Ngaba unazo ezi mpawu? Masithethe nge-Non-Hodgkin Lymphoma (NHL)

Ngaba wakha waphawula iqhuma okanye ukudumba entanyeni, emakhwapheni, okanye emqolo? Usenokuba ukhe waziva udiniwe okanye uqaqamba. Ezi zinto zinokuba ziqhelekile, kodwa ngamanye amaxesha zinokuba ziimpawu zohlobo lomhlaza wegazi olubizwa ngokuba yi -Non-Hodgkin Lymphoma (NHL) . Ungakhathazeki, masihlale silula.

Yintoni i-Non-Hodgkin Lymphoma (NHL)? Masiyiqonde ngokulula!

Ngamafutshane, i-Non-Hodgkin Lymphoma (NHL) liqela leemhlaza zegazi ezikhula kwinkqubo ye-lymphatic yomzimba wethu. Usenokuba ukhe weva ngohlobo lomhlaza olubizwa ngokuba yi-lymphoma. I-NHL yenye yeentlobo ezimbini eziphambili ze-lymphoma. Ezi mhlaza ziqala kwiiseli ezibizwa ngokuba yi-lymphocytes , uhlobo lweeseli ezimhlophe zegazi emzimbeni wethu. Ezi lymphocytes zifana namapolisa emzimbeni wethu. Zizo ezisikhusela ngokulwa nezifo kunye nosulelo.

Khawucinge nje, kwenzeka ntoni ukuba kukho utshintsho, utshintsho oluthile, kwiijini ezingaphakathi kwezi seli ze-lymphocyte? Kulapho ke ezi seli ze-lymphoma ezingaqhelekanga ziqala ukwakheka khona. Ezi zihlala zikhula kwii-lymph nodes zethu. Kulapho ezi seli ziqokelelana khona kwaye zenze ii-tumor. Nangona kunjalo, oku akupheleli nje kwi-lymph nodes, kodwa kunokukhula nakwezinye izitho zenkqubo yethu ye-lymphatic, njenge-thymus gland, i-spleen, okanye kwizicubu ze-lymph kwezinye iindawo. Eyona nto ibalulekileyo kukuba ukuba ezi NHL azinyangwa ngokufanelekileyo, zinokusasazeka emzimbeni wonke.

Kodwa akukho mfuneko yokukhathazeka. Ngenxa yonyango olutsha olufumanekayo, abantu abaninzi abane-NHL bayaphola kwaye baphila ixesha elide. Ngamanye amaxesha, unyango lunokunyanga ngokupheleleyo esi sifo. Ngamanye amaxesha, injongo yonyango kukulawula isifo, ukusibeka kwindawo "yokuxolelwa", kwaye sihlale sinjalo ixesha elide kangangoko kunokwenzeka.

Ziziphi iintlobo eziphambili ze-NHL?

Ungamangaliswa kukufumanisa ukuba kukho iintlobo ze-NHL ezingaphezu kwama-70! Oogqirha bazihlela ngokweentlobo ze-lymphocyte ezichaphazelekayo:

• I-B-cell lymphoma: Lo mhlaza uvela kwiiseli ze-B. Iiseli ze-B luhlobo lweeseli ezenza ii-antibodies ukulwa neentsholongwane emizimbeni yethu. I-B-cell lymphoma ibangela i-85% yokuxilongwa kwe-NHL.
• I-T-cell lymphoma: Lo mhlaza uvela kwii-T cells. Ii-T cells luhlobo lweeseli ezijolise kwaye zihlasele iintsholongwane kunye nabahlaseli bamanye amazwe kwaye zinceda ii-B cells ukuba zenze ii-antibodies.

Oogqirha bakwabeka ii-lymphomas ze-B-cell kunye ne-T-cell njenge- "aggressive" kunye ne- "indolent ." Ii-NHL ezi-Aggressive zisasazeka ngokukhawuleza kunee-NHL ezi-Indolent. Ke ngoko, ii-NHL ezi-Aggressive zihlala zifuna unyango olunzima ngakumbi.

Ixhaphake kangakanani le sifo ibizwa ngokuba yi-NHL?

Ngokwenene luhlobo lomhlaza oluqhelekileyo. Umzekelo, eMelika, kulindeleke ukuba kubekho amatyala amatsha angama-80,620 e-NHL ngo-2024. Ikwangumhlaza we-11 oxhaphakileyo emhlabeni. I-Non-Hodgkin lymphoma ixhaphake kakhulu kune -Hodgkin lymphoma , olunye uhlobo lwe-lymphoma.

Ziziphi iimpawu ze-Non-Hodgkin Lymphoma?

Uphawu oluqhelekileyo kukudumba okungenabuhlungu okanye iqhubu entanyeni, emakhwapheni, okanye emqolo. Olu luphawu lokuba ii-lymph nodes kwezo ndawo zidumbile. Ezinye iimpawu zixhomekeke ekubeni zikuphi iiseli ze-lymphoma. Ezinye iimpawu ze-NHL zingabandakanya:

• Ukudinwa rhoqo
• Iintlungu zesifuba
• Ukukhwehlela
• Ubunzima bokuphefumla (ukuphelelwa ngamandla)
• Intlungu yesisu okanye ukudumba
• Ukuziva ugcwele nangona emva kokutya kancinci
• Umkhuhlane ongachazwanga (ingakumbi umkhuhlane ongaphezulu kwama-39.5 degrees Celsius (103 Fahrenheit) ongapheliyo emva kweeyure ezimbini nangaphezulu ngonyango lwasekhaya, okanye ukuba umkhuhlane ubukho kangangeentsuku ezingaphezu kwezimbini)
• Ukubila kakhulu ebusuku kangangokuba amashiti ayamanzi
• Ukwehla kobunzima obungachazekiyo malunga ne-10% yobunzima bomzimba (kwiinyanga ezi-6)

Into ebalulekileyo ekufuneka uyikhumbule kukuba uninzi lwezi mpawu zinokubangelwa zezinye iimeko. Ukuba nenye okanye ngaphezulu kwezi mpawu akuthethi ukuba une-NHL. Nangona kunjalo, ukuba ubona naluphi na utshintsho emzimbeni wakho, ingakumbi into entsha ebisenzeka kangangeeveki ezininzi, kulungile ukubona ugqirha ngoko nangoko.

Zithini iimpawu "B"?

Xa oogqirha befumanisa i-lymphoma, bajonga neempawu "B" . Ezi mpawu "B" zezi:

• Umkhuhlane ngaphandle kwesizathu
• Ukubila kakhulu ebusuku
• Ukunciphisa umzimba ngaphandle kwesizathu

Nokuba unazo ezi mpawu okanye awunazo kuya kunceda ugqirha wakho ukuba agqibe ukuba loluphi uhlobo lwe-NHL onalo kunye nonyango olungcono.

Kutheni i-Non-Hodgkin Lymphoma isenzeka?

I-Non-Hodgkin Lymphoma ibangelwa kukuba umzimba wakho uvelisa ii-lymphocytes ezininzi kakhulu (ii-B-cells, ii-T-cells, okanye ii-NK cells ezingaqhelekanga). Oku kungenxa yokuguqulwa kwezakhi zofuzo ezifunyenweyo kwiijini ezichaphazela uphuhliso lwe-lymphocyte. "I-Acquired" ithetha ukuba asiyonto ozalwa nayo, kodwa yinto eyenzekayo ebomini bakho.

Xa ii-lymphocytes zingaba yinto engaqhelekanga, ziyahlukana kwaye ziphindaphindeke ngokukhawuleza, ekugqibeleni zenze ii-tumor. Ezi tumor zihlala ziqala kwi-lymph nodes. Ngenxa yokuba inkqubo yethu ye-lymphatic iqhagamshelwe phantse kuyo yonke indawo yomzimba wethu, i-Non-Hodgkin Lymphoma idla ngokusasazeka kwamanye amalungu akwinkqubo ye-lymphatic.

Ziziphi izinto ezibangela umngcipheko wokuphuhlisa i-NHL?

Kukho izinto ezininzi ezonyusa umngcipheko wokufumana i-Non-Hodgkin Lymphoma. "I-risk factor" luphawu, umsebenzi, okanye imeko eyonyusa amathuba okufumana isifo. Umzekelo, oku kulandelayo kunokwenzeka ngakumbi ukuba kufumaneke i-NHL:

• Abantu abangaphezu kweminyaka engama-60 ubudala (umngcipheko we-NHL uyanda ngokukhula)
• Kwamadoda
• Kwabamhlophe (le yinto ethethwayo kwizifundo zangaphandle)

Ezinye izinto ezinokubangela umngcipheko zezi:

• Ubuthathaka benkqubo yomzimba yokuzikhusela: Ubuthathaka benkqubo yomzimba yokuzikhusela ngenxa yeemeko ezifana ne-HIV bunokunyusa umngcipheko we-NHL. Kwakhona, ukuthatha amayeza okunciphisa ukhuseleko emva kokufakelwa ilungu lomzimba yinto enobungozi.
• Izifo ezizikhusela ngokwazo: Abantu abanezifo ezifana nesifo samathumbu esibangelwa kukudumba (IBD), isifo samathambo esibizwa ngokuba yirheumatoid arthritis, kunye nepsoriasis basengozini enkulu yokuba ne-NHL.
• Izifo: Iintsholongwane ezibangelwa ziintsholongwane ezifana nosulelo lwe-H. pylori, intsholongwane ye-T-lymphotropic yabantu Uhlobo I, i-hepatitis C, kunye nentsholongwane ye-Epstein-Barr zifunyenwe zidibene ne-NHL.
• Ukuvezwa kwizinambuzane ezibulala izinambuzane: Olunye uphando lubonise ukuba abantu abachaphazeleka kakhulu yimithi yokubulala izinambuzane kunye nemithi yokubulala izinambuzane banokuba nomngcipheko okhulayo wokufumana i-NHL.
• Imbali yosapho: Ukuba omnye wabazali bakho, abantakwenu, oodadewenu, okanye abantwana bakho bane-lymphoma okanye omnye umhlaza wegazi, nawe usenokuba sengozini enkulu.

I-Non-Hodgkin Lymphoma ifunyanwa njani?

Ukuchonga i-Non-Hodgkin Lymphoma yinkqubo enamanyathelo amaninzi. Okokuqala, kuya kwenziwa uvavanyo ukuze kuthintelwe ezinye iimeko eziqhelekileyo ezinokubangela iimpawu zakho. Umzekelo, ii-lymph nodes ezivuvukileyo zinokwenzeka ukuba zibangelwe lusulelo kune-lymphoma. Nje ukuba ugqirha wakho afumanise ukuba une-Non-Hodgkin Lymphoma, uya kwenza uvavanyo oluthe kratya ukuze afumanise uhlobo kunye nokuba lusasazeke kangakanani ('inqanaba').

Ezinye iimvavanyo okanye iinkqubo onokuzifuna ukuze uxilonge i-Non-Hodgkin Lymphoma ziquka:

• Uvavanyo lomzimba: Ugqirha wakho uza kukubuza ngeempawu zakho aze ajonge iimpawu zeNon-Hodgkin Lymphoma, ezifana nee-lymph nodes ezivuvukileyo.
• Uvavanyo lwegazi: Uvavanyo lwegazi, olufana nokubalwa kwegazi okupheleleyo (i-CBC), lunokukunika umbono wempilo yakho iyonke. Banokukhangela neentsholongwane ezinxulumene ne-Non-Hodgkin Lymphoma okanye izinto ezisegazini lakho ezibonisa umonakalo wezicubu obangelwe sisifo.
• Uvavanyo lokucinga: Olu vavanyo lubonisa apho iiseli zomhlaza zikhoyo ngaphakathi emzimbeni wakho. Ngokuxhomekeke apho iiseli ze-lymphoma zikhoyo, unokufuna i-CT scan, i-MRI, i-ultrasound scan, okanye i-PET scan.
• Uvavanyo lwe-biopsy:Eyona ndlela yokwazi ngokuqinisekileyo ukuba iiseli ezingaqhelekanga ziyi-NHL kukusebenzisa i-biopsy. Kule meko, ugqirha uthatha iqhekeza elincinci lezicubu kwi-lymph node okanye kwindawo echaphazelekayo aze alithumele kwilebhu. Apho, ingcali yezifo ihlola izicubu phantsi kwe-microscope ukuze ibone ukuba kukho iiseli ze-lymphoma.
• Uvavanyo lwe-Immunophenotyping: Olu vavanyo lunceda ekuchongeni iintlobo ezithile ze-NHL. Luhlulahlula iiseli zomhlaza ngokusekelwe kwiimpawu (ii-antigens) ezikumphezulu wazo.

Ziziphi iinqanaba ze-Non-Hodgkin Lymphoma?

Iziphumo zovavanyo zinceda oogqirha ukuba bamisele inqanaba lomhlaza (ukukhula komhlaza). Inqanaba lomhlaza lisetyenziselwa ukucwangcisa unyango nokunika umbono wesiphumo esilindelekileyo (ukuxela kwangaphambili). Izigaba zeNon-Hodgkin Lymphoma zezi zilandelayo:

• Isigaba I: Iiseli zomhlaza zikhona kwindawo enye ye-lymph node okanye kwilungu elithile kwinkqubo ye-lymphatic. Okanye, i-lymphoma ikhona kwindawo enye yelungu elinye elingaphandle kwenkqubo ye-lymphatic.
• Isigaba sesiBini: Kukho i-lymphoma kumaqela amabini okanye ngaphezulu e-lymph node kwicala elinye (okanye kufutshane) ne-diaphragm.
• Inqanaba lesi-3: Kukho iiseli zomhlaza kwi-lymph nodes ezingaphezulu nangaphantsi kwe-diaphragm, okanye kwi-lymph nodes ezingaphezulu kwe-diaphragm nakwi-spleen.
• Isigaba sesi-4: I-lymphoma isasazeke ukuya kwilungu elinye elingaphandle kwenkqubo ye-lymphatic, njengesibindi okanye imiphunga.

Ziziphi iindlela zonyango lwe-Non-Hodgkin Lymphoma?

Kukho iindlela ezahlukeneyo zonyango lwe-Non-Hodgkin Lymphoma. Unyango oludingayo luxhomekeke kwizinto ezifana nohlobo lwe-NHL, inqanaba lomhlaza, kunye nempilo yakho iyonke. Iindlela zonyango ziquka:

• Ukuhlolwa okusebenzayo: Ukuba une-lymphoma engeyiyo iHodgkin kwaye awubonisi zimpawu, ugqirha wakho unokulibazisa ukuqala unyango. Oku kubizwa ngokuba kukuhlolwa okusebenzayo okanye "ukulinda ngononophelo." Oogqirha baya kujonga impilo yakho rhoqo, ukuze baqale unyango ngokukhawuleza xa kuvela iimpawu.
• Unyango lweKhemotherapy: Unyango lweKhemotherapy lunyango olusebenzisa amayeza ukubulala iiseli zomhlaza emzimbeni wonke. Olu lolona nyango luqhelekileyo kwi-NHL. Unokufumana unyango lwekhemotherapy kuphela okanye kunye nolunye unyango.
• Unyango olujoliswe ekujoliswe kulo: Olu nyango lujolise kubuthathaka obuthile kwiiseli zomhlaza kwaye luzitshabalalise. Unyango lwe-antibody ye-Monoclonal lunyango olujoliswe ekujoliswe kulo olusetyenziswa rhoqo kwi-NHL.
• Unyango lwe-immunotherapy:Olu nyango luvuselela inkqubo yakho yomzimba yokuzikhusela, nto leyo eyenza ibe namandla okutshabalalisa iiseli zomhlaza. Unyango lweeseli ze-CAR-T luhlobo lwe-immunotherapy olusetyenziswa kakhulu kwi-NHL. Ii-antibodies ze-Bispecific luhlobo olutsha lwamayeza. Ezi zijolise kwiiseli zakho ze-T kwaye zibulala iiseli ze-lymphoma ezinomhlaza.
• Unyango ngemitha: Olu nyango lusebenzisa imitha enamandla aphezulu evela kumatshini ukubulala iiseli zomhlaza. Oku kunokwanela kwi-NHL yesigaba sokuqala. Oogqirha basebenzisa le ndlela ukubulala iiseli ze-lymphoma ezinokusala emva kwe-chemotherapy.
• Unyango lwe-chemotherapy olusebenzisa ukufakelwa kweeseli ze-stem: Kolu nyango, kunikwa iidosi eziphezulu ze-chemotherapy ukunyanga umhlaza. Emva koko, iiseli zegazi ezingavuthwanga ezonakeleyo yi-chemotherapy zithathelwa indawo ziiseli ze-stem eziphilileyo ezivela emzimbeni wakho okanye ezivela kumnikeli. Ungadinga olu tyando ukuba ezinye iindlela zonyango ze-NHL azincedanga.

Zithini iziphumo ebezingalindelekanga zonyango?

Unyango oluqhelekileyo lomhlaza kwi-Non-Hodgkin Lymphoma, olufana ne-chemotherapy, unyango lwe-radiation, kunye ne-immunotherapy, lunokubangela iziphumo ebezingalindelekanga. Uninzi lwazo luhlala ixesha elifutshane kwaye luyaphela xa unyango lugqityiwe. Nangona kunjalo, ezinye iziphumo ebezingalindelekanga zinokuhlala ixesha elide.

Ngaphambi kokuba uqale unyango, qiniseka ukuba ubuza ugqirha wakho ngemiphumo enokubakho. Angachaza iingenelo zonyango kunye neengozi zemiphumo emibi.

Buza kuba njani ubomi nge-NHL? (Imbono/Ukuxela kwangaphambili)

Kwezinye iimeko, unyango lunokunyanga ngokupheleleyo i-Non-Hodgkin Lymphoma. Oku kuthetha ukuba zonke iiseli zomhlaza zitshatyalaliswa ngokusisigxina ngonyango. Oku kuhlala kubonakala emva kokuba ii-lymphomas ze-B-cell ezinobundlongondlongo zinyangiwe. Ukuba i-Non-Hodgkin Lymphoma iyabuya, kudla ngokwenzeka kwiminyaka emibini yokuqala emva konyango. Ngaphandle koko, isenokungaphindi ibuye. Nangona kunjalo, kuya kufuneka uhlolwe rhoqo ukuze ujonge ukuphinda ubuye.

Ezinye iintlobo zeNon-Hodgkin Lymphoma, ingakumbi ezo zisasazeka kancinci (ezingasebenziyo), zinokuhlala ixesha elide. Oku kuthetha ukuba unokufuna unyango rhoqo okanye ngamanye amaxesha ebomini bakho.

Kodwa, eyona nto ibalulekileyo kukuba nangona i-Non-Hodgkin Lymphoma ingenakunyangwa, unyango lwangoku luvumela abantu ukuba baphile ubomi obude nobonwabisayo ngesi sifo . Abantu abaninzi abane-lymphoma ekhula kancinci bayafa ngenxa yezinye izizathu, nokuba i-lymphoma ayinakunyangwa.

Ingakanani izinga lokubuyela kwi-NHL?

Ngokutsho kwe-US National Cancer Institute, ama-74% abantu abane-Non-Hodgkin Lymphoma baphila iminyaka emihlanu emva kokuba bexilongiwe.

Ngokubanzi, abantu abafunyenwe benesifo ngaphambi kokuba sisasazeke baphila ixesha elide kunabo bafunyenwe benesifo emva kokuba umhlaza usasazekile. Izinga lokusinda kweminyaka emihlanu kubantu abane-Non-Hodgkin Lymphoma (isigaba I kunye nesesi-II) liphakathi kwe-79% kunye ne-87%. Kubantu abane-advanced-stage disease (isigaba III kunye nesesi-IV), izinga liphakathi kwe-64% kunye ne-73%.

Ungazinyamekela njani njengomntu one-NHL?

Zininzi izinto onokuzenza ukuze uphile ne-Non-Hodgkin Lymphoma. Ezi zinto aziyi kusenza siphele isifo sakho, kodwa zinokukunceda uzive uqinisekile ngokuphila naso:

• Yitya ukutya okunempilo: Ukutya kukunika amandla. Ukutya kakuhle yindlela yokugcina amandla. Cela ingcali yokutya ukuze ufumane ulwazi oluthe kratya okanye izimvo malunga nokutya kunye nezidlo ezincinci.
• Phumla kangangoko unako: Unyango olufana ne-chemotherapy lunokukwenza uzive udiniwe kakhulu. Ukuphumla kunceda umzimba wakho ubuyele esiqhelweni kwaye ubuye unamandla.
• Lawula uxinzelelo: Ukuphila ne-Non-Hodgkin Lymphoma akulula. Usenokuba ukhathazekile malunga nendlela esi sifo kunye nonyango oluya kuyichaphazela ngayo ubomi bakho bemihla ngemihla. Ukuba ukhathazekile malunga noqikelelo lwakho, thetha nogqirha wakho. Angaphendula imibuzo yakho aze akuxelele ngeenkqubo ezinokukunceda, ezifana namaqela enkxaso.
• Ukuzilolonga: Ukuzilolonga rhoqo yenye yezona ndlela zilungileyo zokugcina ingqondo nomzimba wakho uphilile. Thetha nogqirha wakho malunga neentlobo zokuzilolonga kunye nokuqina okufanelekileyo kuwe.
• Fumana uncedo olongezelelweyo: Ukuba uhlala ne-Non-Hodgkin Lymphoma, jonga unyango oluthomalalisayo. Unyango oluthomalalisayo lubonelela ngoncedo lweempawu kunye nenkxaso kubantu abanomhlaza, nokuba bakwinqanaba elingakanani na lesifo okanye ukuba banesifo esingakanani na.

Ndifanele ndimbone nini ugqirha?

Ukuba unyangwa i-Non-Hodgkin Lymphoma, bonana nogqirha wakho ngoko nangoko ukuba iimpawu zakho ziyabuya okanye ziya ziba mandundu. Emva kokuba unyango lwakho lugqityiwe, qiniseka ukuba uya kuzo zonke iityelelo zokulandelela njengoko kucwangcisiwe.

Ufanele uye nini kwigumbi likaxakeka?

Ukuba uneempawu eziqatha, okanye ukuba iimpawu zakho ziya zisiba mandundu ngaphandle kokukhululeka kwizinto ozenzayo ukunciphisa ukungakhululeki kwakho, yiya kwigumbi likaxakeka.

Imibuzo ebalulekileyo yokubuza ugqirha wakho

Nantsi eminye imibuzo onokuyibuza ugqirha wakho:

• Luhlobo luni lwe-Non-Hodgkin Lymphoma endinalo?
• Ithini inqanaba lesifo sam?
• Loluphi unyango olucebisayo?
• Zithini iziphumo ebezingalindelekanga zezo ndlela zonyango?
• Ngaba i-Non-Hodgkin Lymphoma yam inganyangeka?
• Lithini ithuba lokuba umhlaza uphinde ubuye?

Ukufumanisa ukuba une-Non-Hodgkin Lymphoma (NHL) kunokuba yinto enzima ngenxa yezizathu ezahlukeneyo. Kukho iintlobo ezahlukeneyo zesifo, ngasinye sineziphumo ezahlukeneyo. Ezinye iintlobo ezisasazeka ngokukhawuleza zinokufuna unyango olungakumbi kwaye zinokuba neziphumo ebezingalindelekanga ezingathandekiyo - kodwa ekugqibeleni ziyanyangeka. Ezinye iintlobo zisenokungadingi unyango olukhawulezileyo, kodwa kuya kufuneka zilawulwe ixesha elide. Akukho zimpendulo zilula ngolu xilongo.

Ugqirha wakho angakuchazela indlela ukuxilongwa kwakho yi-NHL okuya kuyichaphazela ngayo impilo yakho yexesha elizayo. Okwangoku, khumbula ukuba abantu abanale sifo ngoku baphila ixesha elide. Buza ugqirha wakho malunga noqikelelo lwakho ngokusekelwe kwimeko yakho.

Amanqaku abalulekileyo ekufuneka uwakhumbule (Umyalezo oya nawo ekhaya)

Nangona i-Non-Hodgkin Lymphoma (NHL) iyinto yokoyika, kubalulekile ukuba nolwazi olufanelekileyo kwaye ufumane ingcebiso yezonyango ngokukhawuleza. Khumbula:

• Ukuba uneempawu ezifana nokudumba okungachazekiyo, ukudinwa okungapheliyo, ukubila ebusuku, okanye ukwehla kobunzima ngendlela engachazekiyo , bona ugqirha.
• Unyango olusebenzayo lwe-NHL ngoku luyafumaneka, kwaye abantu abaninzi baphila ngempumelelo nesi sifo.
• Thetha ngokukhululekileyo nogqirha wakho uze ubuze yonke imibuzo yakho.
• Ukuhlala unethemba nokuzinyamekela kakuhle kubaluleke kakhulu kolu hambo.

Awuwedwa. Sinethemba lokuba olu lwazi luza kukunika amandla.

I- Non-Hodgkin Lymphoma, i-Lymphoma, umhlaza, ii-lymph nodes, iimpawu, unyango, i-NHL