I-Medulloblastoma

I-Medulloblastoma iyi-primary central central nervous system (CNS) isimila. Lokhu kusho ukuthi iqala ebuchosheni noma emgogodleni.

Ukuze uthole ukuxilongwa okunembile, ucezu lwe isisu izicubu zizokhishwa ngesikhathi sokuhlinzwa, uma kungenzeka. I-neuropathologist kufanele ibuyekeze izicubu zesimila.

I-Medulloblastoma isimila sobuchopho esinomdlavuza (esiyingozi) esiqala ku-cerebellum, etholakala ngaphansi ngemuva kobuchopho. Ukuxhumanisa imisipha, ibhalansi, nokunyakaza konke kulawulwa yi-cerebellum.

I-Medulloblastoma isakazekela kwezinye izingxenye zobuchopho nomgogodla ngokusebenzisa uketshezi lwe-cerebrospinal (CSF), uketshezi oluzungeza futhi luvikele ubuchopho nomgogodla. Akuvamile ukuba lesi simila sisabalele kwezinye izingxenye zomzimba.

I-Medulloblastoma iwuhlobo lwesimila sombungu esiqala emangqamuzaneni engane yobuchopho (embryonic). Kukhona okungenani izinhlobo ezine ze-medulloblastoma ezisekelwe ezinhlotsheni ezihlukene zokuguqulwa kofuzo. Naphezu kweqiniso lokuthi i-medulloblastoma ayizuzwa njengefa, iziyaluyalu ezifana ne-Gorlin's noma i-Turcot's syndrome zingase zikhulise ukwenzeka kwalesi sifo.

Izinhlungu zekhanda, isicanucanu, ukuhlanza, ukukhathala, isiyezi, ukubona kabili, ukungakwazi ukusebenzisana kahle, ukuhamba ngendlela engazinzile, nezinye izimpawu zonke ziyizimpawu nezimpawu ze-medulloblastoma. Lezi zimpawu zingabangelwa isimila noma ukunqwabelana kokucindezela ngaphakathi kobuchopho.

I-Medulloblastoma ingathinta noma ubani kunoma isiphi iminyaka, kodwa ivame kakhulu ezinganeni ezincane. I-Medulloblastoma iyithumba ebuchosheni eliyingozi kakhulu ezinganeni, naphezu kokutholakala kwaso. Izingane kufanele zibonwe ithimba lochwepheshe bezingane abanolwazi nolwazi ngamathumba ebuchosheni bezingane, kanye nokufinyelela kubuchwepheshe obukamuva kanye nokwelashwa kwezingane.

Amabanga we-medulloblastoma

Izimila ze-CNS eziyinhloko zihlukaniswa ngokusekelwe endaweni yesimila, uhlobo lwesimila, izinga lokusabalala kwesimila, okutholwe ngofuzo, ubudala besiguli, kanye nesimila esisele ngemva kokuhlinzwa, uma kungenzeka ukuhlinzwa.

Ama-Medulloblastomas wonke ahlukaniswa njengezimila zeBanga lesi-IV. Lokhu kusho ukuthi ziyingozi (umdlavuza) futhi zikhula ngokushesha.

Kunezinhlobo ezincane ezine ezikhonjwe ezinganeni ezine-medulloblastoma.

1. I-WNT yenziwe yasebenza
2. I-SHH yenziwe yasebenza
3. Iqembu 3 (okungelona i-WNT / okungeyona i-SHH)
4. Iqembu 4 (okungelona i-WNT / okungeyona i-SHH)

Kubantu abadala abane-medulloblastoma, lezi zinhlobo ezincane azichazwa kahle njengoba zinjalo ezinganeni.

Izimpawu ze-medulloblastoma

Izimpawu ezihlobene ne-medulloblastoma zincike endaweni yesimila. Nazi ezinye izimpawu ezingaba khona.

Izimpawu ze-Medulloblastoma

Abantu abane-medulloblastoma ku-cerebellum bangase babe:

• Izinkinga zokuhamba, ibhalansi, kanye/noma amakhono amahle emoto

Uma isimila sivimba i-CSF, lokhu kungaholela ekwenyukeni kwengcindezi ngaphakathi kogebhezi. Le nkinga yaziwa nge-hydrocephalus.

Izimpawu nezimpawu ze-hydrocephalus zingabandakanya:

• Ukuphathwa yikhanda
• I-nausea
• Ukuvota
• Ukubona okufiphele nokukabili
• Ubuthongo obukhulu
• Ukudideka
• Ukuquleka ngisho nokuquleka

Uma i-medulloblastoma isakazekele emgogodleni, izimpawu zingabandakanya:

• Ubuthakathaka noma ukuba ndikindiki ezingalweni noma emilenzeni
• Ushintsho emikhubeni evamile yamathumbu noma esinyeni
• Ubuhlungu bomgogodla

Ukuxilongwa kwe-medulloblastoma

Inqubo yokuxilongwa ngokuvamile iqala ngokubuyekezwa komlando wezokwelapha kanye nengxoxo yezimpawu nezimpawu. Ukuhlolwa nezinqubo ezisetshenziselwa ukuxilonga i-medulloblastoma zifaka:

• Ukuhlolwa kwezinzwa. Phakathi nale nqubo, ukubona, ukuzwa, ibhalansi, ukuxhumanisa kanye ne-reflexes kuhlolwa. Lokhu kusiza ekunqumeni ukuthi iyiphi ingxenye yobuchopho engase ithintwa isimila.
• Ukuhlola ukuhlolwa. Ukuhlolwa kwesithombe kungasiza ukucacisa indawo nosayizi we ebuchosheni. Lezi zivivinyo nazo zibaluleke kakhulu ukukhomba ingcindezi noma ukuvinjwa kwemikhondo ye-CSF. I-computerized tomography (CT) scan noma imaging resonance magnetic (I-MRI) ingenziwa ngokushesha. Lezi zivivinyo zivame ukusetshenziselwa ukuxilonga izimila zobuchopho. Amasu athuthukile, njenge-perfusion MRI kanye ne-magnetic resonance spectroscopy, angasetshenziswa.
• Ukuhlolwa kwesampula yezicubu (i-biopsy). I-biopsy ngokuvamile ayenziwa, kodwa ingase inconywe uma ukuhlolwa kwe-imaging kungekona okwejwayelekile kwe-medulloblastoma. Isampuli yezicubu ezisolisayo ihlaziywa elebhu ukuze kutholwe izinhlobo zamaseli.
• Ukususwa kwe-cerebrospinal fluid ukuze kuhlolwe (i-lumbar puncture). Ebizwa nangokuthi impompi yomgogodla, le nqubo ihilela ukufaka inaliti phakathi kwamathambo amabili emgogodleni ongezansi ukuze kukhishwe uketshezi lwe-cerebrospinal oluzungeze intambo yomgogodla. Uketshezi luhlolelwa ukubheka amaseli wesimila noma okunye okungavamile. Lokhu kuhlola kwenziwa kuphela ngemva kokulawula ingcindezi ebuchosheni noma ukususa isimila.

Ukwelashwa kwe-medulloblastoma

Ukwelashwa okujwayelekile kakhulu kwe-medulloblastoma ukuhlinzwa ukuze kukhishwe isimila, kulandelwe imisebe ne-chemotherapy. Odokotela baseSt. Jude baye benza ukwelashwa okusekelwe engozini ngokusekelwe emaqenjini ahlukahlukene amangqamuzana. Le ndlela isetshenziselwa ukuthuthukisa amazinga okusinda ngenkathi yehlisa imiphumela emibi ehlobene nokwelashwa. Uma ukubikezela kwesiguli kuvuma, ukwelashwa okuphansi kungase kunconywe. Iziguli ezinesifo esiyingozi kakhulu zingase zithole ukwelashwa okunamandla ukuze kwandiswe amathuba azo okusinda.

• Ukuhlinzwa – ngokuvamile kuyisinyathelo sokuqala sokwelapha i-medulloblastoma. Umgomo uwukukhipha ngokuphelele isimila. Ukuphumelela kokuhlinzwa kungancika endaweni yesimila nokuthi singakanani esingasuswa ngokuphepha.
• Ukwelashwa kwamafutha - isebenzisa ama-X-ray anamandla amakhulu noma ezinye izinhlobo zemisebe efana ne-proton beam radiation ukubulala amangqamuzana omdlavuza noma ukuwavimba ukuthi angakhuli. Umthamo onikeziwe uncike esigabeni sesifo kanye nesigaba sobungozi. Imisebe ingase ihlanganiswe ne-chemotherapy ukuze kuthuthukiswe imiphumela.
  • I-Proton beam radiation ingenye indlela yokwelashwa ngemisebe. Lolu hlobo lwemisebe lusebenzisa ama-proton esikhundleni se-X-ray. Ama-protons angashintshwa ukuze ame esimila esikhundleni sokungena emzimbeni futhi athinte izicubu ezinempilo njengama-X ray.
• Ukwelashwa ngamakhemikhali - isebenzisa imithi enamandla ukubulala amangqamuzana omdlavuza noma ukuwavimba ekukhuleni (ukuhlukana) nokwenza amangqamuzana omdlavuza amaningi. Ezinganeni ezincane, i-chemo ingase inikezwe ukubambezela imisebe kuze kube yilapho isiguli sesikhulile. Ezinye izinhlobo ze-medulloblastoma zingelashwa ngempumelelo ngekhemo kuphela.