Kodi pali chotupa chonga ichi m'thupi mwanu? Tiyeni tiphunzire za icho mosavuta (Adrenal Adenoma)!

Kodi munayamba mwaganizapo kuti nthawi zina tikachita chinthu monga 'scan' kuti tipeze matenda ena, mwangozi tingapeze chinthu chobisika m'thupi chomwe sitinadziwepo kuti chilipo? Umu ndi momwe vutoli lotchedwa 'Adrenal Adenoma' nthawi zina limapezekera. Ichi kwenikweni ndi chotupa chaching'ono, chosakhala khansa, chosakhala choopsa chomwe chimapanga mu adrenal glands yanu. Kodi tikambirane za izi mwatsatanetsatane?

Kodi kwenikweni adenoma ya adrenal ndi chiyani?

Chabwino, choyamba tiyeni tiwone zomwe ma adrenal glands ali. Ma glands awiriwa ali pamwamba pa impso zanu, ngati zipewa ziwiri zazing'ono. Izi ndi zomwe zimapanga mitundu ingapo ya mahomoni omwe ndi ofunikira kwambiri m'thupi lathu. Tangoganizirani, kodi thupi lanu limatani mukadzidzimva mantha kapena nkhawa? Ma mahomoni omwe amathandiza ndi zimenezo amachokera ku ma glands awa. Sikuti ndi okhawo, komanso mahomoniwa amathandiza kuwongolera zinthu zambiri monga kuchuluka kwa shuga m'magazi mwanu, kuthamanga kwa magazi, ndi chitetezo chamthupi.

Pali magawo awiri akuluakulu a adrenal gland: gawo lakunja limatchedwa adrenal cortex, ndipo gawo lamkati limatchedwa adrenal medulla. Adrenal cortex imapanga mahomoni monga `(Cortisol)` ndi `(Aldosterone)`. Adrenal medulla imapanga mahomoni monga `(Dopamine)`, `(Epinephrine)` ndi `(Norepinephrine)`. Ndi mu adrenal cortex momwe zotupa zomwe tikukambazi, zotchedwa adrenal adenoma, zimapangika.

Nthawi zambiri, ma adenoma amenewa samayambitsa zizindikiro zazikulu ndipo safuna chithandizo. Komabe, nthawi zina, zotupazi zimatha kupanga mahomoni amodzi kapena angapo a adrenal kuposa omwe amapangidwa ndi thupi.

Kodi pali mitundu ina ya adenoma ya adrenal?

Inde, pali mitundu iwiri makamaka.

• Ma adenoma Ogwira Ntchito/Ogwira Ntchito: Mitundu iyi ya zotupa imapanga mahomoni ambiri a adrenal gland kuposa masiku onse . Izi zingayambitse zizindikiro ndipo zingafunike chithandizo.
• Ma adenoma osagwira ntchito/osagwira ntchito: Izi sizipanga mahomoni ena owonjezera. Ma adenoma ambiri a adrenal ali m'gulu ili. Nthawi zambiri samayambitsa zizindikiro kapena amafunika chithandizo.

Chofunika kwambiri ndichakuti mwayi woti mtundu uliwonse ukhale ndi khansa ndi wochepa kwambiri. Komabe, n'zotheka kuti adenoma yosagwira ntchito iyambe kugwira ntchito pakapita nthawi.

Kodi adenoma ya adrenal ingakhale khansa?

Izi zimachitika kawirikawiri kwambiri. Izi zikutanthauza kuti, sizingatheke kuti adrenal adenoma isanduke khansa. Mtundu waukulu wa chotupa cha khansa chomwe chimayamba m'matenda a adrenal ndi adrenocortical carcinoma. Monga ma functional adenoma, zotupa za khansa izi zimathanso kupanga mahomoni ochulukirapo. Chifukwa chake, zizindikiro zina zitha kukhala zofanana ndi za functional adenomas.

Tangoganizani, munthu mmodzi pa anthu miliyoni imodzi ndi amene amadwala khansa ya m'magazi. Izi zikutanthauza kuti, zotupa zambiri zomwe zimayamba m'matenda a adrenal si zabwino, sizimayambitsa khansa.

Ndani amene ali ndi mwayi waukulu wopeza vutoli?

Ndipotu, aliyense akhoza kukhala ndi adrenal adenoma. Komabe, mwayi woti ikule umawonjezeka pang'ono mukamakula. Kawirikawiri amati pakati pa 3% ndi 9% ya anthu ali ndi adenoma iyi. Uwu ndiye mtundu wofala kwambiri wa chotupa chomwe chimayamba m'matenda a adrenal.

Kodi adenoma ya adrenal imakhudza bwanji thupi lanu?

Monga tanenera kale, mavuto amayamba chifukwa cha kugwira ntchito kwa adenomas. Izi zimatha kutulutsa mahomoni ambiri kuposa kuchuluka koyenera . Ngati izi zitachitika, mutha kuwona zizindikiro za matenda ena a adrenal. Mwachitsanzo:

• Matenda a Cushing kapena hypercortisolism: Matendawa amapezeka pamene ma adrenal glands anu amatulutsa mahomoni ambiri a cortisol. Matenda a Cushing nthawi zambiri amayamba chifukwa cha chotupa cha pituitary, komanso amathanso kuyamba chifukwa cha chotupa cha adrenal. Zizindikiro zake ndi monga kuthamanga kwa magazi, kunenepa kwambiri (makamaka kuzungulira mimba), komanso kusagwira bwino ntchito kwa ziwalo zogonana . Zingawonjezere chiopsezo chanu chokhala ndi matenda a shuga.

• Matenda a aldosteronism oyamba (Conn's syndrome): Izi zimachitika pamene adenoma imapanga mahomoni ambiri a aldosterone. Zizindikiro zake ndi monga kuchepa kwa potaziyamu, kuthamanga kwa magazi, mutu, kutopa, ndi kufooka kwa minofu .

• Zotsatira za mahomoni ogonana: Nthawi zambiri, adrenal adenoma ingayambitse kupanga mahomoni ogonana mopitirira muyeso. Ngati androgens (monga testosterone) iwonjezeka mwa akazi, ingayambitse kusamba kosakhazikika, tsitsi lochuluka m'thupi (hirsutism), komanso kukulirakulira kwa mawu. Ngati estrogen iwonjezeka mwa amuna, ingayambitse kuchepa kwa chilakolako chogonana komanso kusagwira ntchito bwino kwa erectile.

Kodi zizindikiro za adenoma ya adrenal ndi ziti?

Zizindikirozi zimachitika chifukwa cha kugwira ntchito kwa adenomas. Zizindikirozi zimatha kuchitika, makamaka ngati zimayambitsa kupanga kwambiri cortisol (Cushing's syndrome) kapena aldosterone (primary aldosteronism). Yang'anani ngati muli ndi chilichonse mwa izi:

• Mutu.
• Kufooka kwa minofu kapena nthawi zina dzanzi.
• Kutopa ndi kupweteka kwa thupi (monga kupweteka kwa msana).
• Kuthamanga kwa magazi (BP).
• Kuchuluka kwa shuga m'magazi kapena matenda a shuga.
• Mulingo wochepa wa potaziyamu.
• Mabala otambasula pakhungu la mimba.
• Kulemera, makamaka m'dera lapamwamba la thupi.
• Kusintha kwa maganizo (nkhawa, mantha, kuvutika maganizo, ndi zina zotero).

Kwa akazi, kusamba kosasinthasintha komanso kuchuluka kwa makhalidwe a amuna (virilization) kungachitike. Kwa amuna, kusagwira bwino ntchito zogonana kungachitike.

Kodi ndi zifukwa ziti zomwe zimayambitsa adenoma ya adrenal?

Ofufuza sakudziwabe chifukwa chake adrenal adenomas ndi zotupa zina zosavulaza za adrenal gland zimayamba. Komabe, apeza kuti matenda ena a majini angapangitse chiopsezo. Zitsanzo zina ndi izi:

• Matenda a Endocrine Neoplasia ambiri, mtundu 1 (MEN1)
• Familyal Adenomatous Polyposis (FAP)
• Malo ochitira masewera a Carney
• Matenda a Li-Fraumeni
• Matenda a Endocrine Neoplasia amtundu wachiwiri (MEN2)
• Mtundu 1 wa Neurofibromatosis

Kuphatikiza apo, zinthu monga kunenepa kwambiri ndi kugwiritsa ntchito fodya zingawonjezere chiopsezo cha matenda a adrenal adenoma.

Kodi zotupa za adrenal zimapezeka bwanji?

Anthu ambiri sadziwa ngakhale kuti ali ndi adrenal adenoma. Imapezeka mwangozi panthawi yojambula zithunzi, monga CT scan, yomwe imachitika pazifukwa zina. Ichi ndichifukwa chake nthawi zina amatchedwa "incidentalomas," chifukwa amapezeka mwangozi.

Dokotala wanu adzayamba waona ngati chotupacho ndi khansa (monga adrenocortical carcinoma) kapena chosaopsa (monga adrenal adenoma). Ngati ndi adrenal adenoma, adzayesa kuti awone ngati ikupanga mahomoni ambiri.

Ndi mayeso ati omwe akuchitidwa pa izi?

Dokotala wanu adzakuyezani thupi, adzakufunsani za zizindikiro zanu ndi mbiri yanu yachipatala, kenako angakupatseni mayeso ngati awa kuti mudziwe zambiri za chotupacho:

• Kuyesa magazi kapena mkodzo:Izi zitha kuwona kuchuluka kwa mahomoni m'thupi lanu. Ngati muli ndi chotupa chomwe chikugwira ntchito, kuchuluka kwa mahomoni anu kumatha kukwera. Mungafunikenso kutenga mkodzo wa maola 24 ndikuwona kuchuluka kwa cortisol m'thupi lanu.
• Kujambula: Kujambula kwa CT ndiye njira yodziwika kwambiri yodziwira matenda a adrenal adenoma. Nthawi zina dokotala wanu angakupatseninso MRI. Kujambula kumeneku kungathandize kudziwa ngati chotupacho ndi choipa (khansa) kapena chosaopsa (chosaopsa). Mwachitsanzo, zotupa zazikulu kuposa masentimita 4 zimakhala ndi mwayi waukulu wokhala ndi khansa kuposa zotupa zazing'ono.
• Kufufuza za khansa: Ngati mayeso ena sangathe kudziwa ngati chotupacho ndi khansa kapena adrenal adenoma, dokotala wanu angachite biopsy yotchedwa fine-needle aspiration. Izi zimaphatikizapo kuchotsa chidutswa chaching'ono cha minofu kuchokera pa chotupacho ndi singano yopyapyala. Katswiri wa matenda, katswiri wa labotale, kenako amafufuza minofuyo pansi pa maikulosikopu kuti awone ngati pali zizindikiro zilizonse za khansa.

Mayeso ena, monga kusanthula mitsempha ya adrenal kapena metaiodobenzylguanidine (MIBG) scan, angachitenso.

Kodi mankhwala a adenoma ya adrenal ndi ati?

Chithandizo chomwe mudzalandire chidzadalira ngati chotupacho sichikugwira ntchito kapena sichikugwira ntchito (monga kupanga mahomoni ambiri).

• Ngati chotupa chomwe sichikugwira ntchito ndi chaching'ono, dokotala wanu angakulangizeni kuti muchiyese nthawi ndi nthawi kuti muwone ngati chikukula kapena chikuyamba kugwira ntchito. Ngati chotupacho chikukula mofulumira, kapena ngati chili pafupi ndi masentimita 5, dokotala wanu angakulangizeni opaleshoni. Izi zili choncho chifukwa chotupa chachikulu komanso kukula mofulumira kumakhala ndi mwayi waukulu wokhala ndi khansa.

• Pa matenda a chotupa omwe amagwira ntchito, opaleshoni nthawi zambiri imafunika. Njira zina zochiritsira zimaphatikizapo:

• Kuchotsa Adrenalectomy – Uku ndi kuchotsa adrenal gland: Ngati chotupacho ndi chaching'ono komanso chosaopsa, dokotala wanu angachotse adrenal gland yanu pogwiritsa ntchito laparoscopy. Pa laparoscopy, dokotala wa opaleshoni amadula pang'ono m'mimba mwanu ndipo amachita opaleshoniyo kudzera mwa iwo. Ngati chotupacho ndi chachikulu kapena pali kukayikiridwa kuti ndi khansa, dokotala wanu angadula kwambiri kumbuyo kwanu. Nthawi zina, adrenal gland yotsalayo imatha kupanga mahomoni okwanira kuti mukhale ndi thanzi labwino. Ngati sichoncho, mungafunike chithandizo cha mahomoni kuti mulowe m'malo mwa kusowa kwa mahomoni.

• Mankhwala:Ngati simuli woyenera opaleshoni, dokotala wanu angakupatseni mankhwala oletsa kuti adenoma isapange mahomoni ambiri. Mungafunikenso kumwa mankhwala kwa milungu ingapo mutachotsa adrenalectomy kuti mukhazikitse kuchuluka kwa mahomoni anu.

Kodi zotupa za adrenal gland zingapewedwe?

Palibe njira yopewera zotupa za adrenal, kuphatikizapo adrenal adenomas. Zinthu zomwe zimayambitsa matendawa nthawi zambiri zimadalira majini anu. Komabe, mutha kukhalabe ndi adrenal adenoma ngakhale palibe m'banja mwanu amene wakhala ndi zotupa za adrenal.

Kodi vuto la nthawi yayitali limakhala bwanji mutalandira chithandizo?

Zotsatira za opaleshoni ya adrenal zimakhala zabwino kwambiri. Adrenal gland yomwe yakhudzidwa ikachotsedwa, zizindikiro zomwe zimayambitsidwa ndi adrenal adenoma yomwe ikugwira ntchito nthawi zambiri zimatha.

Kodi ndiyenera kudzisamalira bwanji?

Ngati mwapezeka ndi vuto la adrenal adenoma lomwe silikugwira ntchito bwino, tsatirani malangizo a dokotala wanu okhudza kuchuluka kwa nthawi yomwe muyenera kuyezetsa. Kutengera mtundu wa chotupa chanu, dokotala wanu angakupatseni mayeso a CT scan kapena mahomoni nthawi ndi nthawi.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Mukapita kwa dokotala, musaiwale kufunsa mafunso ngati awa:

• Ndi mtundu wanji wa chotupa cha adrenal gland chomwe ndili nacho?
• Kodi ndi khansa kapena yabwino?
• Kodi pali mwayi wotani woti chotupa changa chisanduke khansa?
• Kodi ndi yogwira ntchito kapena yosagwira ntchito?
• Kodi ndikufunika chithandizo?
• Kodi mumalimbikitsa chithandizo chanji?
• Kodi njira yanga yochizira/kuchiritsa ingafunike chithandizo cha mahomoni?

Kumbukirani, ngati dokotala wanu apeza chotupa pa adrenal gland yanu pa scan, musachite mantha. Nthawi zambiri, zotupa izi sizili zoopsa. Ngati chotupa chanu ndi adrenal adenoma, mayeso amatha kuchitidwa kuti awone ngati chikupanga mahomoni ambiri. Ngati zili choncho, opaleshoni ikhoza kukhala njira yabwino. Ngati chotupacho chili chabwino, dokotala wanu akhoza kuchiyang'anira kuti atsimikizire kuti sichikukhudza mahomoni anu. Ngati akukayikira kuti mwina ndi khansa, akhoza kuchichotsa.

Pomaliza, Uthenga Wopita Nawo Kunyumba

Choncho, adrenal adenoma nthawi zambiri si chinthu chodetsa nkhawa nacho. Ambiri mwa iwo ndi osavulaza komanso si a khansa. Komabe, ena mwa iwo amatha kupanga mahomoni ambiri, choncho ndikofunikira kusamala. Ngati muli ndi kukayikira kapena mafunso okhudza izi, onetsetsani kuti mwalankhula ndi dokotala. Kenako mutha kupeza upangiri woyenera komanso chithandizo chomwe mukufuna. Khalani ndi thanzi labwino!

Adrenal adenoma, mahomoni, adrenal glands, Cushing's syndrome, Conn's syndrome, zotupa, osati khansa