Adenomegaly ndi kukulitsa kwa ma lymph nodes, kukulitsa komwe kumatha chifukwa cha matenda a bakiteriya kapena ma virus, kapena kulumikizidwa ndi kukhalapo kwa zotupa, makamaka.

Zikakhudza ganglia wa mediastinum, ndi mediastinal lymphadenopathy, khomo lachiberekero lymphadenopathy ngati kuchuluka kwa voliyumu kumakhudza ma lymph nodes a khosi, kapena axillary lymphadenopathy pamene awa ndi ma lymph nodes (dzina lina lymph nodes) zomwe zili mu khosi. makhwapa omwe akukulitsidwa. Itha kukhalanso inguinal, ndikukhudza mfundo zomwe zili mu groin. Adenomegaly nthawi zambiri imabwera chifukwa cha kupsinjika kwakukulu kwa chitetezo chamthupi, komwe ma lymph nodes ndi gawo lofunikira.

Adenomegaly - ndichiyani?

Etymologically, adenomegaly amatanthauza kuwonjezeka kwa kukula kwa glands: mawuwa amachokera ku Greek, "adên" kutanthauza "gland" ndi "mega" kutanthauza kuti yaikulu. Chifukwa chake, adenomegaly ndikukula kwa ma lymph nodes, omwe nthawi zina amatchedwanso ma lymph nodes, kutsatira matenda a virus, mabakiteriya kapena tiziromboti, kapena chifukwa cha chotupa, makamaka.

Ma lymph nodes ndi tinthu tating'onoting'ono tomwe timakhala m'mitsempha yamagazi m'malo ena a thupi:

• Mitsempha yamagazi mu mediastinum ili mu mediastinum, m'chigawo chapakati cha nthiti (yomwe ili pakati pa mapapo awiri, pafupi ndi mtima, trachea, bronchi, ndi esophagus). Ngati akukulitsidwa, tidzalankhula za mediastinal lymphadenopathy.
• The khomo lachiberekero mwanabele zili pakhosi: pamene kukula kumawonjezeka, pali khomo lachiberekero lymphadenopathy.
• Ngati adenomegaly imakhudza ma lymph nodes omwe ali pansi pa makhwapa, amatchedwa axillary lymphadenopathy.
• Pomaliza, pamene hypertrophy izi zimakhudza inguinal lymph nodes, kaya alipo mu groin, ife timadzutsa inguinal lymphadenopathy.

Kodi kudziwa adenomegaly?

Ma lymph nodes okulirapo nthawi zambiri amawonetsedwa ndi dokotala pakuwunika kwachipatala. Ndi pa palpation kuti adotolo amatha kuzindikira zotupa zachilendo mu ma lymph nodes awa.

Wodwalayo nthawi zina amadzimva yekha maonekedwe a "chotupa" kapena "unyinji" waung'ono m'khwapa, khosi kapena groin, nthawi zina limodzi ndi malungo.

Njira zina zimatha kutsimikizira kuti ali ndi matenda, monga ultrasound ndi mitundu ina ya kuyesa kwa zithunzi. M'chifuwa, makamaka, ma lymphadenopathies a mediastinal awa adzakhazikitsidwa pogwiritsa ntchito thoracic computed tomography, ndipo matendawa amathanso kupezeka, malingana ndi malo awo, ndi mediastinoscopy (kuwunika kwa mediastinum kudzera mu endoscope), mediastinotomy (kudulidwa kwa mediastinum) kapena thoracoscopy. Histology imapangitsa kuti, powerenga maselo, kudziwa ngati lymphadenopathy ndi yowopsa kapena ayi.

Zowopsa

immunocompromised anthu ali pachiwopsezo chachikulu cha matenda, choncho kukhala adenomegaly: odwala HIV Mwachitsanzo, kapena odwala immunosuppressive mankhwala. 

Matendawa pawokha ndi chiopsezo cha adenomegaly.

Zomwe zimayambitsa kukula kwa ma lymph nodes: kulumikizana ndi gawo lawo pakuteteza chitetezo

Lymph nodes ndi tinthu tating'onoting'ono tosefera ma lymph. Amagwiranso ntchito yofunika kwambiri pachitetezo cha chitetezo cha mthupi, motero chitetezo chake.

Chifukwa chake, mu ganglia iyi ndimomwe kuwonetseredwa kwa ma antigen a matupi akunja (omwe ndi tizilombo toyambitsa matenda, omwe amatha kukhala mabakiteriya, ma virus kapena majeremusi), kuma cell a chitetezo chamthupi otchedwa T ndi B lymphocytes. (ie, maselo oyera a magazi).

Kutsatira chiwonetsero cha antijenichi, chitetezo cha mthupi chimalimbana ndi tizilombo toyambitsa matenda, kapena maselo achilendo amthupi (nthawi zambiri zotupa). Kuyankha kumeneku kumakhudzanso kupanga ma antibodies ndi ma B lymphocyte (omwe amatchedwanso humoral chitetezo) kapena ma cell reaction, omwe amatchedwanso kuti cytotoxic reaction, yomwe imaphatikizapo ma CD8 T lymphocytes (yankho lomwe limatchedwanso kuti chitetezo chamthupi). 

Ndi chifukwa cha kutsegula kwa chitetezo cha m'thupi mkati mwa ganglion kuti hypertrophy yomwe imawonedwa pa nkhani ya adenomegaly idzafotokozedwa: Ndipotu, chiwerengero cha ma lymphocyte (maselo a ganglion) ochuluka kwambiri amachititsa kuwonjezeka. kukula kwa lymph node. Kuphatikiza apo, zimachitikanso kuti maselo a khansa amalowa mu lymph node, ndikuwonjezeranso kukula kwake. Maselo otupa amathanso kuchulukana komweko, ngakhale ma cell a chitetezo chamgululi, zomwe zimatsogolera ku khansa ya ganglia.

Zifukwa zabwino

Zomwe zimayambitsa kukula kwa ma lymph node ndizo:

• sarcoidosis (matenda ambiri a thupi losadziwika chifukwa);
• TB, yomwe idapezeka makamaka pambuyo pa mediastinal lymphadenopathy;
• ndi matenda ena opatsirana, monga mononucleosis yoyambitsidwa ndi kachilombo ka Epstein-Barr, ndi zina zotero.

Zoyambitsa zoipa

Pali zifukwa zowopsa, mwa izi:

• zotupa, khansa ndi ma metastases, monga Hodgkin's kapena non-Hodgkin's lymphomas, nthawi zambiri amapezeka kudzera mu mediastinal lymphadenopathy (kutsatira pachifuwa x-ray);
• matenda a autoimmune: makamaka lupus, kapena nyamakazi;
• matenda owopsa kwambiri, monga omwe amalumikizidwa ndi kachilombo ka Edzi, HIV, kapena chiwindi cha virus, ndi zina zambiri.

Zowopsa zazikulu zazovuta za adenomegaly ndizogwirizana ndi zomwe zimayambitsa:

• Pankhani ya zotupa, matenda akhoza kusanduka zilonda zotupa kapena ngakhale maonekedwe a metastases, kutanthauza kufalitsa maselo a khansa patali ndi lymphadenopathy.
• Pankhani ya kachilombo ka HIV, kachilombo ka Edzi, zovuta zake zimakhala za kupeza chitetezo chamthupi, mwachitsanzo, chiopsezo chotenga matenda amitundu yonse.
• Matenda a autoimmune amakhalanso ndi chisinthiko chokhala ndi chiwopsezo cha zovuta zazikulu, zomwe zingayambitse kupweteka kwambiri komanso kulumala kwakukulu.

Chithandizo chidzakhala cha matenda omwe apezeka pokhudzana ndi ma lymph node okulirapo:

• maantibayotiki kapena mankhwala opha tizilombo toyambitsa matenda, kapena antiparasitic, ngati kupezeka kwa lymph node yokulirapo kumachitika chifukwa cha tizilombo toyambitsa matenda (mabakiteriya, kachilomboka kapena tiziromboti);
• mankhwala odana ndi khansa pakakhala chotupa, chomwe chingaphatikizepo radiotherapy ndi chemotherapy;
• immunosuppressants, mwachitsanzo pa matenda a autoimmune.
• Opaleshoni, nthawi zina, imachotsa node.

Choncho, adenomegaly ndi chizindikiro kuti n'kofunika kuti azindikire mwamsanga, ndi kudziwitsa dokotala wanu mwamsanga: womalizayo akhoza kuchita kafukufuku wa zachipatala ndi palpation mwamsanga pamene misa yachilendo imamveka m'madera a khomo lachiberekero, axillary kapena inguinal, kapena kudziwika pachifuwa chowongolera x-ray, pa mediastinal lymphadenopathy. Katswiri wazachipatalayu atha kusankha kuti ayambitse chithandizo chanji kapenanso katswiri woti akambirane naye. Choncho, mwamsanga chifukwa cha adenomegaly chithandizo, mwayi waukulu wochira.