Chotupa pachifuwa? Tiyeni tiphunzire za Mediastinal Tumor mwachidule

Chotupa cha m'mimba ndi chotupa chomwe chimapangika pakati pa mapapu anu, pakati pa chifuwa chanu ndi mapapu anu. Mwina simunamvepo dzinali kale. Koma ndikofunikira kudziwa za dzinali. Nthawi zina, zotupa izi zimatha kupangika popanda zizindikiro zilizonse. Tiyeni tikambirane za izi mwatsatanetsatane kuti mumvetse bwino.

Mwachidule, kodi chotupa cha mediastinal n'chiyani?

Ganizirani za malo omwe ali mkati mwa chifuwa chanu. Fupa la pachifuwa lili kutsogolo, msana uli kumbuyo, ndipo mapapo ali mbali zonse ziwiri. Malo omwe ali pakati pa ziwalo izi ndi omwe madokotala amati mediastinum . Malo awa ali ndi ziwalo zambiri zofunika, kuphatikizapo mtima wanu, mtsempha wamagazi, mmero, trachea, thymus gland, ndi ma lymph nodes, zomwe ndi gawo la chitetezo chanu chamthupi.

Kotero, kuchuluka kulikonse kwa maselo, kutanthauza chotupa, chomwe chimapangika m'derali chotchedwa mediastinum, timachitcha chotupa cha mediastinal. Pali mitundu iwiri ya chotupa ichi:

• Zabwino: Izi si khansa. Nthawi zambiri zimapangika pamalo amodzi ndipo sizifalikira ku ziwalo zina za thupi.
• Matenda Oopsa: Awa ndi khansa. Amatha kufalikira, kuwononga minofu yozungulira.

Kodi mitundu iyi ya ziphuphu ndi iti? Kodi zimasiyana malinga ndi komwe zimapangidwira?

Inde, ziphuphuzi zimagawidwa m'magawo atatu akuluakulu kutengera komwe zimapangidwira. Izi zikutanthauza kuti, malinga ndi momwe zigawo zitatu za mediastinum zimapangidwira: kutsogolo, pakati, ndi kumbuyo. Tiyeni tiwone zomwe zili.

Ndani amakumana ndi ziphuphuzi? Kodi zimapezeka kawirikawiri bwanji?

Ngakhale kuti mitundu iyi ya ziphuphu imatha kuonekera pa msinkhu uliwonse, nthawi zambiri zimapezeka mwa anthu azaka zapakati pa 30 ndi 50. Komabe, pali kusiyana pang'ono pakati pa akuluakulu ndi ana.

• Akuluakulu: Ziphuphu nthawi zambiri zimayamba m'dera la anterior mediastinum. Izi nthawi zambiri zimakhala matenda a khansa monga lymphoma kapena thymoma.
• Ana: Ziphuphu nthawi zambiri zimayamba mu posterior mediastinum. Izi zimayambira mu mitsempha ndipo nthawi zambiri sizimayambitsa khansa.

Vutoli si lofala kwambiri. Limakhudza anthu osakwana 1% ya anthu onse.

Kodi izi ndi nkhani yaikulu? Kodi ndiyenera kuopa?

Vutoli ndi lomwe anthu ambiri ali nalo. Chofunika kumvetsetsa apa ndichakuti ngakhale kuti chotupachi si cha khansa (chosaopsa), chikhoza kukhala chachikulu kutengera komwe chili .

Tangoganizirani, pamene chotupachi chikukulirakulira, chikhoza kukakamiza ziwalo monga mtima, thumba lopyapyala lozungulira mtima (pericardium), mitsempha ikuluikulu yamagazi, ndi trachea. Komanso, chotupa chomwe chimapangika kumbuyo chingayambitse kukakamiza msana. Chifukwa chake, ngati sichichiritsidwa, mavuto akulu angabuke.

Kodi zizindikiro za izi ndi ziti?

Chodabwitsa n'chakuti, pafupifupi 40% ya anthu omwe ali ndi vutoli saona zizindikiro zilizonse . Chotupachi nthawi zambiri chimapezeka mwangozi panthawi ya X-ray pachifuwa pazifukwa zina.

Ngati zizindikiro zapezeka, nthawi zambiri zimakhala chifukwa chakuti chotupacho chakula ndipo chikukankhira ziwalo zozungulira. Zotupa za khansa ndizo zimayambitsa zizindikiro.

Zizindikiro zomwe zingawonekere nthawi zambiri ndi izi:

• Mawu omveka bwino.
• Phokoso lotsika lochokera pakhosi pamene mukupuma (stridor).
• Kutsokomola, kupuma movutikira, kapena kupuma movutikira (dyspnea).
• Kutsokomola magazi (hemoptysis).
• Kuvuta kumeza chakudya (dysphagia).
• Malungo, kuzizira, kapena thukuta usiku.
• Kupweteka pachifuwa (izi sizichitika kawirikawiri).
• Kukhala woonda popanda chifukwa.
• Ma lymph nodes (tizilombo ta m'mimba) timatupa kapena timafewa tikakhudza.
• Mavuto a maso monga zikope zopindika mbali imodzi ya nkhope ndi mabwalo ang'onoang'ono akuda pa zikope.

N’chifukwa chiyani ziphuphu zimenezi zimapangika?

N'zovuta kupeza chifukwa chimodzi chomwe chimayambitsa izi. Pakhoza kukhala zinthu zingapo zomwe zingayambitse vutoli.

• Kukula kwa maselo kosalamulirika: Zotupa za khansa ndi zosakhala khansa zimakula maselo akamagawikana ndikukula mosalamulirika. Ofufuza sakudziwabe chifukwa chake izi zimachitika.
• Poyankha vuto lina la matenda: Nthawi zina, ma lymph nodes amatha kutupa ndikuwoneka ngati ziphuphu chifukwa cha matenda kapena matenda ena m'thupi.
• Matenda obadwa nawo: Zotupa zina, mwachitsanzo, pericardial cysts ndi bronchogenic cysts, ndi kukula kwa minofu kosazolowereka komwe kumachitika kuyambira kubadwa.

Kodi dokotala amapeza bwanji izi?

Kawirikawiri, ngati chotupa chapezeka pa X-ray ya pachifuwa, dokotala wanu amalamula mayeso ena angapo kuti adziwe zambiri za icho.

• X-ray ya pachifuwa: Izi zingagwiritsidwe ntchito makamaka pofufuza ngati pali chotupa.
• Kujambula kwa CT (Computed Tomography scan): Izi zitha kupanga zithunzi zomveka bwino komanso zatsatanetsatane kuposa X-ray. Zingawonetse kukula ndi mawonekedwe a chotupacho, komanso momwe chakhudzira ziwalo zozungulira.
• Kujambula kwa MRI (Magnetic Resonance Imaging): Kumathandiza kuona ngati chotupacho chikukankhira m'minofu yozungulira kapena chafalikira m'minofuyo (monga momwe zimakhalira ndi khansa).
• Kujambula kwa PET (Positron Emission Tomography scan): Izi zimathandiza kwambiri pozindikira mitundu ina ya khansa, monga lymphoma.
• Kuyezetsa magazi: Kuyezetsa magazi kungayang'ane mapuloteni kapena ma enzyme (zizindikiro za chotupa) zokhudzana ndi mitundu ina ya zotupa.
• Kufufuza za thupi:Iyi ndi njira yofunika kwambiri yoyezera. Kachidutswa kakang'ono ka minofu kamatengedwa kuchokera pa chotupacho n'kuwunikidwa pogwiritsa ntchito maikulosikopu. Njirayi imatha kudziwa mtundu wa maselo omwe chotupacho chimapangidwa ndi ndipo ngati ndi khansa kapena ayi. Izi zitha kuchitika pogwiritsa ntchito njira monga kutenga chotupacho ndi singano pansi pa CT scan (CT-guided needle biopsy), kulowetsa chubu chokhala ndi kamera pansi pa mmero (Esophagoscopy), kapena kulowetsa chubu pansi pa mphuno (Bronchoscopy).

Kodi mankhwala ochizira izi ndi otani?

Chithandizo chimadalira mtundu wa chotupa, komwe chili, momwe chilili ngati ndi khansa, komanso zizindikiro zomwe muli nazo.

• Opaleshoni: Iyi ndi njira yodziwika kwambiri yothandizira. Ziphuphu za khansa, zotupa zomwe zikukankhira ziwalo zapafupi, ndi zotupa zomwe zimayambitsa zizindikiro zingafunike kuchotsedwa opaleshoni. Izi zitha kuchitika kudzera mu sternotomy kapena kudzera m'mabala ang'onoang'ono angapo pogwiritsa ntchito kamera (kanema yothandizidwa ndi thorascopic surgery - VATS).
• Chithandizo cha Radiation: Chithandizochi chimagwiritsa ntchito kuwala kwamphamvu kwambiri kuti chiwononge maselo a khansa. Nthawi zina chimaperekedwa chokha kapena pamodzi ndi opaleshoni.
• Chemotherapy: Kupatsa thupi mankhwala opha maselo a khansa kapena kuchepetsa zotupa.
• Mankhwala opha tizilombo: Ngati chotupacho chayamba chifukwa cha matenda (monga kutupa kwa ma lymph nodes), chingachiritsidwe ndi mankhwala opha tizilombo.
• Kudikira Mosamala: Ngati chotupacho sichili cha khansa ndipo palibe zizindikiro, dokotala wanu angasankhe kusachichiza ndipo m'malo mwake angachiyese kuti awone ngati pali kusintha kulikonse.

Kodi izi zitha kupewedwa?

Kuchuluka kwa chotupacho kumadalira mtundu wa chotupacho, kaya ndi khansa kapena ayi, komanso thanzi lanu lonse. Chifukwa chake, dokotala wanu yekha ndi amene angakupatseni kufotokozera bwino za momwe chotupacho chilili.

Palibe njira yotsimikizika yopewera ziphuphu zamtunduwu kuti zisapangike. Koma chinthu chabwino kwambiri chomwe mungachite ndikuzindikira vutoli msanga . Ngati muli ndi zizindikiro zomwe takambirana kale (monga chifuwa, mawu opweteka, kuvutika kumeza) kwa milungu yoposa iwiri, onetsetsani kuti mwawonana ndi dokotala kuti akupatseni upangiri.

Zinthu zoti mufunse dokotala wanu

Ngati mukuganiza kuti muli ndi vutoli, funsani dokotala wanu mafunso awa.

• Kodi ndi mtundu wanji wa chotupa cha mediastinal chomwe ndili nacho?
• Kodi chotupa ichi ndi khansa kapena ayi?
• Kodi izi ziyenera kuthandizidwadi?
• Kodi mumalimbikitsa chithandizo chanji?
• Kodi ubwino ndi zoopsa za chithandizochi ndi ziti?
• Kodi ndi zotsatira zotani zomwe ndingayembekezere pambuyo pa chithandizo?
• Kodi ndiyenera kuda nkhawa ndi mavuto omwe amabwera chifukwa cha chotupa kapena chithandizo?