He pukupuku pēnei kei roto i tō tinana? Kia mārama tātou ki tēnei (Adrenal Adenoma)!

Kua whakaarohia e koe i ētahi wā, ina mahi tātou i tētahi mea pēnei i te 'matawai' mō tētahi atu mate, ka kitea pea e tātou tētahi mea huna i roto i te tinana kāore i mōhiotia e tātou kei reira? Koinei te huarahi e kitea ai tēnei āhuatanga e kiia nei ko te "Adrenal Adenoma". He pukupuku iti tēnei, ehara i te matepukupuku, ehara i te mea morearea e puta mai ana i roto i ō repe adrenal. Me kōrero taipitopito atu tātou mō tēnei?

He aha tonu te adenoma adrenal?

Āe, tuatahi, me titiro tātou ki ngā repe adrenal. Kei runga i ō whatukuhu ēnei repe e rua, he rite ki ngā taupoki iti e rua. Koinei ngā mea e whakaputa ana i ētahi momo homoni he mea tino nui ki tō tātou tinana. Whakaarohia, me pēhea te tauhohenga a tō tinana ina pāngia koe e te mataku, e te manukanuka rānei? Ko ngā homoni e āwhina ana i tēnā, nō ēnei repe. Ehara i te mea koinā anake, engari ka āwhina anō hoki ēnei homoni ki te whakahaere i ngā mea maha pērā i te taumata huka toto, te toto toto tiketike, me te pūnaha ārai mate.

E rua ngā wāhanga matua o te repe adrenal: ko te wāhanga o waho e kiia ana ko te adrenal cortex, ā, ko te wāhanga o roto e kiia ana ko te adrenal medulla. Ka whakaputahia e te adrenal cortex ngā homoni pēnei i te `(Cortisol)` me te `(Aldosterone)`. Ka whakaputahia e te adrenal medulla ngā homoni pēnei i te `(Dopamine)`, `(Epinephrine)` me te `(Norepinephrine)`. Kei roto i te adrenal cortex ngā pukupuku e kōrerohia ana, e kiia nei ko te adrenal adenoma, e whanake ana.

I te nuinga o te wā, kāore ēnei adenoma e puta he tohu nui, ā, kāore hoki e hiahiatia he maimoatanga. Heoi, i ētahi wā, ka taea e ēnei pukupuku te whakaputa i te nui atu i te rahinga noa o te kotahi, neke atu rānei o ngā homoni adrenal.

He momo adenoma adrenal kei reira?

Āe, e rua ngā momo matua.

• Adenoma Mahi/Hohe: Ka nui ake ngā homoni o te repe adrenal e whakaputaina ana e ēnei momo pukupuku i te mea noa . Ka puta pea ngā tohu, ā, me rongoā pea.
• Adenoma kore mahi/kore mahi: Kāore ēnei e whakaputa i ētahi atu homoni. Ko te nuinga o ngā adenoma adrenal ka taka ki tēnei kāwai. I te nuinga o te wā, kāore e puta he tohu, kāore hoki e hiahiatia he maimoatanga.

Ko te mea nui, he iti rawa te tūponotanga ka huri tetahi o ngā momo ki te mate pukupuku. Heoi, tera pea ka mahi te adenoma kore mahi i roto i te wā.

Ka taea e te adenoma adrenal te huri hei mate pukupuku?

He tino onge tēnei. Arā, he tino iti te tūponotanga ka huri te adenoma adrenal hei matepukupuku. Ko te momo matua o te pukupuku matepukupuku e whanake ana i roto i ngā repe adrenal ko te carcinoma adrenocortical. Pērā i ngā adenoma mahi, ka taea hoki e ēnei pukupuku matepukupuku te whakaputa i ngā homoni nui rawa. Nō reira, ko ētahi o ngā tohu he rite ki ērā o ngā adenoma mahi.

Whakaarohia, kotahi noa iho i roto i te miriona tāngata ka pāngia e te mate pukupuku adrenocortical. Arā, ko te nuinga o ngā pukupuku e tupu ana i roto i ngā repe adrenal he pai, ehara i te mate pukupuku.

Ko wai te mea ka nui ake te tūponotanga ka pāngia e tēnei mate?

Ina hoki, ka taea e te tangata katoa te pāngia e te adenoma adrenal. Heoi, ka piki ake te tūponotanga ka pāngia e tēnei mate i a koe e pakeke haere ana. E kiia ana i waenga i te 3% me te 9% o te taupori he adenoma tēnei. Koinei te momo pukupuku tino noa e pāngia ana e ngā repe adrenal.

He pēhea te pānga o te adenoma adrenal ki tō tinana?

E ai ki tā mātou i kōrero ai i mua ake nei, ka puta ngā raruraru mai i ngā adenoma e mahi ana. Ka taea e ēnei te whakaputa i te nui atu i te tika o te kotahi, neke atu rānei o ngā homoni. Mēnā ka puta tēnei, ka pāngia pea koe e ngā tohu o ētahi mate repe adrenal. Hei tauira:

• Te mate a Cushing, te hypercortisolism rānei: Ka puta tēnei āhuatanga ina nui rawa te homoni cortisol e whakaputaina ana e ō repe adrenal. Ko te mate a Cushing te mea e puta ai te mate nā te pukupuku pituitary, engari ka taea hoki e te pukupuku adrenal te puta. Ko ngā tohu ko te toto toto tiketike, te taumaha nui (ina koa ko te taha o te puku), me te koretake o te moepuku . Ka taea hoki e ia te whakanui ake i tō tupono ki te whakawhanake i te mate huka.

• Te aldosteronism tuatahi (te mate a Conn): Ka puta tēnei ina nui rawa te homoni aldosterone e whakaputaina ana e te adenoma. Ko ngā tohu ko te iti o te pāhare pāporo, te toto toto tiketike, te ānini, te ngenge, me te ngoikore o te uaua .

• Ngā Pānga o ngā Homoni Ira Tangata: He tino onge, ka nui rawa te hanga o ngā homoni ira tangata i te adenoma adrenal. Mēnā ka nui ake ngā androgens (pērā i te testosterone) i roto i ngā wāhine, ka puta he huringa paheketanga koretake, he nui rawa ngā huruhuru o te tinana (hirsutism), me te hohonu o te reo. Mēnā ka nui ake te estrogen i roto i ngā tāne, ka heke te hiahia moepuku me te kore e taea te whakatū ure.

He aha ngā tohu o te adenoma adrenal?

Ko ngā adenoma e mahi ana ngā tohumate. Ka puta pea ēnei tohumate, inā koa mēnā ka nui rawa te cortisol (te mate Cushing) te aldosterone rānei (te aldosteronism tuatahi). Tirohia mēnā kei a koe ētahi o ēnei:

• Te mamae o te upoko.
• Te ngoikore o te uaua, te ngoikore rānei i ētahi wā.
• Te ngenge me te mamae o te tinana (pērā i te mamae o te tuara).
• Te toto toto tiketike (hypertension).
• Te huka toto tiketike, te mate huka rānei.
• Ngā taumata pāhare pāporo iti.
• Ngā tohu totoro i runga i te kiri o te puku.
• Te pikinga o te taumaha, inā koa i te taha o runga o te tinana.
• Ngā huringa wairua (manukanuka, wehi, pouri, me ētahi atu).

Mō ngā wāhine, ka puta pea ngā huringa paheketanga koretake me te pikinga o ngā āhuatanga tāne (te whakapūmau ira tangata) . Mō ngā tāne, ka puta pea te ngoikore o te moepuku .

He aha ngā take o te adenoma adrenal?

Kāore anō kia tino mōhiotia e ngā kairangahau te take e puta ai ngā adenomas adrenal me ētahi atu pukupuku adrenal pai. Heoi, kua kitea e rātou ka piki ake te mōrearea i ētahi āhuatanga ira. Ko ētahi tauira ko:

• Ngā Neoplasia Endocrine Maha, momo 1 (MEN1)
• Te Polyposis Adenomatous Whānau (FAP)
• Te matatini o Carney
• Te mate Li-Fraumeni
• Ngā momo neoplasia endocrine maha 2 (MEN2)
• Neurofibromatosis Momo 1

Hei tāpiri, ko ngā mea pēnei i te momonatanga me te kai tupeka ka piki ake te mōrearea o te whakawhanake i te adenoma adrenal.

Me pēhea te tautuhi i ngā pukupuku repe adrenal?

He tokomaha te hunga kāore i te mōhio kei a rātou te adenoma adrenal. Ka kitea tūponotia i roto i tētahi tikanga whakaahua, pērā i te matawai CT, i mahia mō tētahi atu take. Koia te take i ētahi wā ka kiia ai he "incidentalomas," nā te mea ka kitea tūponotia.

Mā tō tākuta e whakatau tuatahi mēnā he matepukupuku te pukupuku (hei tauira, te adrenocortical carcinoma) he mate pai rānei (hei tauira, te adrenal adenoma). Mēnā he adrenal adenoma, ka whakamātauhia mēnā he nui rawa ngā homoni e whakaputa ana.

He aha ngā whakamātautau e mahia ana mō tēnei?

Ka tirotirohia e tō tākuta te tinana, ka pātai atu mō ō tohu me tō hītori hauora, ā, ka tonoa pea e ia ētahi whakamātautau pēnei i ēnei hei ako atu mō te pukupuku:

• Te whakamātautau toto, te whakamātautau mimi rānei:Ka taea e ēnei te tirotiro mō ngā taumata homoni kua teitei i roto i tō tinana. Mena he pukupuku kei te mahi, tera pea kua teitei ake ō taumata homoni. Me kohi pea koe i tētahi tauira mimi 24-hāora, me te tirotiro hoki i ō taumata cortisol.
• Whakaahua: Ko te matawai CT te whakamātautau tino whakamahia hei tātaritanga i te adenoma adrenal. I ētahi wā ka tono pea tō tākuta i tētahi MRI. Ka taea e tēnei matawai te āwhina ki te whakatau mēnā he kino (matepukupuku) he pai rānei (pai). Hei tauira, ko ngā pukupuku nui ake i te 4 henimita te rahi ka nui ake te tūponotanga kia matepukupuku i ngā pukupuku iti ake.
• Biopsy: Ki te kore e taea e ētahi atu whakamātautau te whakatau mēnā he pukupuku te puku, he adenoma adrenal rānei, ka taea e tō tākuta te mahi i tētahi biopsy e kiia nei ko te fine-needle aspiration. Ko te tikanga o tēnei ko te tango i tētahi wahi iti o te kiko mai i te puku mā te whakamahi i tētahi ngira angiangi. Kātahi ka tirohia e te tohunga mate pukupuku, he tohunga taiwhanga, te kiko i raro i te karuārai hei tirotiro mēnā he tohu o te mate pukupuku.

Tērā pea ka mahia ētahi atu whakamātautau, pērā i te tango tauira o te uaua adrenal, i te matawai metaiodobenzylguanidine (MIBG) rānei.

He aha ngā maimoatanga mō te adenoma adrenal?

Ko te maimoatanga ka whakawhiwhia ki a koe ka whakawhirinaki ki te kore e mahi te pukupuku, te kore rānei e mahi (arā, te nui rawa o te homoni e whakaputaina ana).

• Mena he iti te pukupuku kāore e mahi ana, ka tūtohu pea tō tākuta kia mahia he matawai CT ia wā kia kitea ai mēnā kei te tipu, kei te kaha haere rānei. Mena kei te tere te tipu o te pukupuku, ki te tata atu rānei ki te 5 henimita, ka tūtohu pea tō tākuta kia pokanga. Nā te mea he nui ake te tūponotanga o ngā pukupuku nui me te tere o te tipu ka noho hei mate pukupuku.

• Mō ngā pukupuku e mahi ana, he maha ngā wā ka hiahiatia he pokanga. Ko ngā kōwhiringa maimoatanga ko:

• Te tango i te repe adrenal – Koinei te tango i te repe adrenal: Mena he iti te pukupuku, ā, he pai te āhua, ka tangohia pea e tō tākuta tō repe adrenal mā te whakamahi i te laparoscopy. I te wā o te laparoscopy, ka tapahia e te taote pokanga ētahi tapahi iti ki roto i tō puku, ā, mā roto i aua tapahi ka mahia te pokanga. Mena he nui te pukupuku, he whakapae rānei he mate pukupuku, ka tapahia pea e tō tākuta he tapahi nui ake ki tō tuara. I ētahi wā, ka taea e te repe adrenal e toe ana te whakaputa i ngā homoni hei pupuri i tō hauora. Ki te kore, me rongoā pea koe i te homoni hei whakakapi i te ngoikore o te homoni.

• Ngā rongoā:Mena ehara koe i te kaitono pai mō te pokanga, ka tohua pea e tō tākuta he rongoā hei ārai i te adenoma kei nui rawa te whakaputa homoni. Me tango rongoā anō pea koe mō ētahi wiki i muri i te tangohanga adrenal hei whakau i ngā taumata o ō homoni.

Ka taea te ārai i ngā pukupuku repe adrenal?

Kāore he huarahi hei ārai i ngā pukupuku adrenal, tae atu ki ngā adenoma adrenal. Ko ngā āhuatanga mōrearea mō ēnei mea he mea hangai ki ō ira. Heoi, ka taea tonu e koe te whakawhanake i te adenoma adrenal ahakoa kāore he tangata o tō whānau i pangia e ngā pukupuku adrenal.

He aha te āhua o te āhua mō te wā roa i muri i te maimoatanga?

He tino pai ngā hua o te tango i te adrenal. Kia tangohia te repe adrenal e pāngia ana, ka ngaro haere ngā tohu i puta mai i te adenoma adrenal e mahi ana.

Me pēhea taku tiaki i ahau anō?

Mena kua tāpaetia koe he adenoma adrenal kāore e mahi ana, whai i ngā tohutohu a tō tākuta mō te auau o ngā whakamātautau. I runga i te āhua o tō pukupuku, ka tono pea tō tākuta i ngā karapa CT, i ngā whakamātautau homoni rānei.

He aha ngā pātai me pātai atu e au ki te tākuta?

Ina toro atu koe ki tō tākuta, kaua e wareware ki te pātai i ēnei pātai:

• He aha te momo pukupuku repe adrenal kei a au?
• He pai, he mate pukupuku rānei?
• He aha ngā tūponotanga ka huri taku pukupuku hei matepukupuku?
• He mea e mahi ana, he mea kāore rānei e mahi ana?
• Me rongoā ahau?
• He aha ngā maimoatanga e taunaki ana koe?
• Me whakamahi rānei he rongoā homoni mō taku tukanga maimoatanga/whakaora?

Kia maumahara, ki te kitea e tō tākuta he pukupuku i tō repe adrenal i roto i te matawai, kaua e mataku. I te nuinga o te wā, kāore he kino o ēnei pukupuku. Mena he adenoma adrenal tō pukupuku, ka taea te mahi whakamātautau hei tirotiro mena kei te whakaputa nui rawa i te homoni. Mena koinei te āhua, he pai pea te pokanga. Mena he pai te pukupuku, ka taea e tō tākuta te aroturuki kia kore ai e pā ki ō homoni. Mena kei te whakapae rātou he mate pukupuku, ka taea e rātou te tango.

Hei whakamutunga, he Karere hei Tango ki te Kāinga

Nō reira, kāore he take e manukanuka ai te adenoma adrenal. Ko te nuinga o ēnei he kore kino, ā, ehara i te matepukupuku. Heoi, ka taea e ētahi o ēnei te whakaputa i te nui rawa o te homoni, nō reira he mea nui kia tūpato. Mena he ruarua, he pātai rānei āu mō tēnei, kia mōhio koe ki te kōrero ki te tākuta. Kātahi ka taea e koe te tiki i te tohutohu me te maimoatanga tika e hiahiatia ana e koe. Kia ora tonu!

` Adenoma adrenal, homoni, repe adrenal, mate a Cushing, mate a Conn, pukupuku, kore-matepukupuku