Ingabe kukhona isimila esinjengalesi emzimbeni wakho? Ake sifunde ngaso kalula (i-Adrenal Adenoma)!

Wake wacabanga ukuthi ngezinye izikhathi uma senza into efana ne-'scan' yesifo esithile, singathola ngengozi into efihliwe emzimbeni esingakaze sazi ukuthi ikhona? Yileyo ndlela lesi simo esibizwa ngokuthi 'i-Adrenal Adenoma' ngezinye izikhathi sitholakala ngayo. Empeleni lesi simila esincane, esingenawo umdlavuza, esingeyona ingozi esakheka ezindlaleni zakho ze-adrenal. Ingabe singaxoxa ngalokhu ngemininingwane eyengeziwe?

Iyini ngempela i-adrenal adenoma?

Kulungile, ake siqale sibheke ukuthi ziyini izindlala ze-adrenal. Lezi zindlala ezimbili zitholakala phezu kwezinso zakho, njengezivalo ezimbili ezincane. Lezi yizo ezikhiqiza izinhlobo eziningana zama-hormone ezibaluleke kakhulu emzimbeni wethu. Cabanga nje, umzimba wakho usabela kanjani uma uzizwa wesaba kakhulu noma ukhathazekile? Ama-hormone asiza ngalokho avela kulezi zindlala. Akukhona lokho kuphela, kodwa la ma-hormone asiza nokulawula izinto eziningi njengezinga likashukela egazini lakho, umfutho wegazi, kanye nesistimu yomzimba yokuzivikela.

Kunezingxenye ezimbili eziyinhloko ze-adrenal gland: ingxenye engaphandle ibizwa ngokuthi i-adrenal cortex, kanti ingxenye engaphakathi ibizwa ngokuthi i-adrenal medulla. I-adrenal cortex ikhiqiza ama-hormone afana ne-(Cortisol) kanye ne-(Aldosterone). I-adrenal medulla ikhiqiza ama-hormone afana ne-(Dopamine), (Epinephrine) kanye ne-(Norepinephrine). Kuse-adrenal cortex lapho kuvela khona izimila esikhuluma ngazo, ezibizwa ngokuthi i-adrenal adenoma.

Esikhathini esiningi, lawa ma-adenoma awabangeli izimpawu ezinkulu futhi awadingi ukwelashwa. Kodwa-ke, ngezinye izikhathi, lawa mathumba angakhiqiza inani elingaphezu kwelejwayelekile lehomoni elilodwa noma ngaphezulu le-adrenal.

Ingabe zikhona izinhlobo ze-adrenal adenoma?

Yebo, kunezinhlobo ezimbili ikakhulukazi.

• Ama-adenoma asebenzayo/asebenzayo: Lezi zinhlobo zamathumba zikhiqiza ama-hormone amaningi e-adrenal gland kunokuvamile . Lokhu kungabangela izimpawu futhi kungadinga ukwelashwa.
• Ama-adenoma angasebenzi/angasebenzi: Lawa awakhiqizi ama-hormone engeziwe. Ama-adenoma amaningi e-adrenal awela kulesi sigaba. Ngokuvamile awabangeli izimpawu noma awadingi ukwelashwa.

Into ebalulekile ukuthi amathuba okuba noma yiluphi uhlobo lube nomdlavuza aphansi kakhulu. Kodwa-ke, kungenzeka ukuthi i-adenoma engasebenzi kahle iqale ukusebenza ngokuhamba kwesikhathi.

Ingabe i-adrenal adenoma ingaba umdlavuza?

Lokhu empeleni akuvamile. Okusho ukuthi, akunakwenzeka ukuthi i-adrenal adenoma iphenduke umdlavuza. Uhlobo oluyinhloko lwesimila somdlavuza esikhula ezindlaleni ze-adrenal yi-adrenocortical carcinoma. Njenge-functional adenomas, lawa mathumba omdlavuza angakhiqiza nama-hormone amaningi. Ngakho-ke, ezinye zezimpawu zingafana neze-functional adenomas.

Cabanga nje, cishe umuntu oyedwa kwabayisigidi uba nomdlavuza we-adrenocortical. Okusho ukuthi, izimila eziningi ezikhula ezindlaleni ze-adrenal azinabungozi, azinawo umdlavuza.

Ubani onamathuba amaningi okuthola lesi simo?

Empeleni, noma ubani angaba ne-adrenal adenoma. Kodwa-ke, amathuba okuba nayo ikhule kancane njengoba ukhula. Ngokuvamile kuthiwa phakathi kuka-3% no-9% wabantu banale adenoma. Lolu uhlobo oluvame kakhulu lwesimila olukhula ezindlaleni ze-adrenal.

I-adrenal adenoma ithinta kanjani umzimba wakho?

Njengoba sishilo ngaphambili, izinkinga zivela ekusebenzeni kwama-adenoma. Lawa angakhipha inani elingaphezu kwelejwayelekile le-hormone eyodwa noma ngaphezulu. Uma lokhu kwenzeka, ungase ube nezimpawu zezinye izinkinga ze-adrenal. Isibonelo:

• I-Cushing's syndrome noma i-hypercortisolism: Lesi simo senzeka lapho izindlala zakho ze-adrenal zikhiqiza i-cortisol eningi kakhulu. I-Cushing's syndrome ivame ukubangelwa isimila se-pituitary, kodwa futhi ingabangelwa isimila se-adrenal. Izimpawu zifaka phakathi umfutho wegazi ophakeme, ukukhuluphala (ikakhulukazi eduze kwesisu), kanye nokungasebenzi kahle kocansi . Kungandisa nengozi yakho yokuthola isifo sikashukela.

• I-aldosteronism eyinhloko (i-Conn's syndrome): Lokhu kwenzeka lapho i-adenoma ikhiqiza i-hormone aldosterone eningi kakhulu. Izimpawu zifaka amazinga aphansi e-potassium, umfutho wegazi ophakeme, ikhanda elibuhlungu, ukukhathala, kanye nobuthakathaka bemisipha .

• Imiphumela yama-hormone ocansi: Akuvamile kakhulu, i-adrenal adenoma ingabangela ukukhiqizwa ngokweqile kwama-hormone ocansi. Uma ama-androgens (njenge-testosterone) anda kwabesifazane, angabangela imijikelezo yokuya esikhathini engajwayelekile, izinwele zomzimba eziningi (i-hirsutism), kanye nokujula kwezwi. Uma i-estrogen ikhula kwabesilisa, ingabangela ukwehla kwesifiso sobulili kanye nokungasebenzi kahle kwe-erectile.

Ziyini izimpawu ze-adrenal adenoma?

Izimpawu zibangelwa ama-adenoma asebenzayo. Lezi zimpawu zingavela, ikakhulukazi uma zibangela ukukhiqizwa ngokweqile kwe-cortisol (i-Cushing's syndrome) noma i-aldosterone (i-aldosteronism eyinhloko). Hlola ukuthi unanoma yikuphi kwalokhu:

• Ikhanda elibuhlungu.
• Ubuthakathaka bemisipha noma ngezinye izikhathi ukuba ndikindiki.
• Ukukhathala kanye nobuhlungu bomzimba (njengobuhlungu bomhlane).
• Umfutho wegazi ophezulu (i-Hypertension).
• Amazinga aphezulu kashukela egazini noma isifo sikashukela.
• Amazinga aphansi e-potassium.
• Amamaki okwelula esikhumbeni sesisu.
• Ukwanda kwesisindo, ikakhulukazi endaweni engenhla yomzimba.
• Ukushintsha kwesimo sengqondo (ukukhathazeka, ukwesaba, ukucindezeleka, njll.).

Kwabesifazane, imijikelezo yokuya esikhathini engajwayelekile kanye nokwanda kwezimpawu zabesilisa (ukuchama) kungase kwenzeke. Kwabesilisa, ukungasebenzi kahle kocansi kungase kwenzeke.

Yiziphi izimbangela ze-adrenal adenoma?

Abacwaningi abakakazi kahle ukuthi kungani kuvela ama-adrenal adenomas kanye nezinye izimila ze-adrenal gland ezingengozi. Kodwa-ke, bathole ukuthi izimo ezithile zofuzo zingandisa ingozi. Ezinye izibonelo zifaka:

• I-Multiple Endocrine Neoplasia, uhlobo 1 (MEN1)
• I-Familial Adenomatous Polyposis (FAP)
• I-Carney complex
• I-Li-Fraumeni syndrome
• I-Multiple Endocrine Neoplasia uhlobo 2 (MEN2)
• Uhlobo 1 lwe-Neurofibromatosis

Ngaphezu kwalokho, izinto ezifana nokukhuluphala ngokweqile kanye nokusetshenziswa kogwayi nazo zingandisa ingozi yokuthola i-adrenal adenoma.

Zitholakala kanjani izimila ze-adrenal?

Abantu abaningi abazi nokuthi bane-adrenal adenoma. Itholakala ngengozi ngesikhathi senqubo yokuthwebula izithombe, njenge-CT scan, eyenziwa ngesinye isizathu. Yingakho ngezinye izikhathi ibizwa ngokuthi "ama-incidentalomas," ngoba atholakala ngengozi.

Udokotela wakho uzoqala anqume ukuthi isimila sinomdlavuza (isib., i-adrenocortical carcinoma) noma singenobungozi (isib., i-adrenal adenoma). Uma kuyi-adrenal adenoma, bazohlola ukuze babone ukuthi ikhiqiza ama-hormone amaningi kakhulu.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Udokotela wakho uzokwenza ukuhlolwa ngokomzimba, abuze ngezimpawu zakho kanye nomlando wezokwelapha, bese ecela ukuhlolwa okufana nalokhu ukuze afunde kabanzi ngalesi simila:

• Ukuhlolwa kwegazi noma komchamo:Lokhu kungahlola amazinga aphezulu ama-hormone emzimbeni wakho. Uma unesimila esisebenzayo, amazinga akho ama-hormone angase akhuphuke. Kungadingeka futhi ukuthi uqoqe isampula yomchamo emahoreni angama-24 bese uhlola amazinga akho e-cortisol.
• Ukuthwebula Izithombe: I-CT scan iyisivivinyo esivame kakhulu esisetshenziselwa ukuxilonga i-adrenal adenoma. Ngezinye izikhathi udokotela wakho angase futhi acele i-MRI. Lokhu kuthwebula kungasiza ekunqumeni ukuthi isimila siyingozi (sinomdlavuza) noma asibi (singesihle). Isibonelo, izimila ezinkulu kuno-4 cm cishe zinomdlavuza kunezimila ezincane.
• I-Biopsy: Uma ezinye izivivinyo zingakwazi ukunquma ukuthi iqhubu linomdlavuza noma i-adrenal adenoma, udokotela wakho angenza i-biopsy ebizwa ngokuthi i-fine-needle aspiration. Lokhu kuhilela ukususa ingxenye encane yezicubu eqhubu ngenaliti encane. Udokotela wezifo, uchwepheshe webhulebhu, ube esehlola izicubu ngaphansi kwe-microscope ukuze abone ukuthi zikhona yini izimpawu zomdlavuza.

Ezinye izivivinyo, njengokuthatha isampula yemithambo ye-adrenal noma ukuskena kwe-metaiodobenzylguanidine (MIBG), nazo zingenziwa.

Yiziphi izindlela zokwelapha i-adrenal adenoma?

Ukwelashwa okutholayo kuzoncika ekutheni isimila asisebenzi noma asisebenzi (okungukuthi, sikhiqiza ama-hormone amaningi kakhulu).

• Uma isimila esingasebenzi sincane, udokotela wakho angase ancome ukuthi kwenziwe ama-CT scan njalo ukuze abone ukuthi siyakhula noma siyaqala ukusebenza. Uma isimila sikhula ngokushesha, noma uma siseduze namasentimitha angu-5, udokotela wakho angase ancome ukuhlinzwa. Lokhu kungenxa yokuthi izimila ezinkulu nokukhula ngokushesha kungenzeka kakhulu ukuthi zibe nomdlavuza.

• Kuma-tumors asebenzayo, ukuhlinzwa kuvame ukuba yindlela yokwelapha kuphela. Nazi izindlela zokwelapha:

• Ukuhlinzwa kwe-Adrenal – Lokhu ukususwa kwe-adrenal gland: Uma isimila sincane futhi singenabungozi, udokotela wakho angasusa i-adrenal gland yakho esebenzisa i-laparoscopy. Ngesikhathi se-laparoscopy, udokotela ohlinzayo wenza izimbobo ezimbalwa ezincane esiswini sakho bese enza ukuhlinzwa ngazo . Uma isimila sikhulu noma kukhona okusolakala ukuthi singase sibe nomdlavuza, udokotela wakho angase enze isimbozo esikhulu emhlane wakho. Ngezinye izikhathi, i-adrenal gland esele ingakhiqiza ama-hormone anele ukukugcina uphilile. Uma kungenjalo, ungadinga ukwelashwa kwama-hormone ukuze kuthathelwe indawo ukuntuleka kwama-hormone.

• Imithi:Uma ungeyena umuntu ofanele ukuhlinzwa, udokotela wakho angase akunike imithi yokuvimbela i-adenoma ekukhiqizeni ama-hormone amaningi kakhulu. Kungase kudingeke futhi ukuthi uthathe imithi amasonto ambalwa ngemva kokuhlinzwa kwe-adrenal ukuze uzinzise amazinga ama-hormone akho.

Ingabe izimila ze-adrenal gland zingavinjelwa?

Ayikho indlela yokuvimbela izimila ze-adrenal, okuhlanganisa ne-adrenal adenomas. Izici eziyingozi kuzo zivame ukusekelwe ku-genes yakho. Kodwa-ke, usengaba ne-adrenal adenoma ngisho noma kungekho muntu emndenini wakho oke waba nezimila ze-adrenal.

Sinjani isimo sesikhathi eside ngemva kokwelashwa?

Imiphumela yokuhlinzwa kwe-adrenal inhle kakhulu. Uma i-adrenal gland ethintekile isisusiwe, izimpawu ezibangelwa i-adrenal adenoma esebenzayo zivame ukunyamalala.

Kufanele ngizinakekele kanjani?

Uma kutholakala ukuthi une-adrenal adenoma engasebenzi kahle, landela imiyalelo kadokotela wakho mayelana nokuthi kufanele uhlolwe kangaki. Kuye ngohlobo lwesimila sakho, udokotela wakho angase akucele ukuthi uhlolwe njalo nge-CT scans noma ukuhlolwa kwamahomoni.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Uma uvakashela udokotela wakho, ungakhohlwa ukubuza imibuzo efana nale:

• Uhlobo luni lwesimila se-adrenal gland enginaso?
• Ingabe iyingozi noma inomdlavuza?
• Angakanani amathuba okuthi isimila sami sizophenduka umdlavuza?
• Ingabe iyasebenza noma ayisebenzi?
• Ingabe ngidinga ukwelashwa?
• Yikuphi ukwelashwa okuncomayo?
• Ingabe inqubo yami yokwelashwa/yokwelapha izodinga ukwelashwa ngama-hormone?

Khumbula, uma udokotela wakho ethola isimila ku-adrenal gland yakho ngesikhathi eskeniwa, ungesabi. Esikhathini esiningi, lezi zimila azinangozi. Uma isimila sakho siyi-adrenal adenoma, ukuhlolwa kungenziwa ukuze kubonakale ukuthi sikhiqiza ama-hormone amaningi yini. Uma kunjalo, ukuhlinzwa kungaba yindlela enhle. Uma isimila singengozi, udokotela wakho angasiqapha ukuqinisekisa ukuthi asithinti ama-hormone akho. Uma besola ukuthi singaba nomdlavuza, bangasisusa.

Ekugcineni, Umyalezo Wokuya Ekhaya

Ngakho-ke, i-adrenal adenoma ngokuvamile ayiyona into okufanele ikhathazeke ngayo. Iningi layo alinangozi futhi alinawo umdlavuza. Kodwa-ke, amanye awo angakhiqiza ama-hormone amaningi kakhulu, ngakho-ke kubalulekile ukuqaphela. Uma unokungabaza noma imibuzo ngalokhu, qiniseka ukuthi ukhuluma nodokotela. Ngemuva kwalokho ungathola iseluleko esifanele kanye nokwelashwa okudingayo. Hlala uphilile!