanesa he haʻahaʻa loa ia. Eia nō naʻe, hiki i kahi adenoma hana ʻole ke lilo i mea hana i ka hala ʻana o ka manawa.

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Hiki i ka adenoma adrenal ke lilo i maʻi kanesa?

He mea kākaʻikahi loa kēia. ʻO ia hoʻi, he mea paʻakikī loa ka lilo ʻana o kahi adenoma adrenal i kanesa. ʻO ke ʻano nui o ka puʻupuʻu kanesa e ulu ana i loko o nā kelepa adrenal ʻo ia ka adrenocortical carcinoma. E like me nā adenomas hana, hiki i kēia mau puʻupuʻu kanesa ke hana i nā hormones keu. No laila, hiki ke like kekahi o nā hōʻailona me nā adenomas hana.

E noʻonoʻo wale, hoʻokahi wale nō i loko o hoʻokahi miliona mau kānaka e loaʻa ana i ka adrenocortical carcinoma. ʻO ia hoʻi, ʻo ka hapa nui o nā puʻupuʻu e ulu ana i loko o nā kelepa adrenal he benign, ʻaʻole cancerous.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?

ʻOiaʻiʻo, hiki i kekahi ke loaʻa i kahi adenoma adrenal. Eia nō naʻe, piʻi iki ka likelika o ka loaʻa ʻana i kou wā ʻelemakule. Ua ʻōlelo nui ʻia ma waena o 3% a me 9% o ka heluna kanaka i loaʻa kēia adenoma. ʻO kēia ke ʻano maʻamau o ka puʻupuʻu e ulu ana i loko o nā kelepa adrenal.

Pehea ka hopena o ka adenoma adrenal i kou kino?

E like me kā mākou i ʻōlelo ai ma mua, kū mai nā pilikia mai nā adenomas hana. Hiki i kēia mau mea ke hoʻokuʻu i ka nui kūpono o hoʻokahi a ʻoi aku paha mau hormones. Inā hana kēia, hiki iā ʻoe ke ʻike i nā hōʻailona o kekahi mau maʻi adrenal. Eia kekahi laʻana:

• ʻO ka maʻi Cushing a i ʻole hypercortisolism: Hiki mai kēia ʻano ke hana nui kāu mau kelepa adrenal i ka hormone cortisol. Hoʻokumu pinepine ʻia ka maʻi Cushing e kahi puʻupuʻu pituitary, akā hiki ke hana ʻia e kahi puʻupuʻu adrenal. ʻO nā hōʻailona e komo pū me ke koko kiʻekiʻe, ka piʻi ʻana o ke kaumaha (ʻoi aku hoʻi a puni ka ʻōpū), a me ka hana ʻino o ka moekolohe . Hiki iā ia ke hoʻonui i kou pilikia o ka loaʻa ʻana o ka maʻi diabetes.

• ʻO ka aldosteronism mua (Conn's syndrome): Hana ʻia kēia ke hana nui ka adenoma i ka hormone aldosterone. ʻO nā hōʻailona e komo pū me nā pae potassium haʻahaʻa, ke koko kiʻekiʻe, ka ʻeha poʻo, ka luhi, a me ka nāwaliwali o nā ʻiʻo .

• Nā hopena o nā hormones wahine: He mea kākaʻikahi loa, hiki i kahi adenoma adrenal ke hoʻoulu i ka hana nui ʻana o nā hormones wahine. Inā piʻi aʻe nā androgens (e like me ka testosterone) i nā wahine, hiki iā lākou ke hana i nā pōʻaiapuni menstrual ʻole, ka lauoho kino nui (hirsutism), a me ka hohonu o ka leo. Inā piʻi aʻe ka estrogen i nā kāne, hiki iā lākou ke hana i ka emi ʻana o ka makemake moekolohe a me ka hana erectile dysfunction.

He aha nā hōʻailona o ka adenoma adrenal?

Hoʻokumu ʻia nā hōʻailona e nā adenomas hana. Hiki ke loaʻa kēia mau hōʻailona, ​​ʻoiai inā lākou e hoʻoulu ai i ka hana nui ʻana o ka cortisol (Cushing's syndrome) a i ʻole aldosterone (aldosteronism mua). E nānā e ʻike inā loaʻa iā ʻoe kekahi o kēia mau mea:

• ʻEha poʻo.
• Ka nāwaliwali o nā ʻiʻo a i ʻole ka mae ʻana o ka ʻiʻo i kekahi manawa.
• Ka luhi a me nā ʻeha kino (e like me ke kua).
• Ke koko kiʻekiʻe (Hypertension).
• Nā pae kō koko kiʻekiʻe a i ʻole ka maʻi diabetes.
• Nā pae potassium haʻahaʻa.
• Nā māka kikoo ma ka ʻili o ka ʻōpū.
• Ka piʻi ʻana o ke kaumaha, ʻoiai ma ka ʻāpana o luna o ke kino.
• Nā loli o ke ʻano (hopohopo, makaʻu, kaumaha, a pēlā aku).

No nā wahine, hiki ke loaʻa nā pōʻaiapuni menstrual kūpono ʻole a me ka hoʻonui ʻia o nā ʻano kāne (virilization) . No nā kāne, hiki ke loaʻa ka hana pono ʻole o ka moekolohe .

He aha nā kumu o ka adenoma adrenal?

ʻAʻole maopopo i nā kānaka noiʻi ke kumu e ulu ai nā adenomas adrenal a me nā ʻōpū adrenal benign ʻē aʻe. Eia nō naʻe, ua ʻike lākou e hiki i kekahi mau kūlana genetic ke hoʻonui i ka pilikia. ʻO kekahi mau laʻana:

• ʻO ka Neoplasia Endocrine lehulehu, ʻano 1 (MEN1)
• ʻO ka Polyposis Adenomatous Familial (FAP)
• ʻO ka hale paʻakikī ʻo Carney
• ʻO ka maʻi Li-Fraumeni
• ʻO ka Neoplasia Endocrine Multiple ʻano 2 (MEN2)
• ʻAno Neurofibromatosis 1

Eia kekahi, ʻo nā mea e like me ka momona a me ka hoʻohana ʻana i ka paka hiki ke hoʻonui i ka pilikia o ka hoʻomohala ʻana i ka adenoma adrenal.

Pehea e ʻike ʻia ai nā maʻi ʻōpū adrenal?

ʻAʻole ʻike ka nui o ka poʻe he adenoma adrenal ko lākou. Ua ʻike ʻia ia ma ke ʻano ulia pōpilikia i ka wā o ke kaʻina hana kiʻi, e like me ka CT scan, i hana ʻia no kekahi kumu ʻē aʻe. ʻO ia ke kumu i kapa ʻia ai lākou he "incidentalomas," no ka mea, ua ʻike ʻia lākou ma ke ʻano ulia pōpilikia.

E hoʻoholo mua kāu kauka inā he maʻi kanesa ka puʻupuʻu (e.g., adrenocortical carcinoma) a i ʻole benign (e.g., adrenal adenoma). Inā he adrenal adenoma ia, a laila e hoʻāʻo lākou e ʻike inā e hana ana ia i nā hormones he nui loa.

He aha nā hoʻokolohua e hana ʻia nei no kēia?

E hana kāu kauka i kahi hoʻokolokolo kino, e nīnau e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino, a laila e kauoha paha i nā hoʻokolohua e like me kēia e aʻo hou e pili ana i ka puʻupuʻu:

• Hoʻāʻo koko a mimi paha:Hiki i kēia ke nānā i nā pae hormone kiʻekiʻe i loko o kou kino. Inā he puʻupuʻu hana kou, hiki ke kiʻekiʻe kou mau pae hormone. Pono paha ʻoe e hōʻiliʻili i kahi hāpana mimi 24-hola a nānā i kāu mau pae cortisol.
• Kiʻi: ʻO ka CT scan ka hoʻāʻo maʻamau i hoʻohana ʻia e ʻike i ka adenoma adrenal. I kekahi manawa e kauoha paha kāu kauka i kahi MRI. Hiki i kēia scan ke kōkua i ka hoʻoholo ʻana inā he malignant (cancerous) a benign paha (benign) ka puʻupuʻu. No ka laʻana, ʻoi aku ka nui o nā puʻupuʻu i ʻoi aku ma mua o 4 kenimika i ka maʻi kanesa ma mua o nā puʻupuʻu liʻiliʻi.
• Biopsy: Inā ʻaʻole hiki i nā hoʻokolohua ʻē aʻe ke hoʻoholo inā he maʻi kanesa ka puʻupuʻu a he adenoma adrenal paha, hiki i kāu kauka ke hana i kahi biopsy i kapa ʻia he fine-needle aspiration. Pili kēia i ka wehe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupuʻu me kahi nila lahilahi. A laila nānā kahi pathologist, he loea hoʻokolohua, i ka ʻiʻo ma lalo o kahi microscope e ʻike inā he mau hōʻailona o ka maʻi kanesa.

Hiki ke hana ʻia nā hoʻokolohua ʻē aʻe, e like me ka lawe ʻana i ka laʻana o nā vein adrenal a i ʻole ka metaiodobenzylguanidine (MIBG) scan.

He aha nā lāʻau lapaʻau no ka adenoma adrenal?

ʻO ka lāʻau lapaʻau āu e loaʻa ai e hilinaʻi ia i ka hana ʻole ʻana o ka puʻupuʻu a i ʻole ka hana ʻana (ʻo ia hoʻi, ka hana ʻana i ka nui o ka hormone).

• Inā liʻiliʻi kahi puʻupuʻu hana ʻole, hiki i kāu kauka ke paipai i nā scan CT manawa e ʻike ai inā e ulu ana a i ʻole e hana ana. Inā e ulu wikiwiki ana ka puʻupuʻu, a inā kokoke i 5 kenimika, hiki i kāu kauka ke paipai i ke ʻoki kino. ʻO kēia no ka mea ʻoi aku ka nui o nā puʻupuʻu nui a me ka ulu wikiwiki ʻana e lilo i maʻi kanesa.

• No nā ʻōpū e hana ana, pono pinepine ke ʻoki kino. ʻO nā koho lapaʻau e komo pū me:

• ʻO Adrenalectomy - ʻO kēia ka wehe ʻana o ke kelepa adrenal: Inā liʻiliʻi a maikaʻi ʻole ka puʻupuʻu, hiki i kāu kauka ke wehe i kāu kelepa adrenal me ka hoʻohana ʻana i ka laparoscopy. I ka wā o ka laparoscopy, hana ke kauka lapaʻau i kekahi mau ʻoki liʻiliʻi i loko o kou ʻōpū a hana i ke ʻoki ma o lākou. Inā nui ka puʻupuʻu a i ʻole he kānalua paha he maʻi kanesa, hiki i kāu kauka ke hana i kahi ʻoki nui aʻe i kou kua. I kekahi manawa, hiki i ke kelepa adrenal i koe ke hana i nā hormones lawa e mālama iā ʻoe i ke olakino. Inā ʻaʻole, pono paha ʻoe i ka lāʻau lapaʻau hormone e pani i ka hemahema o ka hormone.

• Nā lāʻau lapaʻau:Inā ʻaʻole ʻoe he moho maikaʻi no ke ʻoki kino, hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e pale aku i ka adenoma mai ka hana ʻana i ka nui o ka hormone. Pono paha ʻoe e lawe i ka lāʻau lapaʻau no kekahi mau pule ma hope o kahi adrenalectomy e hoʻopaʻa i kāu mau pae hormone.

Hiki ke pale ʻia nā ʻōpū o ke kelepa adrenal?

ʻAʻohe ala e pale aku ai i nā puʻupuʻu adrenal, me nā adenomas adrenal. Hoʻokumu pinepine ʻia nā kumu pilikia no lākou ma kāu mau genes. Eia nō naʻe, hiki nō iā ʻoe ke hoʻomohala i kahi adenoma adrenal ʻoiai inā ʻaʻohe mea o kou ʻohana i loaʻa i nā puʻupuʻu adrenal.

Pehea ke ʻano o ke kūlana lōʻihi ma hope o ka mālama ʻana?

He maikaʻi loa nā hopena o ka adrenalectomy. Ke wehe ʻia ka ʻōpū adrenal i hoʻopilikia ʻia, nalowale pinepine nā hōʻailona i hoʻokumu ʻia e ka adenoma adrenal hana.

Pehea lā wau e mālama ai iaʻu iho?

Inā ua ʻike ʻia ʻoe me kahi adenoma adrenal hana ʻole, e hahai i nā ʻōlelo a kāu kauka e pili ana i ka pinepine o kāu hana ʻana i nā hoʻokolohua. Ma muli o ke ʻano o kou puʻupuʻu, hiki i kāu kauka ke kauoha i nā scan CT a i ʻole nā ​​​​hoʻokolohua hormone i kēlā me kēia manawa.

He aha nā nīnau e pono iaʻu e nīnau aku i ke kauka?

Ke kipa aku ʻoe i kāu kauka, mai poina e nīnau i nā nīnau e like me kēia:

• He aha ke ʻano o ka puʻupuʻu kelepa adrenal i loaʻa iaʻu?
• He maʻi ʻole a he maʻi ʻaʻai paha?
• He aha nā manawa kūpono e lilo ai koʻu puʻupuʻu i ka maʻi kanesa?
• He mea hana paha a he mea hana ʻole paha?
• Pono anei au i ka lāʻau lapaʻau?
• He aha nā lāʻau lapaʻau āu e paipai nei?
• E pono anei kaʻu hana lapaʻau/ho'ōla i ka lāʻau lapaʻau hormone?

E hoʻomanaʻo, inā loaʻa i kāu kauka kahi puʻupuʻu ma kou kelepa adrenal ma kahi scan, mai hopohopo. ʻO ka hapa nui o ka manawa, ʻaʻohe mea ʻino kēia mau puʻupuʻu. Inā he adenoma adrenal kāu puʻupuʻu, hiki ke hana ʻia nā hoʻokolohua e ʻike ai inā nui loa ka hana ʻana o ka hormone. Inā pēlā, he koho maikaʻi paha ke ʻoki ʻana. Inā maikaʻi ʻole ka puʻupuʻu, hiki i kāu kauka ke nānā iā ia e hōʻoia ʻaʻole ia e hoʻopilikia i kāu mau hormones. Inā manaʻo lākou he maʻi kanesa paha, hiki iā lākou ke wehe.

ʻO ka hope loa, he leka lawe-i-ka-home

No laila, ʻaʻohe mea e hopohopo ai ka adenoma adrenal. ʻO ka hapa nui o lākou he mea ʻino ʻole a ʻaʻole maʻi kanesa. Eia nō naʻe, hiki i kekahi o lākou ke hana i ka nui o ka hormone, no laila he mea nui e makaʻala. Inā he kānalua a nīnau paha kāu e pili ana i kēia, e kamaʻilio me ke kauka. A laila hiki iā ʻoe ke loaʻa ka ʻōlelo aʻoaʻo kūpono a me ka lāʻau lapaʻau āu e pono ai. E noho olakino!