I-T-cell lymphoma yesikhumba

Iyini i-cutaneous T-cell lymphoma?

Incazelo: Noma yiliphi iqembu le-T-cell non-Hodgkin lymphomas eliqala esikhumbeni njengokuluma, ukuqubuka okubomvu okungajiya noma kwakhe isimila. Izinhlobo ezivame kakhulu yi-mycosis fungoides kanye ne-Sézary syndrome.

I-CTCL (i-cutaneous T-cell lymphoma) wuhlobo olungavamile lomdlavuza oluqala kuma-T cell, okungamangqamuzana amhlophe egazi (T lymphocyte). Lawa maseli ngokuvamile asiza amasosha omzimba wakho ekulweni namagciwane. Amaseli T atholakala esikhumbeni T-cell lymphoma thuthukisa ukukhubazeka okubangela ukuthi bahlasele isikhumba.

I-T-cell yesikhumba i-lymphoma kubangela ukuba bomvu kwesikhumba okufana nokuqubuka, amachashaza ayindilinga aphakeme kancane noma ama-scaly esikhumbeni, namathumba esikhumbeni kwezinye izimo.

Kunezinhlobo eziningana ze-T-cell lymphoma ye-cutaneous. I-Mycosis fungoides ifomu elivame kakhulu. I-Sezary syndrome iwuhlobo olungavamile lobubomvu besikhumba oluthinta wonke umzimba. Ezinye izinhlobo ze-T-cell lymphoma ye-cutaneous, njenge-mycosis fungoides, ziqhubeka kancane kuyilapho ezinye zithuthuka ngokushesha.

Iyiphi indlela yokwelapha engcono kakhulu kuwe incike ohlotsheni lwe-T-cell lymphoma yesikhumba onalo. Okhilimu besikhumba, ukwelapha okukhanyayo, ukwelapha ngemisebe, kanye nemithi ye-systemic efana ne-chemotherapy yizo zonke izinketho zokwelapha.

I-Non-lymphoma Hodgkin's ibhekisela eqenjini lama-lymphoma ahlanganisa i-T-cell lymphoma ye-cutaneous.

Izinhlobo ze-cutaneous T-cell lymphoma (CTCL)

I-CTCL ichaza izifo eziningi ezahlukene ezinezimpawu ezahlukene, imiphumela, nokucatshangelwa kokwelashwa:

• I-Mycosis Fungoides (MF): uhlobo oluvame kakhulu lwe-CTCL, olubalelwa cishe ingxenye eyodwa yawo wonke ama-CTCL. I-MF ingabukeka ihlukile esigulini ngasinye, ibe nezimpawu zesikhumba ezingase zivele njengamabala, ama-plaque, noma izimila.
• I-Sézary Syndrome: ebonakala ngokuba khona kwe amaseli e-lymphoma egazini, iziguli ezine-Sézary Syndrome zivame ukuba namaqhubu amancane, abomvu, alumayo avame ukuvela esikhumbeni.

Izimpawu ze-cutaneous T-cell lymphoma

Izimpawu nezimpawu ze-T-cell lymphoma e-cutaneous zihlanganisa:

• Iziqephu eziyisiyingi zesikhumba ezingase ziphakame noma zibe nezikhwepha futhi ezilumayo
• Iziqephu zesikhumba ezibonakala zilula ngombala kunesikhumba esizungezile
• Izigaxa ezakha esikhumbeni futhi zingase zivuleke
• Ama-lymph node akhulisiwe
• Ukulahlekelwa izinwele
• Ukuqina kwesikhumba ezintendeni zezandla nasematheni ezinyawo
• Ububomvu besikhumba obufana nokuqubuka emzimbeni wonke esiluma kakhulu

Izimbangela ze-T-cell lymphoma ye-cutaneous

Akukacaci ukuthi yini ebangela i-T-cell lymphoma ye-cutaneous.

Ngokuvamile, umdlavuza ukhula lapho i-DNA yamaseli iba noshintsho (ukuguqulwa kwezakhi zofuzo). I-DNA yengqamuzana ineziqondiso eziyitshela ukuthi yenzeni. Ukuguqulwa kwe-DNA kuyala amaseli ukuthi ande futhi aphindaphindeke ngokushesha, okuholela enanini elikhulu lamaseli ahlukile.

Izinguquko ku-cutaneous T-cell lymphoma zibangela ukuchichima ngokweqile kwamaseli e-T ahlasela isikhumba. Ama-T cell angamangqamuzana omzimba omzimba ajwayele ukusiza umzimba wakho ekulweni namagciwane. Odokotela bayaxakeka ukuthi kungani amangqamuzana ehlasela isikhumba.

Ukuxilongwa kwe-T-cell lymphoma ye-cutaneous

Ukuhlolwa kanye nezinqubo ezisetshenziselwa ukuxilonga i-T-cell lymphoma ye-cutaneous ihlanganisa:

• Ukuhlolwa ngokomzimba. Udokotela wakho uzohlola isikhumba sakho ukuze abone ukuthi kukhona amabala, ama-scaly noma okuqinile, okukhulayo. Uzohlolelwa futhi izimpawu zokuthi ama-lymph nodes akho noma ezinye izitho zingase zithinteke.
• Ukuhlolwa kwegazi. Ukuhlolwa kwegazi okufana nenani legazi eliphelele kungase kusetshenziselwe ukuqonda kangcono isimo sakho. Ngezinye izikhathi amangqamuzana omdlavuza atholakala egazini, ikakhulukazi nge-Sezary syndrome.

• Ama-biopsies esikhumba. Inqubo yokusika isampula encane yesikhumba (i-skin biopsy) ngokuvamile iyadingeka ukuze kuhlonzwe i-T-cell lymphoma ye-cutaneous. Isikhumba singasikwa ngethuluzi eliyindilinga (punch biopsy). Ukuze uthole izilonda ezinkulu namathumba i-biopsy ingase yenziwe ngommese omncane (i-excisional biopsy).

  Udokotela ochwepheshe ekuhlaziyeni igazi nezicubu (i-pathologist) uhlola isampula elebhu ukuze anqume ukuthi linamaseli omdlavuza. Kwesinye isikhathi ama-biopsies esikhumba amaningi ayadingeka ukuze uqinisekise ukuxilongwa kwakho. Ukuhlolwa kwelebhu okuthuthukisiwe ukuze kuhlaziywe izicubu kungase kwembule izinkomba ngomdlavuza wakho ezizosiza udokotela wakho aqonde ukubikezela kwakho futhi anqume izinketho zakho zokwelapha.

• Ukuhlola ukuhlolwa. Uma kukhona ukukhathazeka ngokuthi amangqamuzana omdlavuza asabalele kwezinye izingxenye zomzimba, udokotela wakho angase atuse ukuhlolwa kwe-imaging, njenge-computerized tomography (CT) noma izikena ze-positron emission tomography (PET).

Ukwelashwa kwe-cutaneous T-cell lymphoma

Abantu abane-T-cell lymphoma ye-cutaneous bangakhetha ezinhlobonhlobo zokwelapha. Ukwelashwa okuphelele kwakho kunqunywa izimo zakho ezihlukile, okuhlanganisa inani nesigaba se-lymphoma yakho. Iningi labantu abane-T-cell lymphoma ye-cutaneous bathola inhlanganisela yokwelapha.

Izinketho zokwelapha zingabandakanya:

• Okhilimu besikhumba namafutha okugcoba. Imithi ingasetshenziswa esikhumbeni sakho ngendlela yama-creams, ama-gel namafutha okugcoba. I-Corticosteroids ingasiza ekulawuleni ukubomvu kwesikhumba nokuluma. I-Chemotherapy ingasetshenziswa esikhumbeni ukuhlasela amangqamuzana omdlavuza.
• Ukwelashwa okukhanyayo (i-phototherapy). I-Phototherapy ihilela ukuchaya isikhumba kumaza okukhanya, njenge-ultraviolet B noma i-ultraviolet A. Imishini ehlukahlukene isetshenziswa ekwelashweni kwezithombe, okuhlanganisa namadokodo aveza ingxenye enkulu yomzimba wakho ekukhanyeni. Ngezinye izikhathi i-phototherapy yenziwa ngemva kokusetshenziswa komuthi okwenza amangqamuzana esikhumba azwele kakhulu ekukhanyeni (ukwelashwa kwe-photodynamic). Amangqamuzana anempilo avuseleleka ngokushesha, kodwa amangqamuzana omdlavuza awakwenzi.
• Ukwelashwa ngemisebe. Ukwelapha ngemisebe kusebenzisa imishayo yamandla ukubulala amangqamuzana omdlavuza. Uma unendawo eyodwa ye-T-cell lymphoma ye-cutaneous, ukwelashwa ngemisebe okujwayelekile ngama-X ray kungase kunconywe. Kubantu abanezindawo eziningi zomdlavuza, ukwelashwa ngemisebe kungenziwa ngemishayo yama-electron, eqondise esikhunjeni futhi engathinti izitho zangaphakathi. Imisebe ye-electron beam ngokuvamile isetshenziswa kuso sonke isikhumba.
• Imithi. Imithi esetshenziselwa ukwelapha i-T-cell lymphoma e-cutaneous ihlanganisa imithi yokulawula amasosha omzimba, njengezidakamizwa ze-steroid kanye ne-interferon. Imithi yokwelapha ngamakhemikhali ihlasela amangqamuzana akhula ngokushesha, kuhlanganise namangqamuzana omdlavuza. Imithi yokwelapha eqondisiwe ihlasela amaseli omdlavuza ngokuqondisa ubungozi obukhethekile bamaseli.
• Ukuveza amangqamuzana egazi ekukhanyeni. Inqubo ebizwa ngokuthi i-extracorporeal photopheresis ihlanganisa ukuphuza umuthi owenza amaseli akho azwele kakhulu ekukhanyeni. Khona-ke igazi lakho lihlungwa ngomshini olichaya ekukhanyeni kwe-ultraviolet ngaphambi kokubuyisela igazi emzimbeni wakho.
• Ukufakelwa komnkantsha. Ukufakelwa komnkantsha, okwaziwa nangokuthi ukufakelwa kwe-stem cell, kuyinqubo yokufaka umnkantsha wakho ogulayo esikhundleni somnkantsha onempilo ovela kumnikeli ofanayo (ukufakelwa komnkantsha we-allogeneic). Ngesikhathi sokufakelwa uzothola izidakamizwa ze-chemotherapy ukuze ucindezele umnkantsha wakho ogulayo. Ngemuva kwalokho amaseli anikelayo anempilo afakwa emzimbeni wakho lapho aya khona emathanjeni akho futhi aqale ukwakha kabusha umnkantsha wakho.