Koj puas tau muaj ib lub pob, uas peb hu ua "lub pob," ntawm koj lub caj dab, qhov chaw mos, lossis qhov chaw mos? Qee zaum, cov pob zoo li no yuav o tuaj thaum koj mob khaub thuas lossis qee yam kev kis kab mob. Qhov ntawd yog ib txwm muaj. Tab sis yog tias koj muaj cov pob o zoo li no yam tsis muaj laj thawj, ntev heev, thiab koj kuj xav tias nkees thiab poob phaus, koj yuav tsum txhawj me ntsis. Hnub no, peb yuav tham txog ib qho mob tsis tshua muaj uas tuaj yeem xav tias muaj thaum lub sijhawm zoo li no. Qhov ntawd yog Castleman Kab Mob.
Hais yooj yim xwb, Kab mob Castleman yog dab tsi?
Xav txog tias peb lub cev zoo li ib lub teb chaws. Ces peb lub cev tiv thaiv kab mob yog cov tub rog uas tiv thaiv lub teb chaws ntawd. Thaum ib tug kab mob (yeeb ncuab) nkag mus rau hauv lub cev los ntawm sab nraud, cov tub rog no mus rau hauv kev sib ntaus sib tua thiab kov yeej tus yeeb ncuab ntawd. Thaum kev sib ntaus sib tua tas, cov tub rog rov qab mus rau hauv lub tsev tub rog thiab ntsiag to. Qhov no yog qhov tshwm sim hauv lub cev ntawm ib tug neeg noj qab nyob zoo.
Tab sis nrog ib tug neeg uas muaj tus kab mob Castleman, nws txawv. Qhov tshwm sim ntawm no yog tias cov tub rog uas tau mus ua tsov rog, lub cev tiv thaiv kab mob, tsis nyob twj ywm txawm tias tom qab kev sib ntaus sib tua tas lawm. Lawv tseem ua haujlwm. Nws zoo li lawv ib txwm npaj rau kev ua tsov rog. Qhov no ua rau lub cev o mus ntev. Qhov no tuaj yeem ua rau peb cov kabmob puas tsuaj.
Lub caij no, peb cov qog ntshav, cov khoom me me ntawd, zoo li cov chaw tub rog. Lawv ua haujlwm ntau heev, zoo li lim cov kab mob thiab khaws cov qe ntshav tiv thaiv kab mob. Tam sim no, vim tias lub cev tiv thaiv kab mob ua haujlwm tas li, cov qog ntshav no kuj ua haujlwm tas li. Yog li ntawd, cov qe ntshav hauv lawv pib loj hlob ntau dhau. Yog vim li cas cov qog ntshav o hauv Castleman tus kab mob. Nws tsis yog tsuas yog o xwb, nws txawm ua rau muaj kev hloov pauv hauv cov nqaij ntawm cov qog ntshav ntawd.
Qhov tseem ceeb tshaj plaws yog tias tus kab mob Castleman yog ib yam kab mob tsis tshua muaj . Yog li ntawd, tsis txhob ntshai kis tus kab mob no tsuas yog vim koj muaj tus kab zuam xwb. Tab sis nws yog ib qho tseem ceeb heev uas yuav tsum paub txog.
Cov kab mob Castleman tseem ceeb yog dab tsi?
Kab mob Casselman muaj ob hom loj. Cov tsos mob thiab kev kho mob rau txhua hom sib txawv heev. Yog li ntawd, nws yog ib qho tseem ceeb kom nkag siab ob hom no kom meej.
| Hom kab mob | Piav qhia yooj yim |
|---|---|
| 1. Kab mob Castleman uas nyob ib sab ntawm ib sab (UCD) | "Uni" txhais tau tias "ib qho." "Centric" txhais tau tias "nruab nrab." Qhov no txhais tau tias hauv hom no, tsuas yog ib lossis ob peb lub qog ntshav hauv ib cheeb tsam ntawm lub cev o. Piv txwv li, nws tsuas yog nyob rau ib sab ntawm lub caj dab, lossis tsuas yog nyob rau hauv qhov chaw mos xwb. Hom no tau tshaj tawm tias muaj nyob rau hauv peb feem plaub (kwv yees li 75%) ntawm tag nrho cov neeg mob Castleman's. |
| 2. Kab mob Castleman ntau lub hlwb (MCD) | "Ntau" txhais tau tias "ntau." Qhov no txhais tau tias hauv hom no, cov qog ntshav o tuaj ntau qhov chaw ntawm lub cev. Piv txwv li, koj yuav muaj cov qog ntshav o tuaj ntau qhov chaw, xws li caj dab, qhov tso, qhov ncauj, thiab sab hauv siab. Qhov no nyuaj dua li hom UCD. |
Puas muaj cov kab mob Castleman ntau hom (MCD)?
Yog, MCD raug muab faib ua ntau hom me. Kev faib tawm no yog ua raws li qhov ua rau thiab lwm yam mob uas tshwm sim nrog nws.
- MCD uas cuam tshuam nrog POEMS: POEMS yog ib qho mob ntshav tsis tshua muaj. Qee zaum MCD tuaj yeem tshwm sim ua ke nrog POEMS.
- MCD cuam tshuam nrog HHV-8: Qhov no yog tshwm sim los ntawm kev kis tus kab mob hu ua Human Herpes Virus-8 (HHV-8). Hom no feem ntau tshwm sim rau cov neeg uas muaj tus kab mob HIV lossis cov neeg uas lub cev tiv thaiv kab mob tsis zoo vim lwm yam.
- Idiopathic MCD (iMCD): Lo lus kho mob " idiopathic " txhais tau tias "tsis tau pom muaj qhov ua rau." Feem ntau ntawm cov neeg mob MCD muaj hom no. Qhov no txhais tau tias tseem tsis tau paub qhov ua rau tseeb.
Hom iMCD no muab faib ua peb pawg me me:
1. iMCD cuam tshuam nrog TAFRO: TAFRO yog ib lub npe los ntawm kev sib xyaw ua ke ntawm ntau yam tsos mob. Ntawd yog, Thrombocytopenia (cov ntshav platelets qis), Anasarca (lub cev o nrog dej), Fever (kub taub hau), Renal dysfunction (kev ua haujlwm ntawm lub raum tsis muaj zog) thiab Organomegaly (lub siab lossis tus po loj hlob) yog cov tsos mob uas tuaj yeem pom hauv qhov no.
2. iMCD nrog idiopathic plasmacytic lymphadenopathy (iMCD-IPL): Hauv hom no, cov platelet suav yuav nce siab. Kuj tseem yuav muaj cov tshuaj tiv thaiv kab mob ntau dhau los ntawm cov qe ntshav dawb.
3. iMCD, tsis tau teev tseg lwm yam (iMCD-NOS): Cov neeg mob uas muaj iMCD uas tsis muaj feem cuam tshuam nrog TAFRO thiab tsis pom muaj lwm yam ua rau mob no yog cov neeg mob no.
Cov tsos mob ntawm tus kab mob no yuav yog dab tsi?
Cov tsos mob sib txawv nyob ntawm hom kab mob Castleman uas koj muaj.
Kab mob Casselman uas tsis muaj ib qho chaw nyob (UCD) feem ntau tsis muaj tsos mob . Tsuas muaj ib qho cim qhia tias cov qog ntshav hauv lub qhov (adenoid) o. Qee zaum, cov tsos mob (piv txwv li, mob, ua tsis taus pa) tsuas yog tshwm sim thaum cov qog ntshav hauv lub qhov o nias rau lwm lub cev.
Txawm li cas los xij, hauv ntau lub hlwb Castleman kab mob (MCD), cov tsos mob pom tseeb dua. Ntxiv nrog rau cov qog o, koj yuav muaj:
- kub taub hau ntau zaus
- Xav tias nkees heev thiab qaug zog heev yam tsis muaj laj thawj (qhov no kuj tseem yuav yog vim muaj ntshav tsis txaus)
- Tawm hws ntau dhau thaum hmo ntuj
- Xeev siab thiab ntuav
- Kev poob phaus tsis tau xav txog
- O ntawm ob txhais ceg, pob luj taws, lossis plab
- Lub qhov ntswg loj (splenomegaly) lossis lub siab loj (hepatomegaly)
- Kev tsis muaj zog ntawm tes thiab taw (peripheral neuropathy)
Vim li cas tus kab mob no thiaj tshwm sim? Puas muaj tej yam uas ua rau muaj kev pheej hmoo?
Qhov tseeb, cov kws tshawb fawb tseem tsis tau pom ib qho laj thawj tshwj xeeb rau tus kab mob Castleman unicentric (UCD) .
Kab mob Castleman ntau lub hlwb (MCD) muaj feem cuam tshuam nrog tus kab mob HHV-8 uas tau hais los saum toj no. Txawm li cas los xij, cov kws tshawb fawb tseem tab tom tshawb nrhiav seb lwm yam kab mob, kev hloov pauv ntawm cov noob caj noob ces, lossis kev teb ntawm lub cev tiv thaiv kab mob puas yog lub luag haujlwm rau hom iMCD uas tsis paub.
Thaum nws los txog rau cov yam uas ua rau muaj kev pheej hmoo, tsis muaj cov yam uas paub tias ua rau muaj kev pheej hmoo rau UCD thiab iMCD. Txawm li cas los xij, yog tias koj muaj tus kab mob HIV lossis lwm yam kab mob tiv thaiv kab mob tsis muaj zog, koj muaj feem yuav muaj tus kab mob HHV-8-associated MCD ntau dua.
Txawm hais tias tus kab mob no tuaj yeem tshwm sim rau cov neeg txhua lub hnub nyoog, nws feem ntau tshwm sim rau cov neeg hnub nyoog 30 thiab 60 xyoo .
Cov teeb meem uas yuav tshwm sim los ntawm tus kab mob no yog dab tsi?
Kab mob Castleman tej zaum yuav ua rau koj muaj feem yuav mob lwm yam mob me ntsis, tshwj xeeb yog mob qog noj ntshav , xws li lymphoma, uas yog mob qog noj ntshav ntawm lub cev lymphatic.
Qhov no tsis yog mob qog noj ntshav, tab sis nws tuaj yeem ua rau muaj kev pheej hmoo ntawm mob qog noj ntshav. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum tau nyob hauv kev saib xyuas ntawm kws kho mob.
Tsis tas li ntawd xwb, cov neeg uas muaj UCD muaj feem yuav mob tawv nqaij uas tsis tshua muaj tab sis loj heev hu ua paraneoplastic pemphigus (PNP). Cov neeg uas muaj MCD muaj feem yuav mob ntau yam kab mob. Yog tias tsis kho, cov kab mob no tuaj yeem ua rau lub cev puas tsuaj thiab tuag taus.
Tab sis tsis txhob txhawj, koj tus kws kho mob yuav saib xyuas qhov mob no tas li thiab ua cov kauj ruam tsim nyog los pab tiv thaiv cov teeb meem no kom ntau li ntau tau.
Tus kws kho mob yuav kuaj mob no li cas kom meej?
Vim tias cov tsos mob ntawm tus kab mob Castleman zoo ib yam li cov kab mob ntawm lwm yam kab mob, xws li mob khaub thuas lossis mob ntsws, tus kws kho mob yuav kuaj xyuas cov kab mob uas tshwm sim. Tsuas yog tom qab ntawd lawv thiaj li xav tias muaj tus kab mob Castleman thiab ua cov kev kuaj mob tshwj xeeb.
Cov kev ntsuam xyuas hauv qab no feem ntau yog ua tiav:
- Kev kuaj mob hauv chav kuaj: Koj cov ntshav yuav raug kuaj hauv qab lub tshuab tsom iav kom paub seb puas muaj qhov tsis zoo hauv koj cov qe ntshav thiab lwm yam tsis zoo. Yog tias xav tias muaj MCD cuam tshuam nrog HHV-8, kev kuaj mob HIV kuj tseem yuav ua tau.
- Kev kuaj duab: Kev ntsuas CT thiab PET tuaj yeem pab txheeb xyuas qhov chaw uas cov qog ntshav o nyob hauv lub cev. Lawv kuj tseem tuaj yeem kuaj xyuas seb cov kabmob xws li lub siab thiab tus po puas loj hlob.
- Kev kuaj mob qog ntshav hauv lub qog ntshav: Qhov no yog tib txoj kev thiab txoj kev tseeb tshaj plaws los paub tseeb tias muaj tus kab mob . Qhov no suav nrog kev muab ib daim nqaij me me los ntawm cov qog ntshav hauv lub qog ntshav uas o thiab kuaj nws hauv qab lub tshuab tsom iav. Qhov no tuaj yeem qhia tau tseeb tias puas muaj kev hloov pauv ntawm cov cell tshwj xeeb uas cuam tshuam nrog tus kab mob Casselman.
Cov kev kho mob rau qhov no yog dab tsi?
Cov kev kho mob sib txawv kiag li nyob ntawm hom kab mob.
Kev Kho Mob ntawm Unicentric Casselman Kab Mob (UCD)
Txoj kev kho mob tseem ceeb thiab ua tau zoo tshaj plaws rau UCD yog phais tshem tawm cov qog ntshav uas raug mob . Feem ntau, tus kab mob no kho tau zoo tag nrho tom qab phais no.
Qee zaum, yog tias lub qog loj, kev kho mob hluav taws xob lossis kev kho mob tiv thaiv kab mob yuav muab ua ntej phais kom nws me thiab ua kom yooj yim dua rau tshem tawm.
Yog tias lub qog nyob rau qhov chaw uas tsis tuaj yeem phais tshem tawm, thiab koj tsis muaj tsos mob, koj tus kws kho mob yuav txiav txim siab tsis kho nws thiab tsuas yog saib nws xwb. Txawm li cas los xij, rau ib tus neeg uas tsis yog tus neeg sib tw rau kev phais thiab tseem muaj tsos mob, tib yam kev kho mob rau MCD tuaj yeem muab tau.
Kev kho mob ntawm ntau lub chaw nres tsheb Casselman (MCD)
Vim tias MCD yog ib yam mob uas kis mus rau ntau qhov ntawm lub cev, nws tsis tuaj yeem kho tau los ntawm kev phais lossis kev kho mob hluav taws xob. Yog li ntawd, lwm yam kev kho mob raug siv. Kev kho mob nyob ntawm seb koj puas muaj HHV-8 thiab tus kab mob hnyav npaum li cas.
Cov kev kho mob hauv qab no feem ntau yog muab:
- Corticosteroids: Cov tshuaj no pab tswj cov tsos mob los ntawm kev txo qhov o ntawm lub cev.
- Cov tshuaj kho mob qog noj ntshav: Cov no ua haujlwm los ntawm kev tswj tus nqi uas cov hlwb hauv lub cev lymphatic loj hlob sai dhau. Rituximab feem ntau yog siv rau HHV-8-cuam tshuam MCD.
- Kev Kho Mob Tiv Thaiv Kab Mob: Cov kev kho mob no ua haujlwm los ntawm kev ua kom koj lub cev tiv thaiv kab mob tsis ua haujlwm zoo. Siltuximab (Sylvant®) yog tib yam tshuaj uas tau pom zoo rau iMCD.
- Cov tshuaj tua kab mob: Yog tias koj muaj HHV-8-associated MCD, koj yuav tau txais cov tshuaj no los tswj tus kab mob HIV lossis HHV-8.
Kuv yuav tsum mus ntsib kws kho mob thaum twg?
Yog tias koj pom ib lub pob los yog lub qhov me me ntawm koj lub caj dab, qhov tsoob, lossis qhov ncauj uas koj tuaj yeem kov tau, nco ntsoov qhia rau koj tus kws kho mob txog qhov ntawd.
Tsis tas li ntawd xwb, yog tias cov tsos mob uas tau hais hauv tsab xov xwm no, xws li kub taub hau uas tsis paub meej, poob phaus, thiab qaug zog heev, tseem muaj li ob peb lub lis piam, nco ntsoov nrhiav kev pab kho mob.
Puas ua tau kom nyob nrog tus kab mob no?
Cov lus teb rau lo lus nug no nyob ntawm seb koj muaj hom Casselman li cas.
Ib tug neeg uas muaj UCD tuaj yeem cia siab tias yuav tau txais txiaj ntsig zoo heev . Thaum lub qog raug phais tshem tawm, tus kab mob feem ntau kho tau zoo tag nrho. Tom qab kev kho mob, qhov no yuav tsis cuam tshuam rau koj lub neej ntev li qub.
Qhov kev kwv yees rau cov neeg uas muaj MCD yog qhov nyuaj me ntsis . Nws txawv nyob ntawm hom thiab qhov hnyav ntawm tus kab mob. Rau qee tus, cov tsos mob tuaj yeem ua rau hnyav zuj zus thiab ua rau tuag taus. Rau lwm tus, cov tsos mob tuaj yeem kav ntev, tab sis muaj kev cia siab. Nruab nrab ntawm 65% thiab 75% ntawm cov neeg uas kuaj pom tias muaj MCD nyob tau ntau tshaj tsib xyoos . Qhov no zoo dua nrog kev kho mob tshiab.
Tsis muaj ib lo lus teb yooj yim, ib qho loj-haum-txhua tus rau tus kab mob Casselman. Nws yuav nyob ntawm koj qhov kev paub dhau los, hom kab mob uas koj muaj, thiab seb koj puas muaj lwm yam mob, xws li HIV, TAFRO, lossis POEMS. Qee zaum kev phais thiab kev saib xyuas kev kho mob tas li yuav txaus. Lossis koj yuav tsum tau txais ntau yam kev kho mob thoob plaws koj lub neej. Yog li nws yog qhov zoo tshaj plaws los tham nrog koj tus kws kho mob txog koj tus mob, koj txoj kev kho mob, thiab koj lub neej yav tom ntej.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab mob Castleman tsis yog mob qog noj ntshav, tab sis nws yog ib qho kab mob tsis tshua muaj uas tshwm sim los ntawm lub cev tiv thaiv kab mob ua haujlwm ntau dhau.
- Muaj ob hom tseem ceeb: UCD, uas tsuas yog muaj rau ib cheeb tsam xwb, thiab MCD, uas kis thoob plaws lub cev.
- Yog tias muaj ib lub pob ntawm koj lub cev o ntev heev, thiab muaj cov tsos mob xws li kub taub hau, qaug zog, thiab poob phaus, mus ntsib kws kho mob tam sim ntawd.
- Tsuas yog kuaj tau tus kab mob no los ntawm kev kuaj ib qho nqaij ntawm cov qog ntshav xwb.
- Cov kev xaiv kho mob sib txawv nyob ntawm hom kab mob. UCD feem ntau tuaj yeem kho tau tag nrho nrog kev phais. MCD xav tau kev kho mob ntev.
- Koj tus kws kho mob paub koj tus mob zoo tshaj plaws, yog li nrog nws tham yog tias koj muaj lus nug lossis kev txhawj xeeb.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus