Ngaba ufumana amaqhuqhuva rhoqo emzimbeni wakho? Masifunde ngale (Marginal Zone Lymphoma - MZL)?

Ngaba ngamanye amaxesha uba namaqhuma anje emzimbeni wakho? Okanye uzive udiniwe ngaphandle kwesizathu, okanye uzive ngathi ulahlekelwa bubunzima? Uninzi lwexesha, ezi zizinto eziqhelekileyo, kodwa ngamanye amaxesha zinokuba luphawu lwesifo esifuna ingqalelo ethile. Namhlanje siza kuthetha ngohlobo olungaqhelekanga lwe-lymphoma olubizwa ngokuba yi-`(Marginal Zone Lymphoma - MZL)` ekufuneka sonke siluqaphele. Ungakhathazeki, siza kuthetha ngale nto ngokulula nangendlela onokuyiqonda.

Yintoni i-`(Marginal Zone Lymphoma - MZL)`? Ngamafutshane...

I-Marginal Zone Lymphoma ligama eliqhelekileyo leentlobo ezininzi ezingaqhelekanga ze-lymphoma ezikhula kancinci, oko kuthetha ukuba azisasazeki ngokukhawuleza, kwaye ziyinxalenye yeqela lee-cancer ezibizwa ngokuba yi-Non-Hodgkin Lymphoma. Ezi zicubu zihlala zikhula kwizicubu ze-lymphoid, eziyinxalenye yenkqubo yomzimba wethu yokuzikhusela . Ezi zicubu ziqulathe uhlobo lweeseli ezimhlophe zegazi ezibizwa ngokuba zii-B cells. Ubusazi na ukuba ii-B cells zifana neeseli zomzimba, uhlobo lweeseli ezisinceda ekukhuseleni kwizifo? Zifumaneka ikakhulu kwi-lymph nodes zethu (ezibizwa ngokuba zii-lymph nodes) kunye ne-spleen.

Ngoku khangela, ngaphakathi kwi-lymph nodes zethu kukho iindawo ezincinci ezibizwa ngokuba yi-`(lymphoid follicles)`. Ezi `(lymphoid follicles)` zineendawo ezimbini - enye ibizwa ngokuba yi-`(mantle zone)` kwaye enye ibizwa ngokuba yi-`(marginal zone)`. Njengokongeza olunye umaleko kwikhekhe, le `(marginal zone)` ikwindawo ejikeleze i-`(mantle zone)`. `(Marginal Zone Lymphoma)` yenziwa xa iiseli ze-`(B cells)` kuloo `(marginal zone)` zitshintsha , oko kukuthi, zenza utshintsho oluthile, zibe ziiseli ezingaqhelekanga, kwaye ziqala ukwanda ngokungalawulekiyo.

Le meko, ethi ``Marginal Zone Lymphoma'', idla ngokubonakala kakhulu kubantu abaneminyaka engaphezu kwama-60 ubudala. Ikwaxhaphake kancinci kumadoda kunakwabasetyhini.

Ziziphi iintlobo eziphambili ze-`(Marginal Zone Lymphoma)`?

Kukho iintlobo ezintathu eziphambili ze-`(MZL)`. Masibone ukuba zeziphi:

1. I-Mucosa-assisted lymphoid tissue (MALT) lymphoma: Olu lolona hlobo luqhelekileyo lwe-MALT. Oogqirha ngamanye amaxesha bayibiza ngokuba yi-extranodal marginal cell lymphoma. I-"Extranodal" ithetha ukuba iqala ngaphandle kwee-lymph nodes. Olu hlobo lwe-lymphoma lunokuqala kulwelo lwesisu (gastric MALT), okanye kwimiphunga, kulusu, kwi-thyroid, kwi-salivary glands, emathunjini, okanye kwiindawo ezijikeleze amehlo (non-gastric MALT).

2. I-Nodal marginal zone lymphoma: Olu hlobo luchaphazela ii-lymph nodes zakho. Oko kukuthi, ii-lymph nodes zakho. Kodwa ngamanye amaxesha zinokubonakala nakwi-bone mongo wakho.

3. I-Splenic marginal zone lymphoma: Olu luhlobo olungaqhelekanga. Luchaphazela i-spleen yakho, igazi, kunye nomongo wethambo.

Zithini iimpawu ze-`(Marginal Zone Lymphoma)`?

I-Marginal Zone Lymphoma idla ngokuba sisifo esikhula kancinci . Ngoko ke, unokuba nale meko ixesha elide ungenazo iimpawu. Iimpawu ziyahluka ngokuxhomekeke kuhlobo lwe-lymphoma. Ngokubanzi, i-Marginal Zone Lymphoma inokubangela iimpawu ezifana nezi:

• Umkhuhlane (umkhuhlane oza ngaphandle kwesizathu)
• Ukubila kakhulu ebusuku (kangangokuba amashiti ebhedini ayamanzi)
• Ukunciphisa umzimba ngaphandle kwesizathu (ukuba unciphisa umzimba ngaphandle kokuzama)

Ngamanye amaxesha ezi sizibiza ngokuba "ziimpawu ze-B."

Iimpawu ze-`(MALT)` Lymphoma

Iimpawu ze-`(Extranodal marginal zone lymphoma)` okanye `(MALT)` lymphoma ziyahluka ngokuxhomekeke ekubeni iphi i-lymphoma. Umzekelo, ukuba une-`(MALT)` lymphoma esiswini sakho, unokufumana iimpawu ezifana nezi:

• Isicaphucaphu nokuhlanza
• Intlungu yesisu okanye ukungakhululeki
• Ukuziva ugcwele nangona emva kokutya ukutya okuncinci

Ukuba i-lymphoma ikwindawo engeyiyo esiswini (i-MALT engeyiyo eyesisu), umzekelo elisweni, utshintsho lunokubonwa kwi-conjunctiva okanye kwi-lacrimal glands.

Iimpawu ze-`(Nodal marginal zone lymphoma)`

Kolu hlobo, uphawu oluphambili kukudumba kwamasende. Ukongeza, iimpawu eziqhelekileyo ezikhankanyiweyo ngaphambili nazo zinokubakho:

• Ifiva
• Ukubila ebusuku
• Ukunciphisa umzimba ngaphandle kwesizathu

Iimpawu ze-`(Splenic marginal zone lymphoma)`

Olu hlobo lomhlaza wepleen lunokubangela iimpawu ezifana nezi:

• Ukudinwa nokudinwa
• I-spleen ekhulisiweyo (isenokuvakala ngathi inzima okanye igcwele kwinxalenye ephezulu yasekhohlo yesisu)
• Ukubila ebusuku
• Ukunciphisa umzimba ngaphandle kwesizathu

Zithini izizathu ze-`(Marginal Zone Lymphoma)`?

Ngokwesiqhelo, abantu abaneMarginal Zone Lymphoma banembali yosapho lwabo ye-lymphoma, okanye basenokuba nosulelo oluqhelekileyo, okanye banokuba nezifo zokuzikhusela komzimba. Nangona kunjalo, kukho izizathu ezithile ze-subtype nganye.

• I-MALT lymphoma: Oku kubangelwa kakhulu zizifo ezibangelwa ziintsholongwane, ingakumbi i-H. pylori. Usenokuba ukhe weva ukuba i-gastritis nayo ibangelwa yile ntsholongwane. Ukongeza, izifo ezibangelwa ziintsholongwane ezifana nesifo sikaHashimoto (isifo esichaphazela i-thyroid gland) okanye i-Sjögren's syndrome (isifo esomisa amathe kunye neentlungu), kunye nembali yosapho ye-lymphoma nazo zinokuba ngumngcipheko.
• I-Splenic marginal zone lymphoma: Oku kunxulunyaniswa nosulelo lwe-hepatitis C kunye nezifo ezizikhuselayo emzimbeni.
• I-Nodal marginal zone lymphoma: Oku kufunyenwe kunxulunyaniswa nosulelo lweHepatitis C.

Kubalulekile:Ayinguye wonke umntu ophuhlisa `(MZL)` ngenxa yezi zizathu. Kwakhona, abanye abantu banokuyiphuhlisa ngaphandle kwezi zizathu. Ezi zizinto nje ezinobungozi.

Ziziphi izinto ezibangela umngcipheko we-`(Marginal Zone Lymphoma)`?

Njengoko bekutshiwo ngaphambili, izinto eziphambili ezibangela umngcipheko yimbali yosapho ye-lymphoma, usulelo oluthile (olufana ne-H. pylori, i-Hepatitis C), kunye nezifo ezibangelwa kukuzikhusela komzimba (isifo sikaHashimoto, isifo sikaSjögren).

Ifunyanwa njani iMarginal Zone Lymphoma?

Ugqirha wakho uza kuqala akubuze imibuzo embalwa ukuze afumanise esi sifo. Oku kuquka iimpawu onazo, imbali yakho yezonyango, kunye nokuba kukho umntu kusapho lwakho okhe waba neemeko ezifanayo.

Emva koko, kuya kufuneka kwenziwe iimvavanyo ezininzi ukuqinisekisa ukuxilongwa.

Zithini iimvavanyo zokuxilonga?

Iimvavanyo ezenziwayo zingahluka kancinci ngokuxhomekeke kwi-subtype ye-lymphoma, kodwa ngokubanzi, ezi mvavanyo zilandelayo zingenziwa:

• Ubalo lweGazi olupheleleyo (CBC): Lujonga inani leentlobo ezahlukeneyo zeeseli (iiseli ezibomvu, iiseli ezimhlophe, iiplatelets) egazini.
• Uvavanyo lwe-`(LDH - Lactate Dehydrogenase)`: Olu yi-enzyme eyandayo egazini xa iiseli zonakele.
• `(Beta-2 microglobulin)`: Oku kusetyenziswa njengesalathisi somhlaza wegazi.
• Uvavanyo lokusebenza kwesibindi .
• Uvavanyo lokusebenza kwezintso (izintso) .
• Ukulungiswa kweproteni ye-serum (IFX): Uvavanyo lokujonga utshintsho kwiiproteni egazini.
• Uvavanyo losulelo oluthile lweentsholongwane kunye neentsholongwane (umz., `(H. pylori)`, `(Hepatitis C)`).
• `(CT scan)`: Thatha imifanekiso eneenkcukacha zangaphakathi lomzimba. Bona izinto ezifana ne-lymph nodes ezivuvukileyo kunye ne-spleen ekhulisiweyo.
• I-Needle biopsy: Isampuli encinci yezicubu ezivela kwi-lymph node evuvukileyo okanye kwenye indawo isuswa ngenaliti ize ihlolwe phantsi kwe-microscope. Le yindlela ekuphela kwayo yokwazi ngokuqinisekileyo ukuba zikhona na iiseli ze-lymphoma.
• Uvavanyo lwe-bone marrow biopsy: Olu vavanyo ngamanye amaxesha lwenziwa ukuze kubonwe ukuba i-lymphoma isasazeke na kumongo wethambo.
• Ezinye iimvavanyo ze-`(Biopsy)`: Ukuthatha isampuli yeeseli okanye izicwili kuyo nayiphi na indawo yomzimba ekucingelwa ukuba ichaphazelekile kwaye uyivavanye.

Zithini izigaba zomhlaza kwi-`(MZL)`?

Ukumisela umhlaza ngendlela yokumisela ukuba umhlaza usasazeke kangakanani emzimbeni. Oku kubalulekile ekucwangciseni unyango kunye nokufumana umbono wendlela esiza kuqhubeka ngayo esi sifo kwixesha elizayo. Amanqanaba e-MZL adla ngokuba ngolu hlobo lulandelayo:

• Inqanaba lokuQala: Umhlaza ukwindawo enye kuphela ye-lymph node.
• Inqanaba lesiBini:Umhlaza ukwiindawo ezimbini okanye ngaphezulu ze-lymph node kwicala elinye, nokuba ngaphezulu okanye ngaphantsi kwe-diaphragm (umsipha owahlula isifuba nesisu sethu).
• Inqanaba lesi-3: Umhlaza usasazeke kwiindawo ezininzi ze-lymph node ngaphezulu nangaphantsi kwe-diaphragm, oko kuthetha ukuba kukho i-lymph nodes kumacala omabini.
• Inqanaba lesi-4: Umhlaza usasazeke ngaphandle kwenkqubo ye-lymphatic uye kwelinye okanye amanye amalungu omzimba, njengesibindi, imiphunga, okanye umongo wethambo.

Ziziphi iindlela zonyango ze-`(Marginal Zone Lymphoma)`?

Ngenxa yokuba iMarginal Zone Lymphoma sisifo esikhula kancinci, abanye abantu banokungadingi ukuqala unyango kwangoko. Ngamanye amaxesha oogqirha bacebisa indlela yonyango ebizwa ngokuba yi-"waiting waiting" okanye "active surveillance." Oku kuthetha ukuba ujongwa rhoqo de kuvele iimpawu okanye isifo sibe sibi kakhulu.

Ukuba unyango luyadingeka, unyango olunikiweyo luya kwahluka ngokuxhomekeke kuhlobo oluthile lwe-lymphoma. Unyango oluqhelekileyo luquka:

• Ii-antibiotics: Ingakumbi ukuba i-lymphoma ibangelwa yintsholongwane i-H. pylori, ii-antibiotics zinikwa ukubulala iintsholongwane. Kwiimeko ezininzi, oku kunokuyinyanga i-lymphoma.
• I-Chemotherapy: Amayeza anikwa ukubulala iiseli zomhlaza.
• Unyango ngemitha: Ukusetyenziswa kwemitha enamandla aphezulu ukutshabalalisa iiseli zomhlaza. Oku kudla ngokusetyenziswa xa i-lymphoma ikwindawo ethile.
• Unyango olujoliswe kuko: Ezi ziintlobo ezintsha zamayeza asebenza ngokujolisa kwiimolekyuli ezithile kwiiseli zomhlaza.
• Unyango lwe-Immunotherapy: Luvuselela inkqubo yomzimba yokulwa neeseli zomhlaza.

Ngaba i-`(Marginal Zone Lymphoma)` inganyangeka ngokupheleleyo?

Oku kuxhomekeke ngokwenene kuhlobo lwe-lymphoma, inqanaba, kunye nempilo yakho iyonke. Umzekelo, i-gastric (MALT) lymphoma ebangelwa lusulelo lwe-H. pylori inethuba eliphezulu lokuphiliswa ngokupheleleyo ngonyango lwe-antibiotic.

Kwezinye iintlobo, unyango lunokufaka isifo kwi-"remission" . "Remission" kuthetha ukuba iimpawu azisekho kwaye uvavanyo alubonisi bungqina besifo. Nangona kunjalo, i-"Marginal Zone Lymphoma" ngamanye amaxesha inokubuya ('recur') emva konyango. Ke ngoko, oogqirha baya kuqhubeka nokukubeka esweni.

Ingakanani izinga lokusinda kwe-`(Marginal Zone Lymphoma)`?

Amanani okusinda ziinkcukacha-manani nje. Abonisa ipesenti yabantu abaphilayo emva kweminyaka emihlanu emva kokufunyaniswa ukuba banayo le ntsholongwane. Kodwa anokwahluka kumntu nomntu. Amava akho anokwahluka.

Ngokutsho kolunye uphando:

• Malunga nama -88% abantu abane-extranodal marginal zone lymphoma (MALT) baphila iminyaka emihlanu emva kokuba bexilongiwe.
• Malunga nama -79% abantu abane-splenic marginal zone lymphoma baphila emva kweminyaka emihlanu emva kokufunyaniswa ukuba banayo le ngxaki.
• Malunga nama- 76.5% abantu abane-nodal marginal zone lymphoma baphila iminyaka emihlanu emva kokuba bexilongiwe.

Khumbula: Ezi zizinto eziqhelekileyo. Ngenxa yokuba iMarginal Zone Lymphoma idla ngokuvela kubantu abadala, uninzi lwaba bantu lufa ngenxa yezizathu ezingezizo i-lymphoma. Ngugqirha wakho kuphela onokukunika ulwazi oluchanekileyo malunga nemeko yakho. Ngoko ke, ungothuswa zezi zibalo zodwa.

Ngaba i-Marginal Zone Lymphoma ingathintelwa?

Asinakulawula ezinye zezinto ezibangela uphuhliso lwesi sifo, ezifana nezifo ezibangelwa kukuzikhusela komzimba okanye iimpembelelo zemfuza. Nangona kunjalo, ukuba kukho usulelo olune-`(H. pylori)`, lunokuncipha ngandlela thile ngokuthatha unyango olufanelekileyo kunye nokuthatha amanyathelo okuzikhusela kwiintsholongwane ezifana ne-`(Hepatitis C)`.

Ndifanele ndimbone nini ugqirha wam?

Ukuba ufunyenwe une-"Marginal Zone Lymphoma", qiniseka ukuba ubona ugqirha wakho ukuba:

• Ukuba ubona utshintsho emzimbeni wakho ocinga ukuba lunokuba ziimpawu zeMarginal Zone Lymphoma (umz., kuvela iqhuma elitsha, elikhoyo liyakhula, umkhuhlane, ukubila ebusuku, ukwehla kobunzima).
• Ukuba iimpawu zakho ziya zisiba mandundu ngelixa ufumana unyango .
• Ukuba uphilile kwaye uqala ukubona iimpawu zokuba isifo siyabuya, kusenokwenzeka ukuba siphinde sibuye .

Ndingayinyamekela njani impilo yam?

Xa uphila nesifo esifana ne-MZL, ukuzinyamekela kubaluleke kakhulu. Nazi ezinye zezinto onokuzenza:

• Lawula uxinzelelo: Abanye abantu abane-MZL basenokungabi nazimpawu kwaye basenokungadingi unyango. Nangona oko kuyinto entle, usenokuba ukhathazekile malunga nokuba "kuza kuba mandundu nini?" Ukuzilolonga, ukumamela umculo, ukwenza i-yoga, okanye ukuzibandakanya kwinto oyithandayo kunokukunceda uphumle.
• Sela amanzi aneleyo: Unyango lomhlaza kunye nemiphumo yalo engemihle lunokwenza umzimba ungabi namanzi, ngoko zama ukusela ubuncinane iiglasi ezisi-8 zamanzi ngosuku.
• Yitya ukutya okunesondlo esifanelekileyo: Faka ukutya okunesondlo okufana neziqhamo, imifuno, amandongomane, kunye neemveliso zobisi ekutyeni kwakho. Yitya ukutya okuncinci endaweni yokutya ukutya okuninzi.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ungabuza ugqirha imibuzo efana nale:

• Luhlobo luni lwe-"Marginal Zone Lymphoma" endinalo?
• Ithini inqanaba lesifo sam?
• Ngaba ndifuna unyango ngoko nangoko?
• Ukuba kufuneka unyango, loluphi unyango onokulucebisa kwaye ngoba?
• Zithini iziphumo ebezingalindelekanga zezi ndlela zonyango?
• Ngaba kukho naziphi na iimvavanyo zeklinikhi endinokuthi ndithathe inxaxheba kuzo?
• Ungandixelela ntoni ngesifo sam?

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

I-Marginal Zone Lymphoma (MZL) luhlobo olungaqhelekanga nolukhula kancinci lwe-lymphoma oluwela kudidi lwe-Non-Hodgkin Lymphoma. Kukho iintlobo ezahlukeneyo ze-lymphoma, kwaye iimpawu, unyango, kunye nokuqikelela ziyahluka ngokuxhomekeke kuhlobo. Okubaluleke kakhulu, kuba isifo siqhubeka kancinci, abanye abantu banokungadingi unyango iminyaka. Kwabanye, unyango lunokubangela ukuba isifo siphinde siphele.

Ukuba unesi sifo, kungcono ungoyiki, kodwa thetha nogqirha wakho kwaye ufumane ulwazi oluhambelana nemeko yakho. Ugqirha wakho uza kukuchazela indlela esi sifo esichaphazela ngayo umzimba wakho kunye neendlela zonyango ezikhoyo. Khumbula, awuwedwa, kwaye kukho oogqirha kunye nabantu obathandayo abanokukunceda.

Indawo eseMarginal Lymphoma, MZL, iNon-Hodgkin Lymphoma, iLymphoma, umhlaza, iMALT Lymphoma, iiseli ze-B, i-H. pylori, iChemotherapy, ii-lymph nodes