Qhov Tseem Ceeb - Myeloma vs Lymphoma
Myeloma thiab Lymphoma yog ob qhov kev cuam tshuam cuam tshuam nrog cov qog ntshav qog ntshav. Myelomas feem ntau tshwm sim hauv cov pob txha pob txha thaum lymphomas tuaj yeem tshwm sim hauv txhua qhov chaw ntawm lub cev uas muaj cov ntaub so ntswg lymphoid. Qhov no yog qhov sib txawv tseem ceeb ntawm myeloma thiab lymphoma. Qhov tshwj xeeb etiology ntawm cov kab mob no tsis paub tab sis qee yam kab mob, irradiation, tiv thaiv kab mob thiab cytotoxic tshuaj lom tau ntseeg tias muaj qee yam cuam tshuam rau kev hloov pauv ntawm cov hlwb uas ua rau cov kab mob malignancies.
Lymphoma yog dab tsi?
Malignancies ntawm lymphoid system hu ua lymphomas. Raws li tau hais dhau los, lawv tuaj yeem tshwm sim ntawm txhua qhov chaw uas muaj cov ntaub so ntswg lymphoid. Nws yog 5th ntau tshaj plaws hauv ntiaj teb sab hnub poob. Tag nrho qhov tshwm sim ntawm lymphoma yog 15-20 ib 100000. Peripheral lymphadenopathy yog cov tsos mob tshaj plaws. Txawm li cas los xij, hauv kwv yees li 20% ntawm cov neeg mob, lymphadenopathy ntawm thawj qhov chaw ntxiv nodal raug pom. Hauv cov neeg mob tsawg, cov tsos mob ntawm lymphoma txuam nrog B xws li poob phaus, ua npaws, thiab tawm hws tuaj yeem tshwm sim. Raws li WHO kev faib tawm, lymphomas tuaj yeem muab faib ua ob pawg xws li Hodgkin's thiab Non-Hodgkin's lymphomas.
Hodgkin's Lymphoma
Qhov tshwm sim ntawm Hodgkin's lymphomas yog 3 rau 100000 nyob rau sab hnub poob ntiaj teb. Cov pawg dav no tuaj yeem raug faib ua pawg me li Classical HL thiab Nodular Lymphocyte predominant HL. Hauv Classical HL, uas suav txog 90-95% ntawm cov neeg mob, cov cim tseem ceeb yog Reed-Sternberg cell. Hauv Nodular Lymphocyte Predominant HL, "popcorn cell", ib qho txawv ntawm Reed-Sternberg tuaj yeem pom nyob rau hauv lub tshuab tsom.
Etiology
Epstein-Barr Virus DNA tau pom nyob rau hauv cov ntaub so ntswg los ntawm cov neeg mob Hodgkin's lymphoma.
Tshuaj Kho Mob
Painless cervical lymphadenopathy yog qhov kev nthuav qhia ntau tshaj plaws ntawm HL. Cov qog no yog rubbery ntawm kev kuaj. Ib feem me me ntawm cov neeg mob tuaj yeem tshwm sim nrog hnoos vim yog mediastinal lymphadenopathy. Qee tus tuaj yeem tsim pruritus thiab mob cawv ntawm qhov chaw ntawm lymphadenopathy.
Kev tshawb nrhiav
- Chest X-ray rau mediastinal widening
- CT scan ntawm lub hauv siab, plab, plab, caj dab
- PET scan
- pob txha pob txha biopsy
- ntshav suav
Kev tswj hwm
Kev nce qib hauv kev kho mob tsis ntev los no tau txhim kho qhov kev cia siab ntawm tus mob no. Kev kho mob thaum ntxov ntawm tus kab mob muaj xws li 2-4 lub voj voog ntawm doxorubicin, bleomycin, vinblastine thiab dacarbazine, tsis ua kom tsis muaj menyuam, ua raws li irradiation, uas tau pom ntau dua 90% kho tus nqi.
kab mob siab heev tuaj yeem kho nrog 6-8 lub voj voog ntawm doxorubicin, bleomycin, vinblastine, thiab dacarbazine nrog rau kev kho mob.
Non-Hodgkin's Lymphoma
Raws li WHO kev faib tawm, 80% ntawm Non-Hodgkin's lymphomas yog B-cell keeb kwm thiab lwm tus yog T-cell keeb kwm.
Etiology
- tsev neeg keeb kwm
- Human T-cell Leukemia Virus type-1
- YHelicobacter pylori
- YChlamydia psittaci
- EBV
- tshuaj tiv thaiv kab mob thiab kab mob
Pathogenesis
Thaum lub sijhawm sib txawv ntawm kev txhim kho lymphocyte, malignant clonal expansion ntawm lymphocytes tuaj yeem tshwm sim, ua rau muaj ntau hom lymphomas. Kev ua yuam kev hauv chav kawm hloov lossis hloov cov noob rau immunoglobulin thiab T cell receptors yog cov kab mob ua ntej uas tom qab tau nce mus rau kev hloov pauv tsis zoo.
Type of Non-Hodgkin's Lymphoma
- Follicular
- YLymphoplasmacytic
- Mantle cell
- Diffuse loj B cell
- Burkitt's
- Anaplastic
Daim duab 01: Burkitt lymphoma, kov prep
Tshuaj Kho Mob
Qhov kev nthuav qhia ntau tshaj plaws yog qhov tsis mob lymphadenopathy lossis cov tsos mob tshwm sim vim muaj kev cuam tshuam los ntawm cov qog ntshav qog ntshav.
Myeloma yog dab tsi?
Cov kab mob phem tshwm sim los ntawm cov ntshav plasma hauv cov pob txha pob txha hu ua myelomas. Tus kab mob no cuam tshuam nrog kev loj hlob ntawm cov ntshav plasma ntau dhau, uas ua rau muaj ntau tshaj ntawm monoclonal paraproteins, feem ntau yog IgG. Kev tshem tawm ntawm lub teeb chains hauv cov zis (Bence Jones proteins) tuaj yeem tshwm sim hauv paraproteinemia. Myelomas feem ntau pom ntawm cov txiv neej laus.
Cytogenetic abnormalities tau txheeb xyuas los ntawm FISH thiab microarray cov txheej txheem hauv feem ntau ntawm myeloma. Cov pob txha lytic lesions tuaj yeem pom nyob rau hauv tus txha nraub qaum, pob txha taub hau, cov pob txha ntev thiab tav vim qhov tsis zoo ntawm cov pob txha hloov kho. Kev ua haujlwm osteoclastic tau nce ntxiv nrog tsis muaj kev nce ntxiv hauv kev ua haujlwm osteoblastic.
Clinicopathological nta
pob txha puas tuaj yeem ua rau vertebral vau lossis tawg ntawm cov pob txha ntev thiab hypercalcemia. Tus txha caj qaum compressions tuaj yeem tshwm sim los ntawm cov nqaij mos plasmacytomas. Cov pob txha pob txha infiltration nrog cov ntshav plasma tuaj yeem ua rau mob ntshav qab zib, neutropenia, thiab thrombocytopenia. Kev raug mob raum tuaj yeem tshwm sim los ntawm ntau qhov laj thawj xws li theem nrab hypercalcemia lossis hyperuricemia, siv NSAIDs thiab lwm yam amyloidosis.
Symptoms
- Symptoms of anemia
- Kev kis kab mob rov muaj dua
- Cov tsos mob ntawm lub raum tsis ua haujlwm
- pob txha
- Cov tsos mob ntawm hypercalcemia
Kev tshawb nrhiav
- Cov ntshav suav tag nrho - Hemoglobin, cov qe dawb thiab cov platelet suav yog qhov qub lossis qis
- ESR (Erythrocyte Sedimentation Rate)-feem ntau siab
- Urea thiab electrolytes
- Serum calcium-ib txwm lossis siab
- tag nrho cov qib protein
- Serum protein electrophoresis-tus yam ntxwv qhia tau hais tias monoclonal band
- Skeletal survey-cov yam ntxwv lytic lesions tuaj yeem pom
zaj movie
Daim duab 02: Histopathological duab ntawm ntau yam myoloma
Kev tswj hwm
Txawm hais tias lub neej expectancy ntawm cov neeg mob myeloma tau txhim kho los ntawm tsib xyoos nrog kev txhawb nqa zoo thiab kev kho mob, tseem tsis tau muaj kev kho mob rau tus mob no. Txoj kev kho no yog tsom rau kev tiv thaiv cov teeb meem ntxiv thiab ua kom muaj sia nyob ntev.
Kev Pab Txhawb Kev Kho Mob
Kev ntshav ntshav tuaj yeem kho nrog ntshav. Hauv cov neeg mob hyperviscosity, ntshav yuav tsum tau ua kom qeeb. Erythropoietin tuaj yeem siv tau. Hypercalcemia, raum raug mob thiab hyperviscosity yuav tsum tau kho kom tsim nyog. Cov kab mob tuaj yeem kho nrog tshuaj tua kab mob. Kev txhaj tshuaj txhua xyoo tuaj yeem muab tau yog tias tsim nyog. Kev mob pob txha tuaj yeem txo tau los ntawm kev siv xov tooj cua thiab kev siv tshuaj khomob lossis tshuaj dexamethasone siab. Pathological fractures tuaj yeem tiv thaiv tau los ntawm kev phais orthopedic.
Kev Kho Mob Tshwj Xeeb
- Tshuaj kho -Thalidomide / Lenalidomide / bortezomib / steroids / Melphalan
- Autologous pob txha pob txha hloov
- Radiotherapy
Qhov txawv ntawm Myeloma thiab Lymphoma yog dab tsi?
YMyeloma vs Lymphoma |
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| Cov kab mob phem tshwm sim los ntawm cov ntshav plasma hauv cov pob txha pob txha hu ua myelomas. | Malignancies ntawm lymphoid system hu ua lymphomas. |
| Myeloma tsawg dua. | Lymphoma ntau dua myelomas. |
| Qhov no feem ntau tshwm sim hauv cov pob txha. | Qhov no tuaj yeem tshwm sim hauv txhua qhov chaw uas muaj cov ntaub so ntswg lymphoid. |
Summary – Myeloma vs Lymphoma
Lymphomas yog cov qog nqaij hlav qog nqaij hlav thaum lub sijhawm myelomas yog cov qog nqaij hlav uas tshwm sim los ntawm cov plasma hlwb hauv cov pob txha pob txha. Qhov no yog qhov txawv ntawm myeloma thiab lymphoma. Txij li cov kab mob no loj heev thiab ua rau muaj kev hem thawj rau lub neej, kev saib xyuas tshwj xeeb yuav tsum tau muab rau tus neeg mob lub siab thaum tswj tus kab mob. Kev txhawb nqa los ntawm tsev neeg yuav tsum tau txais txhawm rau txhim kho cov qauv kev ua neej nyob ntawm tus neeg mob.
Download PDF Version of Myeloma vs Lymphoma
Koj tuaj yeem rub tawm PDF version ntawm kab lus no thiab siv nws rau offline hom phiaj raws li cov ntawv sau tseg. Thov download PDF version ntawm no Qhov txawv Ntawm Myeloma thiab Lymphoma.
