ʻO ka puʻupuʻu mediastinal he puʻupuʻu e hana ʻia ana ma ka hakahaka ma waena o kou mau māmā, ma waena o kou umauma a me kou mau māmā. ʻAʻole paha ʻoe i lohe i kēia inoa ma mua. Akā he mea nui e ʻike e pili ana i ia mea. I kekahi manawa, hiki i kēia mau puʻupuʻu ke ulu me ka ʻole o nā hōʻailona. No laila e kamaʻilio kākou e pili ana i ia mea me nā kikoʻī hou aku i hiki iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha ka maʻi mediastinal?
E noʻonoʻo i ka hakahaka i loko o kou umauma. Aia ka iwi umauma ma mua, aia ka iwi kuamoʻo ma hope, a aia nā māmā ma nā ʻaoʻao ʻelua. ʻO ka hakahaka ma waena o kēia mau ʻōkana ka mea a mākou e kapa nei ma ke ʻano lapaʻau ʻo mediastinum . Aia i loko o kēia hakahaka nā ʻōkana koʻikoʻi he nui, me kou puʻuwai, aorta, esophagus, trachea, thymus gland, a me nā lymph nodes, ʻo ia kekahi hapa o kāu ʻōnaehana pale.
No laila, ʻo kēlā me kēia puʻupuʻu o nā cell, ʻo ia hoʻi, he puʻupuʻu, e hana ʻia ma kēia wahi i kapa ʻia ʻo mediastinum, kapa mākou ia he puʻupuʻu mediastinal. ʻElua ʻano o kēia mau puʻupuʻu:
- ʻAno maikaʻi: ʻAʻole kēia he maʻi kanesa. Hoʻokumu pinepine lākou ma kahi hoʻokahi a ʻaʻole e laha i nā ʻāpana ʻē aʻe o ke kino.
- ʻOno: He mau maʻi ʻaʻai kēia. Hiki iā lākou ke laha, e hōʻino ana i nā ʻiʻo a puni.
He aha kēia mau ʻano puʻupuʻu? He ʻokoʻa anei lākou ma muli o ko lākou wahi i hana ʻia ai?
ʻAe, ua māhele ʻia kēia mau puʻupuʻu i ʻekolu ʻāpana nui ma muli o ko lākou wahi i hana ʻia ai. ʻO ia hoʻi, e like me ke ʻano o ka hana ʻia ʻana o nā ʻāpana ʻekolu o ka mediastinum: ke alo, waena, a me ke kua. E nānā kākou i ke ʻano o lākou.
| ʻAno Puʻupuʻu | Wehewehe Pōkole |
|---|---|
| Nā Tumors ma ka Anterior Mediastinum | |
| ʻO Thymoma a me ka Thymic Carcinoma | ʻO kēia nā ʻano maʻamau. Nā maʻi kanesa e ulu ana i loko o ka ʻōpū thymus. I ka hapa nui o ka manawa, ulu mālie lākou. Akā, ʻo kahi ʻano i kapa ʻia ʻo thymic carcinoma e laha koke ana. |
| Nā Cysts Thymic | ʻAʻole kēia he mau maʻi kanesa. Ua like lākou me nā cysts i piha i ka wai. Pono wale nō ka lāʻau lapaʻau inā ke kumu nei lākou i nā hōʻailona a ke kaomi nei i nā ʻōpū a puni. |
| ʻO ka maʻi ʻōpū | He mau maʻi kanesa kēia. Hoʻokomo pū lākou i ka Hodgkin lymphoma a me ka non-Hodgkin lymphoma. |
| ʻO ka puʻupuʻu o ke kelepona germ | ʻO ka hapa nui o kēia ʻano puʻupuʻu e ulu aʻe ma kēia wahi ma waho o nā ovaries a me nā testicles. Eia nō naʻe, ʻaʻole ka hapa nui he maʻi kanesa. |
| Ka nui o ka thyroid | He ʻano maʻi ʻaʻole ia he maʻi ʻaʻai, e like me ka goiter. |
| Nā Tumors ma ka Middle Mediastinum | |
| ʻO ka Cyst Bronchogenic | He mau cysts liʻiliʻi kēia, ʻaʻole i hoʻopilikia i ka maʻi kanesa i piha i ka wai a i ʻole ka mucus. |
| ʻO ka Lymphadenopathy Mediastinal | Ka pehu ʻana o ke kuʻekuʻe wāwae. Hiki paha kēia ma muli o kahi maʻi a i ʻole kekahi maʻi ʻē aʻe. |
| ʻO ka cyst Pericardial | ʻO nā puʻupuʻu ʻaʻole cancerous e hana ʻia i loko o ka ʻeke piha wai (pericardium) a puni ka puʻuwai. |
| Nā ʻōpū Tracheal a i ʻole Esophageal | He maʻi kanesa paha kēia a ʻaʻole paha. |
| Nā puʻupuʻu ma ka Posterior Mediastinum | |
| Nā ʻōpū Neurogenic | Nā puʻupuʻu i hana ʻia mai nā ʻiʻo aʻalolo. ʻO ke ʻano puʻupuʻu maʻamau ma kēia wahi. ʻAʻole ka hapa nui he maʻi kanesa. |
| ʻO nā mea ʻē aʻe... | Aia paha nā mea e like me nā lymph nodes pehu, nā puʻupuʻu e hana ʻia ana i loko o ka iwi iwi (extramedullary hematopoiesis), nā pilikia o ka iwi kuamoʻo, a me nā pilikia me nā kīʻaha koko nui (aortic aneurysms). |
ʻO wai ka mea e loaʻa ai kēia mau puʻupuʻu? Pehea ka maʻamau o lākou?
ʻOiai hiki ke ulu kēia ʻano puʻupuʻu i kēlā me kēia makahiki, ʻike pinepine ʻia lākou i nā poʻe ma waena o 30 a me 50 mau makahiki. Eia nō naʻe, aia kekahi mau ʻokoʻa iki ma waena o nā pākeke a me nā keiki.
- Nā pākeke: Hoʻomohala pinepine ʻia nā puʻupuʻu ma ka mediastinum mua. ʻOi aku ka nui o kēia mau mea i nā maʻi kanesa e like me ka lymphoma a i ʻole ka thymoma.
- Nā keiki: Hoʻomaka pinepine nā puʻupuʻu ma ka posterior mediastinum. Hoʻomaka kēia mau mea ma nā aʻalolo a ʻaʻole maʻamau he maʻi kanesa.
ʻAʻole kēia he maʻi maʻamau loa. ʻAʻole hiki i ka 1% o ka heluna kanaka ke loaʻa iā ia.
He kūlana koʻikoʻi anei kēia? Pono anei au e makaʻu?
He pilikia kēia i loaʻa i nā kānaka he nui. ʻO ka mea nui e hoʻomaopopo ma ʻaneʻi, ʻoiai ʻaʻole kēia puʻupuʻu he maʻi kanesa (benign), hiki ke lilo i mea koʻikoʻi ma muli o kona wahi .
E noʻonoʻo, i ka ulu ʻana o kēia puʻupuʻu, hiki iā ia ke kau i ke kaomi ma luna o nā ʻōpū e like me ka puʻuwai, ka ʻeke lahilahi a puni ka puʻuwai (pericardium), nā kīʻaha koko nui, a me ka trachea. Eia kekahi, ʻo kahi puʻupuʻu i hana ʻia ma ke kua hiki ke kau i ke kaomi ma luna o ke kaulahao iwi kuamoʻo. No laila, inā ʻaʻole mālama ʻia, hiki ke loaʻa nā pilikia koʻikoʻi.
ʻO ka nūhou maikaʻi, ʻo kahi o 75% o nā puʻupuʻu i loko o ka mediastinum ʻaʻole ia he maʻi kanesa. Eia nō naʻe, ma kahi o 60% o nā puʻupuʻu i loko o ka lobe frontal he maʻi kanesa. No laila he mea nui e hopohopo e pili ana i kekahi puʻupuʻu.
He aha nā hōʻailona o kēia?
ʻO ka mea kupanaha, ma kahi o 40% o ka poʻe me kēia maʻi ʻaʻole i ʻike i kekahi mau hōʻailona . ʻIke pinepine ʻia ka puʻupuʻu i ka wā o ka X-ray umauma no kekahi kumu ʻē aʻe.
Inā loaʻa nā hōʻailona, no ka mea ua ulu ka puʻupuʻu a ke kaomi nei i nā ʻōpū a puni. ʻOi aku ka nui o ka hiki i nā puʻupuʻu maʻi kanesa ke hoʻoulu i nā hōʻailona.
Eia nā hōʻailona i ʻike ʻia ma ke ʻano laulā:
- Ka leo palahalaha.
- He leo haʻahaʻa e puka mai ana mai ka puʻu aku i ka wā e hanu ana (stridor).
- ʻŪhū, hānō, a paʻakikī paha ka hanu ʻana (dyspnea).
- Ke ʻū ʻana i ke koko (hemoptysis).
- Ka paʻakikī i ka ale ʻana i ka meaʻai (dysphagia).
- Kuni, anu, a i ʻole ka hou ʻana o ka pō.
- ʻEha umauma (ʻaʻole kēia i maʻamau).
- Ka wiwi ʻana me ke kumu ʻole.
- Pehu a ʻūlū paha nā lymph nodes (glands) i ka pā ʻana.
- Nā pilikia maka e like me ke kuʻe ʻana o nā lihilihi maka ma kekahi ʻaoʻao o ka maka a me nā pōʻai ʻeleʻele liʻiliʻi ma nā lihilihi maka.
No ke aha i hoʻokumu ʻia ai kēia mau puʻupuʻu?
He mea paʻakikī ke kuhikuhi i hoʻokahi kumu no kēia. Hiki ke loaʻa kekahi mau kumu e pili ana.
- ʻO ka ulu ʻana o nā pūnaewele i kāohi ʻole ʻia: Hoʻomohala ʻia nā puʻupuʻu maʻi kanesa a me nā puʻupuʻu ʻaʻole maʻi kanesa i ka wā e māhelehele ai nā pūnaewele a ulu aʻe ma waho o ke kaohi. ʻAʻole maopopo i nā kānaka noiʻi ke kumu o kēia hana.
- Ma ke ʻano he pane i kahi maʻi ʻē aʻe: I kekahi manawa, hiki i nā lymph nodes ke pehu a ʻike ʻia he puʻupuʻu ma muli o kahi maʻi a i ʻole kekahi maʻi ʻē aʻe i loko o ke kino.
- Nā kūlana hānau: ʻO kekahi mau puʻupuʻu, no ka laʻana, nā cysts pericardial a me nā cysts bronchogenic, he mau ulu ʻana o nā ʻiʻo maʻamau i loaʻa mai ka hānau ʻana.
Pehea e ʻike ai ke kauka i kēia?
ʻO ka maʻamau, inā loaʻa kahi puʻupuʻu ma kahi X-ray umauma, e kauoha kāu kauka i kekahi mau hoʻokolohua hou aʻe e aʻo hou e pili ana i ia mea.
- X-ray o ka umauma: Hiki ke hoʻohana mua ʻia kēia e nānā i kahi puʻupuʻu.
- CT scan (Computed Tomography scan): Hiki i kēia ke hana i nā kiʻi ʻoi aku ka maopopo a me nā kikoʻī ma mua o kahi X-ray. Hiki iā ia ke hōʻike i ka nui a me ke ʻano o ka puʻupuʻu, a pehea kona hopena i nā ʻōpū a puni.
- ʻO ke kiʻi MRI (Magnetic Resonance Imaging): Kōkua e ʻike inā e paʻi ana ka puʻupuʻu i loko o nā ʻiʻo a puni a ua pālahalaha paha i loko o lākou (e like me ke ʻano o ka maʻi kanesa).
- ʻO ka nānā ʻana o ka PET (Positron Emission Tomography scan): He mea pono loa kēia no ka ʻike ʻana i kekahi mau ʻano maʻi kanesa, e like me ka lymphoma.
- Nā hoʻāʻo koko: Hiki i nā hoʻāʻo koko ke nānā i nā protein a i ʻole nā enzymes (nā māka tumor) e pili ana i kekahi mau ʻano tumors.
- Biopsy:ʻO kēia ka hoʻāʻo koʻikoʻi loa. Lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupuʻu a nānā ʻia ma lalo o kahi microscope. Hiki i kēia hoʻāʻo ke haʻi pololei i ke ʻano o nā cell i hana ʻia ai ka puʻupuʻu a inā he maʻi kanesa a ʻaʻole paha. Hiki ke hana ʻia kēia me ka hoʻohana ʻana i nā ʻano hana e like me ka lawe ʻana i kahi ʻāpana me kahi nila ma lalo o kahi CT scan (CT-guided needle biopsy), ka hoʻouna ʻana i kahi paipu me kahi kāmela i lalo o ka esophagus (Esophagoscopy), a i ʻole ka hoʻouna ʻana i kahi paipu i lalo o ka windpipe (Bronchoscopy).
He aha nā lāʻau lapaʻau no kēia?
Aia ka lāʻau lapaʻau i ke ʻano o ka puʻupuʻu, kona wahi, kona pae inā he maʻi kanesa, a me nā hōʻailona āu e loaʻa nei.
- ʻO ke ʻoki kino: ʻO kēia ka lāʻau lapaʻau maʻamau. Pono paha e wehe ʻia nā puʻupuʻu kanesa, nā puʻupuʻu e kaomi ana i nā ʻōpū kokoke, a me nā puʻupuʻu e hoʻoulu nei i nā hōʻailona ma ke ʻoki kino. Hiki ke hana ʻia kēia ma o ka sternotomy a i ʻole ma o kekahi mau ʻoki liʻiliʻi me ka hoʻohana ʻana i kahi kāmela (ʻoki kino thorascopic kōkua wikiō - VATS).
- Lapaʻau Radiation: Hoʻohana kēia lāʻau i nā kukuna ikehu kiʻekiʻe e luku i nā hunaola kanesa. I kekahi manawa hāʻawi wale ʻia a i ʻole me ke ʻoki kino.
- Chemotherapy: Hāʻawi i ke kino i nā lāʻau lapaʻau e pepehi ai i nā hunaola kanesa a hoʻēmi paha i nā puʻupuʻu.
- Nā lāʻau antibiotic: Inā loaʻa ka puʻupuʻu i kahi maʻi (e like me nā ʻōpū lymph pehu), hiki ke mālama ʻia me nā lāʻau antibiotic.
- Ke Kali Makaʻala: Inā ʻaʻole maʻi kanesa ka puʻupuʻu a ʻaʻohe hōʻailona, hiki i kāu kauka ke hoʻoholo ʻaʻole e mālama iā ia a hana i nā scan e nānā i ka puʻupuʻu no nā loli.
He aha ka mea e hiki mai ana? Hiki ke pale ʻia kēia?
ʻO ke ʻano o ka nānā ʻana e hilinaʻi wale ʻia ma ke ʻano o ka puʻupuʻu, inā he maʻi kanesa a ʻaʻole paha, a me kou olakino holoʻokoʻa. No laila, ʻo kāu kauka wale nō ke hāʻawi iā ʻoe i ka wehewehe maikaʻi loa no ke ʻano o kou kūlana.
ʻAʻohe ala maopopo e pale aku ai i kēia ʻano puʻupuʻu mai ka hoʻokumu ʻana. Akā ʻo ka mea maikaʻi loa hiki iā ʻoe ke hana, ʻo ia ke ʻike mua i ke kūlana . Inā loaʻa iā ʻoe nā hōʻailona a mākou i kūkākūkā ai ma mua (e like me ke kuni, ka leo haʻalulu, ka paʻakikī i ka ale ʻana) no nā pule ʻelua a ʻoi aku, e ʻike pono i ke kauka no ka ʻōlelo aʻo.
Nā mea e nīnau aku ai i kāu kauka
Inā kānalua ʻoe he maʻi kou, e nīnau i kāu kauka i kēia mau nīnau.
- He aha ke ʻano o ka puʻupuʻu mediastinal i loaʻa iaʻu?
- He maʻi kanesa anei kēia puʻupuʻu a ʻaʻole paha?
- He mea pono anei ke mālama ʻia kēia?
- He aha nā lāʻau lapaʻau āu e paipai nei?
- He aha nā pōmaikaʻi a me nā pilikia o kēlā mau lāʻau lapaʻau?
- He aha nā hopena e hiki iaʻu ke manaʻo ma hope o ka lāʻau lapaʻau?
- Pono anei au e hopohopo e pili ana i nā pilikia mai ka puʻupuʻu a i ʻole ka lāʻau lapaʻau?
Leka Lawe-Home
- ʻO kahi puʻupuʻu mediastinal kahi puʻupuʻu i hana ʻia ma kahi ma waena o kou mau māmā ʻelua.
- ʻAʻole ʻike ka nui o ka poʻe i kekahi mau hōʻailona. ʻIke ʻia ia ma kahi hanana i ka wā o ka hoʻokolokolo X-ray i hana ʻia no kekahi kumu ʻē aʻe.
- ʻAʻole kēia mau puʻupuʻu a pau he maʻi kanesa. ʻO ka hapa nui he maʻi ʻaʻole ia he maʻi kanesa (benign).
- Eia nō naʻe, ʻoiai inā ʻaʻole ka puʻupuʻu he maʻi kanesa, hiki ke lilo i mea koʻikoʻi ma muli o kona wahi (kokoke i ka puʻuwai, nā kīʻaha koko, a i ʻole trachea).
- Inā loaʻa iā ʻoe nā hōʻailona e like me ke kuni, ka leo haʻalulu, ka paʻakikī i ke ale ʻana, a i ʻole ka loli o ka leo no nā pule ʻelua a ʻoi aku, e ʻike pono i ke kauka. He mea nui ka ʻike mua ʻana no ka mālama pono ʻana.
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