Ese twavuga ku kibyimba kidasanzwe cyitwa Pheochromocytoma muri iki gihe?

Ese rimwe na rimwe uhura n'umuvuduko ukabije w'amaraso? Cyangwa ujya ubira ibyuya gusa? Ese urwara umutwe bitewe n'umutima utera cyane? Ntukihutire gutekereza ko bimwe muri ibi ari indwara ikomeye. Ariko, niba ibi bimenyetso bikomeje, cyane cyane iyo umuvuduko ukabije w'amaraso ugoye kuwirinda, ni byiza kugira impungenge gato. Uyu munsi tugiye kuvuga ku ndwara idakunze kugaragara, ariko iyo ivuwe neza, ishobora kuvurwa neza cyane. Iyo ndwara yitwa pheochromocytoma.

Pheochromocytoma ni iki? Reka tubisobanukirwe mu buryo bworoshye.

Mu magambo make, pheochromocytoma ni ikibyimba gikura mu gice cyo hagati cy’uturemangingo tw’inkende, adrenal medulla. Ibi bibyimba bikorwa n’ubwoko bwihariye bw’uturemangingo twitwa chromaffin cells. Utu turemangingo dukora kandi tugasohora imisemburo mu maraso ikenewe kugira ngo umubiri wacu ugire "imirwano cyangwa ihunga". Tekereza nawe, iyo ugize ubwoba butunguranye cyangwa uhuye n’imihangayiko myinshi, impinduka ziba mu mubiri wawe - umutima wawe utera cyane, ubira ibyuya, umubiri wawe uratigita - iyi misemburo ni yo itera ibi.

Ubusanzwe, Pheochromocytoma itera mu gasabo kamwe k’intanga ngabo. Ariko, hari igihe ishobora gutera mu gasabo zombi. Birashoboka ko habaho ibibyimba birenze kimwe mu gasabo kamwe.

Icy'ingenzi ni uko inyinshi muri zo ni indwara zitagira ingaruka mbi (si mbi) . Ibi bivuze ko zitakwirakwira mu bindi bice by'umubiri. Ariko, hagati ya 10% na 15% zishobora kuba kanseri. Niba iyi ari kanseri, ivugwa mu byiciro byinshi by'ingenzi, bitewe n'uburyo yakwirakwiriye:

• Pheochromocytoma yo mu gace kamwe: Ikibyimba kiba mu gasabo kamwe cyangwa twombi tw’intanga ngabo.
• Pheochromocytoma yo mu gace: Kanseri yakwirakwiriye mu tunyangingo tw’imitsi hafi y’utunyangingo tw’intanga cyangwa mu zindi ngingo.
• Pheochromocytoma ya metastatic: Kanseri yakwirakwiriye mu ngingo za kure nko mu mwijima, mu bihaha, cyangwa mu magufwa.
• Pheochromocytoma isubira: Kanseri yagarutse nyuma yo kuvurwa. Ishobora kuba ahantu hamwe yari iri mbere cyangwa ahandi hantu.

Izi glande z'impyiko mu mubiri wacu ni izihe? Ni iyihe nshingano yazo?

Dufite imyakura ibiri y'inkondo y'umura. Iherereye inyuma y'inda yacu, hejuru y'impyiko zacu, nk'umupfundikizo. Ni igice cy'urusobe rw'imisemburo yacu. Buri mvakura ifite ibice bibiri by'ingenzi. Igice cyo hanze cyitwa cortex y'inkondo y'umura, naho igice cyo hagati cyitwa adrenal medulla.

Imisemburo yacu ya adrenal medulla ikora itsinda ry'imisemburo yitwa catecholamines. Iyi misemburo igenzura ibikorwa byinshi by'ingenzi mu mubiri wacu:

• Igipimo cy'umutima
• Umuvuduko w'amaraso
• Igipimo cy'isukari mu maraso `(Glucose mu maraso)`
• Uko umubiri wacu witabira iyo uhanganye n'imihangayiko (igisubizo cyo "kurwana cyangwa guhunga")

Ubwoko bw'ingenzi bwa catecholamines ni:

• Dopamine
• Epinephrine (Adrenaline) `(Epinephrine / Adrenaline)`
• Norepinephrine (Norepinephrine) `(Norepinephrine / Norepinephrine)`

Iyo pheochromocytoma ihari, ishobora kurekura iyi misemburo myinshi, adrenaline na noradrenaline, mu maraso kurusha uko bikenewe. Ni bwo ibimenyetso bitandukanye bitangira kugaragara.

Ni irihe tandukaniro riri hagati ya Pheochromocytoma na Paraganglioma?

Izi ni ubwoko bubiri bw'ibibyimba bisa cyane kandi bidakunze kugaragara. Byombi bikomoka ku turemangingo twa chromaffin twavuze mbere. Ariko, pheochromocytoma ivuka hagati mu gice cy'inyunganiramirire (adrenal medulla), mu gihe paraganglioma ivuka ahandi hatari mu nyunganiramirire .

Ni nde ushobora kugira iyi ndwara cyane? Ni ku rugero rungana iki?

Feochromocytoma ishobora kugaragara mu myaka iyo ari yo yose, ariko ikunze kugaragara cyane ku bantu bari hagati y'imyaka 30 na 50. Hafi 10% by'abayirwaye bagaragara mu bwana.

Iki ni ikibyimba kidasanzwe . Biragoye kuvuga neza umubare w'abantu bafite iki kibazo. Kubera ko hari abantu badafite ibimenyetso bigaragaza, iyi ndwara ishobora kutamenyekana. Bivugwa ko munsi ya 1% by'abantu bafite umuvuduko ukabije w'amaraso bafite pheochromocytoma.

Ni ibihe bimenyetso umuntu urwaye pheochromocytoma agaragaza?

Ibimenyetso bya Pheochromocytoma bibaho iyo ikibyimba gisohoye imisemburo myinshi ya adrenaline (epinephrine) cyangwa noradrenaline (norepinephrine) mu maraso. Ariko, hari ibibyimba bidakora iyi misemburo myinshi kandi bishobora kuba bitagaragara.

Ibimenyetso bikunze kugaragara ni ibi bikurikira:

• Umuvuduko ukabije w'amaraso (Hypertension): Iki ni cyo kimenyetso nyamukuru. Hari igihe bigoye kubigenzura.
• Kuribwa umutwe: Bishobora kuba umutwe ukomeye kandi utunguranye.
• Kubira ibyuya byinshi nta mpamvu.
• Gutera ubwoba ni ukumva umutima utera cyane, udakora neza, cyangwa utera cyane.
• Kumva umubiri wawe urimo kunyeganyega.

Ibimenyetso bidakunze kugaragara:

• Kubabara mu gituza no mu nda.
• Uruhu ruhita rwera cyane kurusha uko bisanzwe.
• Kugira isesemi cyangwa kuruka.
• Impiswi.
• Kwihagarika impatwe.
• Kugabanuka k'umuvuduko w'amaraso mu maraso (Orthostatic hypotension) ni ukugabanuka k'umuvuduko w'amaraso mu buryo butunguranye iyo uhagaze. Ibi bivuze ko wumva uzuzuwe iyo uhagaze uhagaze wicaye.
• Kugabanya ibiro nta mpamvu.

Ibi bimenyetso bishobora kugaragara cyangwa bikarushaho kwiyongera nyuma y'ibintu bimwe na bimwe. Urugero:

• Gukora imyitozo ngororamubiri ikomeye.
• Gukomereka ku mubiri cyangwa guhangayika cyane mu mutwe.
• Kubyara.
• Kubona ikinya.
• Gukora ubuvuzi bwo kubaga.
• Kurya ibiryo bikungahaye kuri tyramine (urugero: divayi itukura, shokora, foromaje).

Ese ibimenyetso bihora bihari? Cyangwa biza bigakomeza kugenda?

Umuntu urwaye pheochromocytoma ashobora kugira umuvuduko ukabije w'amaraso udashira, cyangwa ushobora kuza ugakomeza .

Hari abantu bashobora kugira "ibitero bya paroxysmal," cyangwa ibimenyetso bitunguranye. Ibi bivuze ko habaho kwiyongera gutunguranye k'umuvuduko w'amaraso, bigaherekezwa no kuribwa umutwe cyane, gutera k'umutima kwiyongera, no kubira ibyuya byinshi. Ibi "bitero" bishobora kubaho inshuro nyinshi ku munsi, cyangwa ndetse rimwe cyangwa kabiri mu kwezi.

Icy'ingenzi: Niba ufite kimwe muri ibi bimenyetso, cyane cyane umuvuduko ukabije w'amaraso, kuribwa umutwe, kubira ibyuya no gutera ubwoba mu mugongo, ni ngombwa cyane gushaka inama kwa muganga.

Kuki pheochromocytoma ikura? Ni izihe mpamvu?

Kenshi na kenshi, nta mpamvu yihariye iboneka ya pheochromocytoma. Ibaho ku buryo butunguranye.

Ariko, hagati ya 25% na 35% by'abarwaye, iyi ndwara ifitanye isano n'imiterere y'umubiri. Zimwe mu ngingo z'ingenzi ni izi zikurikira:

• Indwara ya endocrine neoplasia 2, ubwoko bwa A na B (MEN2A na MEN2B)
• Indwara ya Von Hippel-Lindau (VHL)
• Ubwoko bwa Neurofibromatosis (NF1)
• Indwara ya paraganglioma y'uruhererekane
• Carney-Stratakis dyad [paraganglioma na tumour yo mu nda (GIST)]
• Carney triad (paraganglioma, GIST na chondroma y'ibihaha)

Uretse izi ndwara za genetiki, pheochromocytoma ishobora no gukwirakwira bitewe n'impinduka mu ngirabuzimafatizo zigera kuri 10 zitandukanye.

Iyi ndwara ipimwa ite? (Isuzuma)

Feochromocytoma ishobora kugorana kuyisuzuma kuko ari ikibyimba kidakunze kugaragara kandi rimwe na rimwe nta bimenyetso bitera. Hari igihe iki kibyimba kiboneka mu buryo bw’impanuka mu gihe cy’ikizamini cyakozwe ku yindi mpamvu.

Hari impamvu nyinshi zishobora gutuma umuganga akeka iyi ndwara:

• IbyaweAmateka arambuye y'ubuvuzi, cyane cyane niba hari umuntu wo mu muryango wigeze agira pheochromocytoma mbere.
• Isuzuma ryuzuye ry’umubiri n’iry’ubuvuzi.
• Ibimenyetso bimwe na bimwe byihariye , urugero nk'"ibitero bya paroxysmal" twavuzeho n'umuvuduko ukabije w'amaraso udagenzurwa n'ubuvuzi busanzwe.

Ni ubuhe bwoko bw'ibizamini bikorwa?

Muganga wawe ashobora kukugira inama yo gukora ibizamini bikurikira kugira ngo yemeze niba ufite pheochromocytoma:

• Ikizamini cy'inkari mu masaha 24: Ibi bikubiyemo gukusanya inkari zawe umunsi wose no gupima ingano ya catecholamines ziri muri zo. Binapima ibintu bikorwa iyo iyi misemburo yangiritse. Iyo izi ngero ziri hejuru y'ibisanzwe, bishobora kuba ikimenyetso cya pheochromocytoma.
• Ibipimo bya catecholamine mu maraso: Ibi bipima urugero rwa catecholamine mu maraso. Kimwe n'ibipimo by'inkari, binashakisha ibintu biva mu ihindagurika ry'imisemburo.
• Gupima CT (Computer Tomography scan): Ibi bisaba gupima X-rays kugira ngo hakorwe amashusho arambuye y'imbere mu mubiri wawe. Muganga wawe ashobora kukugira inama yo kureba adrenal glands zawe.
• Isuzuma rya MRI (MRI - Ishusho ya Magnetic Resonance): Ibi bikoresha magnet, imiraba ya radiyo, na mudasobwa kugira ngo bikore amashusho arambuye y'imbere mu mubiri. Binakoreshwa mu gusuzuma imyakura y'inkende.

Iyo indwara imaze kwemezwa, hashobora gukorwa ibindi bipimo kugira ngo hamenyekane niba ikibyimba ari kanseri (cyangiza) cyangwa kitari kibi (cyangiza), kandi niba cyarakwirakwiriye mu bindi bice by'umubiri.

Kuki gupima imiterere y'uturemangingo ari ingenzi?

Niba usanzwe urwaye pheochromocytoma, muganga wawe ashobora kukugira inama yo kuguha inama no gupima imiterere y’uturemangingo kugira ngo hamenyekane niba ufite indwara uvukana ishobora kugushyira mu kaga ko kurwara izindi kanseri.

Gupima imiterere y’uturemangingo bishobora gukorwa mu bihe nk'ibi:

• Niba wowe cyangwa umuntu wo mu muryango wawe afite ibimenyetso bifitanye isano na pheochromocytoma cyangwa paraganglioma syndrome.
• Niba ufite ibibyimba mu ngirabuzimafatizo zombi z'inkondo y'umura.
• Iyo hari ibibyimba birenze kimwe mu gasabo kamwe k'inkondo y'umura.
• Iyo hari ibimenyetso by'ubwiyongere bw'urugero rwa catecholamine mu maraso.
• Iyo pheochromocytoma igaragaye mbere y'imyaka 40.

Iyo ikizamini cy’uturemangingo gisanze hari impinduka mu turemangingo, umujyanama mu by’uturemangingo ashobora gusaba abandi bantu bo mu muryango wawe (abadafite ibimenyetso ariko bari mu kaga) nabo gukora iki kizamini.

Ni ubuhe buryo bwo kuvura Pheochromocytoma?

Uburyo bwiza bwo kuvura ibi ni ukubaga ikibyimba, niba bishoboka .

Guhitamo uburyo bwo kuvura biterwa n'ibintu byinshi:

• Ingano y'ikibyimba.
• Niba ikibyimba ari kanseri (cyangiza) cyangwa kitari kibi (kitarwaye).
• Niba hari ibimenyetso biterwa no kwiyongera kw'imisemburo ya catecholamine.
• Ese ikibyimba cyaba giherereye ahantu hamwe, cyangwa cyarakwirakwiriye mu bindi bice by'umubiri? (Byarangiritse)
• Niba iyi ndwara yagaragaye bwa mbere, cyangwa niba yongeye kugaruka nyuma yo kuvurwa mbere.

Niba ufite ibimenyetso biterwa no kwiyongera kw'imisemburo ikora ku misemburo, muganga wawe ashobora kukwandikira imiti yo kugenzura ibyo bimenyetso. Urugero:

• Imiti ifasha umuvuduko w'amaraso kuguma ku rugero rusanzwe, nka alpha-blockers.
• Imiti yo kugumisha umuvuduko w'umutima ku rwego rusanzwe, nka beta-blockers.
• Imiti ibuza ingaruka z'imisemburo irekurwa cyane n'agace k'intanga ngabo.

Uburyo bw'ingenzi bwo kuvura pheochromocytoma ni ubu:

• Kubaga
• Ubuvuzi bushingiye ku mirasire
• Ubuvuzi bwa Chimiotherapie
• Uburyo bwo kuvura indwara yo kubura amaraso
• Uburyo bwo kuvura indwara ya Embolisation
• Ubuvuzi bwibasiwe

Muri kumwe, wowe n'itsinda ry'abaganga muzagena gahunda y'ubuvuzi ikubereye.

Uburyo bw'ingenzi bwo kuvura

• Kubaga:

Ubu ni bwo buryo bw'ingenzi bwo kuvura pheochromocytoma. Hafi 90% by'ibibyimba bishobora gukurwaho neza mu buryo bwo kubaga .

Muganga wawe ashobora kukugira inama yo kubagwa kugira ngo akureho imwe cyangwa zombi mu ngirabuzimafatizo zawe (adrenalectomy). Mu gihe cyo kubagwa, umuganga azasuzuma ingingo zikikije n'uturemangingo tw'imitsi kugira ngo arebe niba ikibyimba cyarakwirakwiriye. Niba cyarakwirakwiriye, azakuraho iyo ngingo, niba bishoboka.

Nyuma yo kubagwa, amaraso yawe cyangwa inkari zawe bizapimwa kugira ngo harebwe urugero rwa catecholamine. Iyo urugero rusubiye ku rugero rusanzwe, bivuze ko uturemangingo twose twa pheochromocytoma twakuweho.

Iyo imisemburo yombi y’inkende ikuweho, uzakenera gufata imiti igabanya ubukana bw’imisemburo ubuzima bwawe bwose kugira ngo usimbuze imisemburo ikorwa n’imisemburo y’inkende.

• Ubuvuzi bushingiye ku mirasire:

Ubu ni uburyo bwo kuvura bukoreshwa mu kwica uturemangingo twa kanseri cyangwa kubuhagarika gukura. Ibi bikorwa mu buryo budahungabanya cyane uturemangingo tuzima uko bishoboka kose.

Hari ubwoko bubiri bw'ubuvuzi bushingiye ku mirasire:

• Ubuvuzi bw'imirasire yo hanze: Imirasire igera aho kanseri yagaragaye iturutse mu mashini iri hanze y'umubiri.
• Ubuvuzi bw'imirasire y'imbere mu mubiri: Ibintu bitera imirasire bishyirwa mu nshinge, imbuto, insinga, cyangwa catheter hanyuma bigashyirwa na muganga aho kanseri yabereye cyangwa hafi yayo.

Ubwoko bw'ubuvuzi bushingiye ku mirasire buterwa no kuba kanseri iherereye ahantu runaka, aho iherereye, aho igaragara, cyangwa aho igaruka. Pheochromocytoma mbi ikunze kuvurwa hakoreshejwe imirasire yo hanze cyangwa 131I-MIBG. 131I-MIBG ni ibintu bitera imirasire bifatanye n'uturemangingo twa kanseri tukabica.

• Ubumenyi bw'imiti ikoresha imiti igabanya ubukana:

Ibi bikoresha imiti mu kwica uturemangingo twa kanseri, kubuza kwigabanya no kugwira, cyangwa guhagarika gukura kwa kanseri. Iyi miti ikunze gutangwa mu mitsi. Nubwo ubu ari uburyo bwiza bwo kuvura, bushobora kugira ingaruka mbi.

• Uburyo bwo kuvura indwara yo mu nda:

Ubu ni uburyo bwo kuvura budakoresha imbaraga nyinshi. Bukoresha ubushyuhe bwinshi cyangwa ubukonje bukabije kugira ngo busenye ibibyimba.

• Gukuraho imirasire y'amaraso: Gukuraho imirasire y'amaraso ikoresha imirasire y'amajwi kugira ngo ishyushye kandi isenye uturemangingo twa kanseri n'uturemangingo tudasanzwe.
• Cryoablation: Ikoresha azote y'amazi cyangwa dioxyde de carbone y'amazi kugira ngo ikonje kandi isenye uturemangingo twa kanseri n'uturemangingo tudasanzwe.

• Uburyo bwo kuvura indwara ya Embolisation:

Muri ibi, imitsi ijyana amaraso muri adrenal gland irafungwa. Ibi bihagarika gutembera kw'amaraso muri prostate, bigatuma uturemangingo twa kanseri tuhakura twica.

• Ubuvuzi bwibasiwe:

Ibi bikoresha imiti cyangwa ibindi bintu byibasira uturemangingo twa kanseri gusa ariko bitagize ingaruka ku turemangingo tuzima. Ubu buryo bukoreshwa ku ndwara ya metastatic na recurrent pheochromocytoma.

Harimo gukorwa ubushakashatsi ku muti ugabanya ubukana bwa tyrosine kinase witwa sunitinib kugira ngo urebe niba urimo kwandura pheochromocytoma. Iyi miti ibuza ikibyimba gukura.

Ese iyi ndwara ishobora kwirindwa?

Ikibabaje ni uko nta buryo bwo kwirinda pheochromocytoma. Ariko, niba ufite ibyago byo kurwara iyi ndwara bitewe n'indwara z'uruhererekane n'uturemangingo, ubujyanama mu by'uturemangingo bushobora kugufasha gusuzuma no kubimenya hakiri kare.

Niba hari uwo mu muryango wawe wa hafi (abavandimwe bawe, ababyeyi) wigeze kugira pheochromocytoma, cyangwa niba ufite indwara ya genetiki nk'iyo twavuze mbere (Multiple endocrine neoplasia 2 syndrome, Von Hippel-Lindau (VHL) disease, Neurofibromatosis type 1 (NF1), Hereditary paraganglioma syndrome, Carney-Stratakis dyad, Carney triad), ni ngombwa cyane kubivuganaho na muganga wawe.

Ni amahirwe angahe yo gukira nyuma yo kuvurwa? (Ibisobanuro)

Icyizere cy'uko pheochromocytoma izabaho muri rusange ni cyiza cyane iyo ivuwe.Twavuze ko hafi 90% by'ibibyimba bishobora gukurwaho neza mu buryo bwo kubaga.

Ariko, iyo itavuwe, iyi ndwara ishobora gutera ingorane zikomeye ndetse zikanashyira ubuzima mu kaga . Urugero:

• Indwara y'umutima
• Myocarditis
• Kuva amaraso mu bwonko mu buryo butunguranye (kuva amaraso mu bwonko)
• Ukwiyongera kw'amazi mu bihaha (Pulmonary edema)

Bamwe mu barwayi ba pheochromocytoma nabo bashobora kurwara indwara yo gucika intege mu bwonko cyangwa indwara y’umutima.

Ni ryari ngomba kujya kwa muganga?

• Niba usanzwe urwaye pheochromocytoma kandi ukagaragaza ibimenyetso bikubangamiye, hita ubonana na muganga wawe.
• Niba ufite ibimenyetso bya pheochromocytoma, nko kurwara umuvuduko ukabije w'amaraso no kuribwa umutwe, vugana na muganga wawe. Nubwo pheochromocytoma idakunze kugaragara, ni ngombwa kuvura umuvuduko ukabije w'amaraso.
• Niba uzi ko umwe mu bavandimwe bawe ba hafi (abavandimwe bawe, ababyeyi) afite indwara ya genetiki nka `Multiple endocrine neoplasia 2 syndrome` cyangwa `Von Hippel-Lindau (VHL) disease`, ushobora kandi kuba uri mu kaga ko kurwara pheochromocytoma, bityo gana muganga kugira ngo muganire ku bijyanye no gupima genetiki.

Ni ibihe bibazo ngomba kubaza muganga?

Niba usanzwe urwaye pheochromocytoma, byaba byiza ubajije muganga wawe ibi bibazo:

• Kuki nagize pheochromocytoma?
• Ese abana banjye cyangwa bene wacu bashobora kugira pheochromocytoma?
• Ni ubuhe buryo bwo kuvura mfite?
• Ni izihe ngaruka mbi z'ubuvuzi butandukanye?
• Ni gute nakwitwara mu gihe mfite ibimenyetso?

Amaherezo, ibintu by'ingenzi cyane ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Yego, nubwo pheochromocytoma ari ikibyimba kidasanzwe, akenshi ntigitera ingaruka mbi kandi kiravurwa . Nanone, gishobora kugaragara mu miryango, bityo rero niba wowe cyangwa umuntu wo mu muryango wawe agaragayeho iyi ndwara, ni ngombwa gupimwa mu buryo bw'uturemangingo. Ibi bishobora kandi gufasha kumenya niba uri mu kaga ko kugira ibindi bibazo by'ubuzima.

Wibuke ko niba ufite ikibazo ku bijyanye n'ibyago byawe byo kurwara pheochromocytoma cyangwa kuri iyi ndwara, ntutinye kuvugana na muganga wawe. Barahari kugira ngo bagufashe. Komeza ubuzima bwiza!

Pheochromocytoma , adrenal gland, catecholamines, umuvuduko ukabije w'amaraso, kuribwa umutwe, ibyuya, ikibyimba, sisitemu y'imisemburo