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He aha nā Thymoma a me Thymic Carcinoma?
I ka ʻōlelo maʻalahi, ʻelua ʻano maʻi kanesa ka thymoma a me ka thymic carcinoma e hoʻomaka ana i loko o kou gland thymus . Aia ka gland thymus ma hope o ka iwi nui ma waenakonu o kou umauma (iwi umauma). I kou wā ʻōpiopio, kōkua ka gland thymus i ka hoʻomohala ʻana i nā T-lymphocytes, a i ʻole nā T-cells, kahi ʻano o ke koko keʻokeʻo he ʻāpana koʻikoʻi o ka ʻōnaehana pale o kou kino e hakakā nei i nā maʻi. Loaʻa i ka gland thymus ʻelua ʻano nui o nā cell: nā cell epithelial a me nā lymphocytes . Hiki i kekahi o kēia mau ʻano cell ke ulu ma ke ʻano ʻē a lilo i cancerous.- Hoʻokumu ʻia ka Thymoma a me ka thymic carcinoma e ka ulu ʻana o nā pūnaewele epithelial ma ke ʻano ʻē.
- ʻO ka ulu ʻana o nā lymphocytes ma ke ʻano kūpono ʻole hiki ke alakaʻi i nā maʻi ʻaʻai e like me Hodgkin lymphoma a i ʻole non-Hodgkin lymphoma .
He aha ka ʻokoʻa ma waena o ka Thymoma a me ka Thymic Carcinoma?
ʻOiai ʻo nā mea ʻelua he mau tumors epithelial thymic (TETs), aia kekahi mau ʻokoʻa koʻikoʻi.- Thymoma: He maʻi kanesa lohi kēia. Kākaʻikahi ka laha ʻana ma ʻō aku o ke kelepaʻi thymus.
- ʻO ka maʻi kanesa Thymic: He maʻi kanesa ulu wikiwiki kēia. Loaʻa iā ia kahi manawa kiʻekiʻe o ka laha ʻana (metastasizing) i nā ʻāpana ʻē aʻe o ke kino.
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ʻO ka Thymoma a me ka thymic carcinoma ka mea maʻamau i nā pākeke ma waena o 40 a me 75 mau makahiki. Ua hōʻike ʻia nā noiʻi ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa he ʻoi aku ka maʻamau o ka maʻi i nā poʻe o ka lāhui ʻAsia a i ʻole ka Pākīpika. Eia nō naʻe, he mea nui e hoʻomanaʻo e hiki ke ulu i loko o kekahi. Hoʻopili pinepine ʻia ka Thymoma me nā kūlana i kapa ʻia ʻo autoimmune paraneoplastic syndromes . ʻO kēia ka manawa e hoʻouka hewa ai ka ʻōnaehana pale o kou kino i kāna mau cell olakino ponoʻī. Hiki i kēia ke hana i nā ʻano hōʻailona ʻoluʻolu ʻole. ʻO kekahi o nā syndromes e pili pinepine ʻia me ka thymoma:- ʻO Myasthenia gravis: He ʻano autoimmune kēia e hoʻopilikia ai i nā aʻalolo a me nā ʻiʻo, e hoʻonāwaliwali ai i nā ʻiʻo .
- ʻO ka aplasia cell ʻulaʻula maʻemaʻe (PRCA): He maʻi koko kēia kahi i hana ʻole ai kou iwi iwi i nā cell koko ʻulaʻula lawa, e hoʻoulu ai i ka anemia .
- Hypogammaglobulinemia (a i ʻole Good syndrome): He nāwaliwali kēia o ka ʻōnaehana pale. Maanei, ʻaʻole hana kou kino i nā antibodies lawa e hakakā ai i nā maʻi a pale i ka maʻi.
- ʻO ka polymyositis
- Lupus ʻulaʻula
- ʻO ka ʻāʻī rheumatoid
- ʻO ka maʻi thyroid
- ʻO ka maʻi Sjögren
Pehea ka maʻamau o ka thymoma a me ka thymic carcinoma?
ʻO ka Thymoma a me ka thymic carcinoma nā ʻano maʻi kanesa maʻamau e ulu ana i loko o ka thymus gland. Eia naʻe, ma ke ʻano holoʻokoʻa, he mau maʻi kanesa kakaikahi loa kēia . No ka laʻana, ʻoiai ma kahi ʻāina nui e like me ʻAmelika Hui Pū ʻIa, aia wale nō ma kahi o 400 mau kānaka i ʻike ʻia me kēia maʻi i kēlā me kēia makahiki.He aha nā hōʻailona o ka thymoma a me ka thymic carcinoma?
ʻAʻole hōʻike ka nui o ka poʻe i kekahi mau hōʻailona i nā pae mua.Hoʻomaka pinepine nā hōʻailona e ʻike ʻia ke ulu ka maʻi kanesa a hoʻomaka e hoʻopilikia i nā ʻōpū ʻē aʻe o ka umauma. Pili kekahi o nā hōʻailona i nā syndromes paraneoplastic i ʻōlelo ʻia ma mua.Nā hōʻailona i hoʻokumu ʻia e ka maʻi ʻaʻai e hoʻopilikia ana i kahi ʻōpū umauma
ʻO ka ʻeha a me ka paʻakikī o ka hanu ʻana he mau hōʻailona ia o ka thymoma a i ʻole ka thymic carcinoma. Eia nā hōʻailona:- ʻEha ka umauma a i ʻole ka manaʻo o ka ʻūmiʻi ma ka umauma.
- He ʻū mau e nalo mau ana.
- Pōkole o ka hanu.
- Ka paʻakikī i ka ale ʻana i ka meaʻai.
- Kuke
- Paʻakikī ka hanu ʻana
- Luhi
- Pōʻino
- ʻEha poʻo
- Ka pehu ʻana o ka ʻāʻī a me ka maka
- Ka pehu ʻana o nā lima a me nā poho lima
- ʻIke maopopo ʻia nā aa koko ma ke kino o luna
Nā ʻano o nā syndromes paraneoplastic
Inā loaʻa iā ʻoe ka thymoma, hiki iā ʻoe ke ʻike i hoʻokahi a ʻoi aku paha o nā hōʻailona o nā syndromes paraneoplastic. Eia kekahi laʻana:- ʻIke pālua, nā lihilihi maka e kulou ana, ka luhi nui, a me ka nāwaliwali o nā ʻiʻo (he mau hōʻailona kēia o ka myasthenia gravis).
- Anemia (hiki paha kēia ma muli o ka aplasia o nā cell koko ʻulaʻula maʻemaʻe).
- Nā maʻi pinepine, ka maʻi pākī, a me nā ʻōpū lymph pehu (he mau hōʻailona kēia o ka hypogammaglobulinemia).
He aha nā kumu o ka thymoma (thymic carcinoma)?
ʻO ka ʻoiaʻiʻo, ʻaʻohe mea pilikia genetic a i ʻole ke kaiapuni i ʻike ʻia no ka thymoma . Ke hoʻomau nei ka noiʻi e hoʻoholo ai inā pili ke ʻano i nā maʻi like ʻole, nā mana hoʻoilina, a me nā ʻano maʻi ʻē aʻe.Pehea e ʻike ʻia ai ka thymoma (thymic carcinoma)? (Diagnosis)
Hiki paha i kāu kauka ke ʻike he ʻano puʻupuʻu kou ma hope o ka hana ʻana i nā hoʻokolohua kiʻi e ʻimi ai i ke kumu o kāu mau hōʻailona. No ka hōʻoia ʻana i ka maʻi, e hana kāu kauka i kahi hoʻokolohua kino a nīnau e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino. A laila, e hana paha lākou i hoʻokahi a ʻoi aku paha o nā hoʻokolohua ma lalo nei e aʻo hou e pili ana i ka puʻupuʻu:- X-ray umauma: Hiki i kahi X-ray ke hōʻike i nā mea e like me nā puʻupuʻu i loko o ke kino. Hiki iā ia ke hāʻawi i ka ʻike koʻikoʻi, e like me ke ʻano o ka wehewehe ʻana o nā lihi o ka puʻupuʻu. ʻOi aku ka maʻalahi o ka wehe ʻana i kahi puʻupuʻu me nā lihi maopopo ma ke ʻoki ʻana.
- Nānā CT:ʻO ka CT scan o ka umauma ka hoʻāʻo kiʻi maʻamau i hoʻohana ʻia e ʻike i ka thymoma. I kekahi manawa e hoʻokomo paha kāu kauka i kahi wai kūikawā (contrast medium) i loko o kou aa. E kōkua kēia i ka ʻike maopopo ʻana o ka puʻupuʻu ma ke scan. I ka hapanui o nā hihia, ua lawa ka CT scan e ʻike i ka thymoma a i ʻole ka thymic carcinoma.
- MRI scan: Hiki i kahi MRI ke hana i nā kiʻi kikoʻī loa o ka puʻupuʻu. Hiki i kēia ke kōkua i ke kauka e hoʻokaʻawale iā ia mai nā ʻano ulu ʻē aʻe. No ka laʻana, hiki i kahi MRI ke kōkua i ka hoʻoholo ʻana inā he thymoma a he thymic carcinoma paha.
- ʻO ka nānā PET a i ʻole ka nānā PET/CT: I ka wā o ka nānā PET, hoʻokomo ke kauka i kahi kō palekana, radioactive i loko o kou aa. Hōʻiliʻili kēia hopena a puni nā cell e hoʻohana nui ana i ka ikehu, e like me nā cell kanesa. ʻOi aku ka ʻike ʻia o nā mea e like me nā puʻupuʻu ma ka nānā. I ka manawa pinepine, hiki ke hana ʻia kahi nānā PET a me kahi nānā CT i ka manawa like (PET/CT).
- Biopsy: ʻO ke ala wale nō e hōʻoia pono ai i kahi hōʻailona, ʻo ia ka hana ʻana i kahi biopsy. ʻO kēia kahi e lawe ai ke kauka i kahi hāpana o nā cell mai ka puʻupuʻu a nānā iā lākou ma lalo o kahi microscope. Inā palekana ke hana pēlā, e wehe ke kauka i ka puʻupuʻu holoʻokoʻa a nānā i nā cell. Inā ʻaʻole hiki ke wehe ʻia ka puʻupuʻu holoʻokoʻa, e lawe wale ʻia kahi hāpana no ka hoʻokolokolo ʻana.
Pehea e hoʻoholo ʻia ai ke kahua o ka thymoma (thymic carcinoma)?
ʻO ke kahua o ke kanesa ka hoʻokaʻawale ʻana o ke kanesa e like me kona koʻikoʻi. Nui nā mea e komo i ka hoʻoholo ʻana i ke koʻikoʻi o ka maʻi. ʻO ka ʻike ʻana i ke kahua o kou kanesa e kōkua i kāu kauka e hoʻolālā i ka lāʻau a hāʻawi iā ʻoe i kahi manaʻo o kou manawa e ola ai. Hoʻonohonoho ʻia ka Thymoma a me ka thymic carcinoma me ka hoʻohana ʻana i ka ʻōnaehana TNM . ʻO TNM ke kū nei no Tumor, Nodes, a me Metastasis. No ka hoʻoholo ʻana i ke kahua o kou kanesa, ʻimi nā kauka i nā pane i nā nīnau e like me:- Puʻupuʻu (T): Aia kekahi puʻupuʻu? Pehea ka nui? Aia ma hea?
- Nā Lymph Nodes - N): Ua pālahalaha anei ke kanesa i nā lymph nodes? ʻO wai nā lymph nodes? Pehea ka mamao o kona laha ʻana?
- Metastasis (M): Ua laha anei ke kanesa i nā ʻāpana ʻē aʻe o ke kino ma waho o ka thymus gland? I nā ʻāpana hea?
He aha nā lāʻau lapaʻau no ka thymoma (thymic carcinoma)?
ʻO ke ʻano o ka lāʻau lapaʻau āu e loaʻa ai ma muli o kekahi mau kumu, me ke ʻano o ka maʻi kanesa āu e loaʻa ai, ke kahua o ke kanesa, a inā ua ʻike hou ʻia ke kanesa a ua hoʻi hou mai paha. Hiki i nā koho lapaʻau ke komo pū me:- ʻOki: Hiki i ke kauka ʻoki thoracic ke wehe i kāu puʻupuʻu me ke ʻoki. Inā ua pālahalaha ke kanesa i nā lymph nodes, thymus gland, a i ʻole ka uhi ʻana o ka māmā, hiki iā lākou ke wehe i nā ʻāpana o ia mea. ʻO ke ʻoki ke ʻano nui o ka lāʻau no ka thymoma mua. Inā ʻaʻole hiki ke wehe palekana ʻia ka puʻupuʻu holoʻokoʻa, e wehe ke kauka ʻoki i ka nui o ia mea e like me ka hiki ke hōʻemi i nā hōʻailona i hoʻokumu ʻia e ka puʻupuʻu.
- Lapaʻau radiation: Hiki i kahi kauka radiation oncologist ke hāʻawi i ka radiation i ke kanesa me ka hoʻohana ʻana i ka radiation therapy kukuna waho . Hoʻohana kēia lāʻau i kahi mīkini e kuhikuhi i nā kukuna X i ka puʻupuʻu e pepehi i nā hunaola kanesa. Hiki ke hoʻohana ʻia hoʻokahi a i ʻole me ka hui pū ʻana me nā lāʻau ʻē aʻe, e like me ka chemotherapy a i ʻole ke ʻoki kino.
- Kemoterapi: Inā ʻaʻole hiki i ke ʻoki kino ke wehe i ka puʻupuʻu, hiki ke hāʻawi ʻia iā ʻoe nā lāʻau lapaʻau chemotherapy e pepehi i nā hunaola kanesa. Hiki i kahi hematologist a i ʻole oncologist lapaʻau ke kuhikuhi i ka chemotherapy e hoʻēmi i ka puʻupuʻu ma mua o ke ʻoki kino a i ʻole e mālama i kahi kanesa i hoʻi mai.
- Lapaʻau i kuhikuhi ʻia: Inā loaʻa i kāu mau hunaola kanesa nā hoʻololi gene kikoʻī, hiki ke hāʻawi ʻia iā ʻoe ka lāʻau lapaʻau i kuhikuhi ʻia. Ua hoʻolālā ʻia kēia mau lāʻau lapaʻau e kuhikuhi i kēlā mau hoʻololi gene kikoʻī a pepehi i nā hunaola kanesa. He koho lapaʻau paha kēia no ka thymoma a me ka thymic carcinoma inā ʻaʻole i holo pono nā lāʻau lapaʻau ʻē aʻe, e like me ka chemotherapy.
- Immunotherapy: Hoʻoikaika kēia lāʻau i kāu ʻōnaehana pale e kōkua iā ia e ʻike a luku i nā hunaola kanesa. He koho paha kēia no ka maʻi kanesa thymic i pane ʻole i ka chemotherapy.
- Nā hoʻokolohua lapaʻau: ʻO ka hoʻokolohua lapaʻau he haʻawina e hoʻāʻo ai i ka palekana a me ka pono o nā lāʻau lapaʻau maʻi kanesa hou a ʻokoʻa paha. Ma muli o kou ʻano maʻi kanesa, hiki paha iā ʻoe ke kūpono no kekahi o kēia mau papahana e hoʻāʻo ai i nā lāʻau lapaʻau maʻi kanesa hou. E nīnau i kāu kauka e pili ana i kēia.
Hiki i kāu kauka ke ʻōlelo aku iā ʻoe e hana pū me kahi hui mālama palliative e kākoʻo iā ʻoe ma o kāu hōʻoia ʻana i ka maʻi kanesa. ʻO nā loea mālama palliative e komo pū me nā kauka, nā kahu maʻi, a me nā loea ʻē aʻe. Hiki iā lākou ke kōkua iā ʻoe e hoʻokele i nā hōʻailona o ka maʻi kanesa a me nā hopena ʻaoʻao o ka lāʻau. ʻAʻohe mea i ke kahua o kou maʻi kanesa a i ʻole kou manawa e hoʻōla ai, he waiwai nui ka mālama palliative.
He aha ka nui o ke ola no ka thymoma a me ka thymic carcinoma?
Ma keʻano laulā, ʻoi aku ka maikaʻi o ka wānana o nā thymoma ma mua o nā carcinoma thymic. Eia kekahi, inā ua kaupalena ʻia ke kanesa i ka gland thymus, ʻoi aku ka maikaʻi o ka helu ola ma mua o ka laha ʻana o ke kanesa. ʻO nā helu ola ʻelima makahiki no ka carcinoma thymic penei (e hoʻomanaʻo, he mau helu awelika kēia):- Inā aia wale nō ke kanesa i loko o ka thymus gland: 95%
- Inā ua pālahalaha aku i nā ʻōpū kokoke a me nā lymph nodes: 78%
- Inā ua pālahalaha aku i nā ʻāpana mamao o ke kino (metastasized): 38%
He aha kaʻu e manaʻo ai inā loaʻa iaʻu kēia maʻi kanesa?
I kekahi mau hihia, e nalowale loa paha nā hōʻailona a me nā ʻōuli o ke kanesa (remission) , a ʻaʻole paha e hoʻi hou mai ke kanesa. Eia nō naʻe, i nā hihia he nui, hiki i nā ʻano kanesa ʻelua ke hoʻi hou mai (recur) . I ke ʻano o ka thymoma, hiki i ke kanesa ke hoʻomau no ka manawa lōʻihi me ka hoʻi ʻole mai. Eia nō naʻe, pono ʻoe e loaʻa nā kipa hahai maʻamau e hōʻoia i ka ʻole o ʻoe i ke kanesa.He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?
E kamaʻilio me kāu hui lapaʻau e pili ana i kāu hōʻailona a me nā koho lapaʻau. Mai kānalua e nīnau i kāu mau nīnau e pili ana i ka maʻi kanesa a pehea e pili ai i kou ola. Makemake paha ʻoe e nīnau i nā nīnau e like me:- He aha ke kahua o koʻu maʻi kanesa?
- He aha nā koho lapaʻau e loaʻa iaʻu?
- Ua kūpono anei au e komo i kahi hoʻokolohua lapaʻau? Manaʻo paha ʻoe e komo wau?
- He aha ka pahuhopu o ka lāʻau lapaʻau?
- He aha nā hopena ʻaoʻao e pono iaʻu ke manaʻo?
- Āhea wau e manaʻo ai e hoʻomaka nā hopena ʻaoʻao?
- He aha ka manawa kūpono e hoʻi hou mai ai ke kanesa?
- Pehea e pili ai kaʻu hōʻailona a me ka lāʻau lapaʻau i koʻu ola?
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