I-Mycosis fungoides

I-Mycosis fungoides iwuhlobo oluncane lomdlavuza owaziwa ngokuthi i-lymphoma yesikhumba (umdlavuza). Amangqamuzana egazi amhlophe angaba nomdlavuza futhi abangele lesi simo. Ukuqubuka esikhumbeni kuvame ukubonakaliswa kokuqala kwe-mycosis fungoides. Ayelapheki, kodwa iziguli ezelashwa ngesikhathi zivame ukubika ukuthi zihamba isikhathi eside ngaphandle kokubona izimpawu.

Isifo esaziwa ngokuthi i-mycosis fungoides (my-KOH-sis fun-GOY-deez) yisimo esithinta i-T-cell lymphocyte (amangqamuzana amhlophe egazi). Ama-T-cell asemzimbeni wakho azoba nomdlavuza uma unalesi simo, futhi azobonakala esikhumbeni sakho.

I-Mycosis fungoides iwuhlobo lwesikhumba T-cell lymphoma (CTCL), okuwuhlobo oluncane lwe-non-lymphoma Hodgkin's ekhula kuma-T-cell atholakala esikhumbeni futhi itholwa ochwepheshe bezokwelapha njenge-cutaneous T-cell lymphoma.

Izimpawu ze-mycosis fungoides

ISIGABA SOKUQALA: Isibonakaliso sokuqala se-mycosis fungoides ngokuvamile umuzwa ojwayelekile wokulunywa owaziwa ngokwezokwelapha ngokuthi i-pruritus, kanye nobuhlungu endaweni yesikhumba ethintekile. Ukuqwasha ngolunye uphawu olungase lube khona lwalesi simo. Kukhona ukubukeka okusabalele kwamabala abomvu (erythematous) esikhumbeni se-trunk kanye namaphethelo. Kungenzeka ukuthi lezi zilonda zizobukeka njengezinye izimo zesikhumba, njenge-eczema, i-psoriasis, i-parapsoriasis, noma i-lichen planus.

ISIGABA II: Isigaba sesibili sokutheleleka saziwa ngokuthi yi-plaque stage noma "isiteji sokungena." Ama-plaque anombala onsomi-obomvu, angaba yindilinga noma amise okweqanda, akhula ezindaweni ezithintekile. Kungenzeka ukuthi izinqe kuzoba yindawo yokuqala ethintekile. Ekuqaleni, lawa ma-plaque ngokuvamile mancane kakhulu futhi azoba nendawo ephakeme. Kungenzeka ukuthi ama-plaque azokhula kancane kancane futhi ahlangane, ekugcineni amboze cishe amaphesenti ayishumi omzimba. Kulesi sigaba, izilonda zingase zibe nesimo sesikhumba esibizwa ngokuthi i-exfoliative dermatitis.

Kukhona futhi ithuba lokuthuthukisa isimo esaziwa ngokuthi i-lipomelanotic reticulosis, esithinta ama-lymph nodes. Lesi simo singabonakala ngokukhula okungavamile kwamangqamuzana athile aziwa ngokuthi ama-macrophage kanye nokuba khona kwezicubu ezinamafutha ezinombala omnyama. I-Lymphadenitis, ukuvuvukala kwama-lymph nodes, kuyinkinga eyengeziwe engase ivele.

ISIGABA III: Isigaba se-fungoid noma isimila sesifo yisigaba sesithathu nesokugcina salesi simo. Isiguli siba nezimila ezifana namakhowe; amathumba angase abe nokubukeka okuyindilinga noma okuqhamuke. Lezi zilonda ezinezilonda ngokuvamile zihluka ngobubanzi ukusuka kuhhafu weyintshi ukuya kumayintshi ayisithupha, futhi umbala wazo ungachazwa njengoluhlaza okwesibhakabhaka noma onsundu ngokubomvu. Kungenzeka ukuthi izingqimba zesikhumba zizojiya, futhi amabhande angajwayelekile amaseli e-lymphoid azongena ongqimbeni olungaphezulu lwesikhumba. Kungenzeka futhi ukuthi la maseli ahlasele izindawo ezingenalutho ezitholakala ezingxenyeni ezingezansi zesikhumba, okuholela ekufeni kwamangqamuzana esikhumba (necrosis).

Abantu abahlushwa uhlobo lwe-tumeur d'emblee lwalesi sifo bangase babe namaqhuqhuva amakhulu naphezu kokungabikho kokwakheka koqweqwe emizimbeni yabo.

ISIGABA IV: Kuleli qophelo lokuqhubeka kwalesi sifo, kungenzeka ukuthi sesisakazekele kwezinye izingxenye zomzimba. Izimpawu zingase zihlanganise umuzwa ovamile wokugula (ukudangala) nokuba buthakathaka, kanye namazinga okushisa aphakeme, ukuncipha komzimba, kanye ne-anemia. Kungenzeka ukuthi kube nokubandakanyeka komgudu wamathumbu noma ngaphandle kwezilonda emathunjini. Kuyenzeka futhi ukuthi isibindi nobende kukhule. Ngaphezu kwalokho, ungase ube nokukhwehlela kanye nobunzima bokugwinya (owaziwa nangokuthi i-dysphagia). Kwezinye izimo, umsipha wenhliziyo nawo ungathinteka. Ubuhlungu bamehlo kanye nokulahlekelwa ikhono lokubona ngokucacile kungase kuzwakale lapho ubuchopho buhilelekile.

Ukuxilongwa kwe-mycosis fungoides

I-Mycosis fungoides ifana nenani lezinye izimo zesikhumba ezimpawu zayo. Ukuhlolwa okulula okubonakalayo kwesikhumba kungase kunganele ukwenza ukuxilongwa okunembile. I-Mycosis fungoides yisimo sesikhumba esivame ukudideka nezinye izimo zesikhumba, njenge-eczema ne-psoriasis.

Ukuqinisekisa noma ukukhipha i-mycosis fungoides, umhlinzeki wakho wokunakekelwa kwezempilo cishe uzosebenzisa ukuhlolwa okwengeziwe okufana nalokhu:

• I-skin biopsy noma i-lymph node biopsy
• Ukuhlolwa kwegazi
• CT scan
• Ukuhlola kwe-PET

Ukwelashwa i-mycosis fungoides

Ukwelashwa kwe-mycosis fungoides kunqunywa isigaba somdlavuza kanye nohlobo lwesikhumba luyashintsha. Ukuncishiswa kwezimpawu kanye nokuthuthukiswa kwezinga lempilo yomuntu yikona okugxilwe kukho kwezinketho eziningi zokwelapha.

• Ukwelashwa okuqondiswe kwesikhumba: Umdlavuza ezindaweni zesikhumba sakho ezithintekile ungelashwa ngamajeli asezindaweni ezishisayo, ama-steroids, ama-retinoids, noma ukukhanya kwe-ultraviolet (UV). I-Phototherapy iyindlela yokwelapha esebenzisa ukukhanya kwe-ultraviolet kanye ne Imithi ebizwa ngokuthi i-psoralens ukubulala umdlavuza amaseli asabalele esikhumbeni. I-topical form ye-chemotherapy, njenge-mechlorethamine, ingase isetshenziswe ngumhlinzeki wakho wokunakekelwa kwezempilo.
• Ukwelashwa kwesistimu: I-Methotrexate futhi i-bexarotene, zombili eziphuzwa ngomlomo, ziyakwazi ukwelapha wonke umzimba wesiguli. I-Interferon gamma kanye ne-histone deacetylase (HDAC) inhibitors ingezinye izigaba zemithi yemithi. Imithi yokwelapha ngamakhemikhali ilawulwa ngomthambo wegazi futhi ingase ihlanganise i-gemcitabine, i-pegylated liposomal doxorubicin, noma i-pralatrexate, phakathi kokunye.
• I-Immunotherapy: Le mithi iqinisa amasosha akho omzimba ukuze ahlasele amangqamuzana omdlavuza. Abacwaningi basafunda ngendlela lokhu okusebenza ngayo.
• I-Monoclonal antibody njengokwelashwa okuhlosiwe: Le mithi ithola futhi ibhubhise amangqamuzana omdlavuza. Abahlinzeki bezempilo bangasebenzisa ukwelapha okuhlosiwe uma umzimba wakho ungakaphenduli kwezinye izindlela zokwelapha, ezifana ne-mogamulizumab-kpkc (POTELIGEO®) kanye i-brentuximab vedotin.
• Ukwelashwa ngemisebe: Ngokwelashwa ngemisebe, imisebe yamandla enamandla evela ngaphandle komzimba wakho ingabhubhisa amangqamuzana omdlavuza noma imise ukukhula kwawo.

I-chemotherapy yendabuko isetshenziswa kuphela ngezikhathi ezithile njengokwelashwa kwe-mycosis fungoides ochwepheshe bezokwelapha. Asikho isiqinisekiso sokuthi i-chemotherapy izophatha ngempumelelo i-mycosis fungoides. Kubuye kuhlotshaniswe nengozi enkulu yemiphumela emibi.