Qhov Tseem Ceeb Qhov Tseem Ceeb - Mob Ntshav Qab Zib vs Ntshav Qab Zib
Cirrhosis yog ib qho mob uas tau cim los ntawm kev hloov pauv ntawm tag nrho lub siab mus rau hauv parenchymal nodules uas nyob ib puag ncig los ntawm fibrous bands thiab qhov sib txawv ntawm cov vascular shunting. Qhov sib txawv tseem ceeb ntawm daim siab cirrhosis thiab mob qog nqaij hlav hauv siab yog tias cov qog nqaij hlav hauv siab tuaj yeem kis mus rau cov kabmob uas nyob ib sab thiab tom qab ntawd mus rau qhov chaw nyob deb vim yog qhov cuam tshuam ntawm cov kab mob malignant thaum cirrhosis nyob rau hauv daim siab.
Dab tsi yog daim siab cirrhosis?
daim siab mob siab yog ib yam mob uas tau cim los ntawm kev hloov pauv ntawm tag nrho lub siab mus rau hauv parenchymal nodules uas nyob ib puag ncig los ntawm fibrous bands thiab qib sib txawv ntawm vascular shunting. Kev mob ntev ntawm daim siab ua rau kev tuag ntawm hepatocytes ntawm qhov loj heev. Raws li cov lus teb rau qhov kev puas tsuaj ntawm hepatocyte, fibrosis yog qhib. Fibrosis hloov cov kab mob hepatocytes uas puas lawm nrog cov caws pliav cov ntaub so ntswg uas muaj collagen, ua rau lub siab ua haujlwm tsis zoo. Cirrhosis yog qhov kawg ntawm qhov rov tshwm sim ntawm tus txheej txheem no.
Caus
- Alcohol
- kab mob siab kab mob siab ntev (hepatitis B lossis C)
- Nonalcoholic fatty siab kab mob
- YPrimary sclerosing cholangitis
- Autoimmune siab kab mob
- Primary thiab secondary biliary cirrhosis
- YCystic fibrosis
- YHemochromatosis
- Wilson's disease
- Alpha 1 antitrypsin deficiency
- Yuav ua li cas lwm yam mob uas cuam tshuam rau daim siab
Pathophysiology
- mob siab
- Kev tsim cov cytokines los ntawm Kupffer hlwb thiab hepatocytes
- Ua kom cov hlwb stellate hauv qhov chaw ntawm Disse los ntawm cytokines
- Kev hloov pauv ntawm cov stellate rau hauv cov hlwb zoo li myofibroblast
- Kev tsim cov collagen, pro inflammatory cytokines thiab lwm tus neeg nruab nrab uas txhawb fibrosis
Morphology
Cirrhosis qhia txog theem kawg ntawm tus kab mob siab. Muaj ntau qhov kev hloov pauv tseem ceeb uas feem ntau pom hauv daim siab cirrhotic.
- A lobule yog lub luag haujlwm ntawm lub siab. Lub siab noj qab nyob zoo muaj ntau lab tus lobules tau teem rau hauv txoj kev ua kom zoo. Hauv kev mob cirrhosis, qhov lobular architecture hloov pauv ua rau lub siab ua haujlwm.
- Kho cov txheej txheem kho tau raug qhib vim tias lub siab tsis tu ncua. Yog li ntawd, fibrous septae thiab ntau regenerative nodules tuaj yeem pom ob qho tib si microscopically thiab macroscopically.
- Raws li qhov tshwm sim ntawm cov nodules, cirrhosis tau muab faib ua peb pawg:
Hauv micronodular cirrhosis, cov nodules kuj me me. Yog tias muaj cov nodules loj uas hom tau txheeb xyuas tias yog macronodular cirrhosis. Qee zaus, nws muaj peev xwm muaj ob qho loj thiab me nodules ua ke hauv daim siab cirrhotic. Daim ntawv cirrhosis ntawd hu ua mixed type cirrhosis.
- Lub network ntawm cov hlab ntsha muab cov ntshav mus rau lub siab parenchyma yog raug rau ntau yam kev hloov pauv vim yog fibrosis. Cov hlab ntsha tshiab tsim nyob rau hauv fibrous septae, shunting cov ntshav kom deb ntawm lub active hepatocytes.
- Collagen accumulates nyob rau hauv qhov chaw ntawm Disse, occluding lub fenestrations nyob rau hauv lub capillaries. Qhov no txo qis qhov ua tau zoo ntawm cov kua hloov pauv los ntawm cov phab ntsa capillary.
- Lub siab yog kua tsib yog daim siab puas yog vim lub siab ntev stasis.
Kev kho mob tshwm sim
Txawm hais tias feem ntau ntawm lub siab ua haujlwm raug cuam tshuam rau theem no, qee zaum, lub peev xwm ua haujlwm ib txwm raug tswj xyuas qis dua. Hauv cov tshuaj kho mob, qhov no tau lees paub tias yog kev them nyiaj cirrhosis. Tab sis nrog rau kev loj hlob ntawm tus kab mob, cov txheej txheem them nyiaj ua haujlwm tsis txaus thiab cov tsos mob ntawm daim siab tsis ua haujlwm pib maj mam tshwm sim. Qhov no raug txheeb xyuas tias yog decompensated cirrhosis.
Kev kho mob ntawm daim siab tsis ua haujlwm yog,
- Hepatomegaly
- Ascites
- Circulatory hloov pauv- kab laug sab telangiectasia, palmar erythema, cyanosis
- Endocrine hloov pauv - Poob libido, alopecia, gynecomastia, mis atrophy, menses tsis xwm yeem, testicular atropy, amenorrhea
- Bruises, purpura, epistaxis
- Portal hypertension ua raws li splenomegaly thiab variceal los ntshav
- Hepatic encephalopathy
Kev tswj hwm
- Endoscopy yuav tsum tau ua los tshuaj xyuas cov kab mob esophageal tsawg kawg ib zaug hauv ob xyoos.
- Cirrhosis ua rau muaj kev pheej hmoo ntawm hepatocellular carcinoma. Yog li ntawd, kev soj ntsuam tas li rau ib qho kev hloov pauv hauv lub siab yog qhov tseem ceeb.
- Qhov laj thawj yuav tsum tau kho.
- khoom noj kom zoo yog qhov tseem ceeb ntawm kev tswj hwm
- Kev hloov daim siab yog qhov kawg kev kho mob modality
Mob qog noj ntshav yog dab tsi?
mob qog nqaij hlav hauv siab yog cov mob hnyav uas tshwm sim hauv daim siab. Cov kab mob no feem ntau tshwm sim los ntawm kev mob ntev uas ua rau muaj kev hloov pauv ntawm hepatocytes.
Tsev plaub hom kab mob siab tau piav qhia
YHepatocellular Carcinoma
Aetiology
- Tus kab mob HBV lossis HBC tus kab mob
- Kev haus dej cawv ntau ntau
- Aflatoxin
- Txhua yam mob uas tuaj yeem ua rau muaj kev hloov pauv hauv lub siab ntev.
Ntau yam kev koom tes tuaj yeem ua rau muaj kev hloov pauv dysplastic hauv cov hepatocytes. Cov kev hloov dysplastic no ua raws li cov kab mob ua ntej rau cov kab mob hepatocellular carcinomas.
Morphology
Macroscopy
Cov qog no tuaj yeem pom tau tias yog cov pob zeb loj lossis ntau qhov focal uas muaj xim daj ntseg ntsuab. Lawv yog cov diffusely infiltrative. Hepatocellular carcinomas ntxeem tau cov hlab ntsha uas nyob ib sab; yog li ntawd lawv metastasize mus rau lwm lub cev los ntawm cov ntshav.
Microscopy
Anaplastic carcinomas yog qhov sib txawv tsawg kawg ntawm cov kab mob hepatocellular carcinomas. Malignant cells ntawm anaplastic carcinoma yog pleomorphic.
Zoo sib txawv carcinomas muaj trabecular, acinar lossis pseudo glandular npaj. Lawv muaj cov hlwb nrog hyperchromic nuclei thiab tseem ceeb nucleoli.
Tshuaj Kho Mob
- Hepatocellular carcinomas muaj ntau ntawm cov txiv neej.
- mob plab, ua npaws, mob plab, ascites, thiab poob phaus yog cov tsos mob tshwm sim ib txwm muaj.
- Serum alpha fetoprotein qib yog nce siab.
Daim duab 01: Kab Mob Siab
Cholangio Carcinomas
Cholangio carcinomas tshwm sim los ntawm cov ducts biliary hauv lossis sab nraum lub siab.
Risk Factors
- YPrimary sclerosing cholangitis
- YCholedochal cyst
- HCV infection
Morphology
Cov qog no khov kho thiab gritty hauv qhov xwm txheej. Markedly desmoplastic hlwb muaj peev xwm invading cov lymphatics thiab cov hlab ntsha tuaj yeem pom microscopically. Cholangio carcinomas feem ntau metastasize rau hauv pob txha, adrenals, thiab hlwb.
YHepatoblastoma
Hepatoblastomas tau pom ntawm cov menyuam yaus thiab yog tshwm sim los ntawm kev hloov pauv dysplastic hauv cov kab mob siab tawv nqaij.
Angiosarcomas
hom kab mob daim siab no muaj qhov pom tsis zoo. Qhov raug rau vinyl chloride yog qhov tseem ceeb ntawm kev pheej hmoo rau tus mob angiocarcinomas.
Dab tsi zoo sib xws ntawm daim siab Cirrhosis thiab mob qog noj ntshav?
Ob lub siab cirrhosis thiab mob qog noj ntshav siab yog kab mob siab
Qhov txawv ntawm daim siab Cirrhosis thiab mob qog noj ntshav yog dab tsi?
daim siab Cirrophosis VS HISTsis mob cancer |
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| Cirrhosis yog ib yam mob uas tau cim los ntawm kev hloov pauv ntawm tag nrho lub siab mus rau hauv parenchymal nodules uas nyob ib puag ncig los ntawm fibrous bands thiab sib txawv qib ntawm vascular shunting. | mob qog nqaij hlav hauv siab yog cov mob hnyav uas tshwm sim hauv daim siab. Cov kab mob no feem ntau tshwm sim los ntawm kev mob ntev uas ua rau muaj kev hloov pauv ntawm hepatocytes. |
| kev sib raug zoo | |
| Kev rov tsim dua tshiab ntawm hepatocytes ua rau muaj kev hloov pauv dysplastic tshwm sim hauv daim siab cirrhotic. Yog li cirrhosis tuaj yeem ua rau mob qog noj ntshav. | mob qog noj ntshav feem ntau tsis ua rau cirrhosis. |
| Cirrhosis raug kaw rau lub siab. | Cov qog nqaij hlav cancer tuaj yeem metastasize rau qhov chaw nyob deb ntawm cov ntshav thiab qog ntshav. |
Summary – Liver Cirrhosis vs Liver Cancer
Thaum ob qho xwm txheej no cuam tshuam rau daim siab, mob qog noj ntshav muaj peev xwm kis tau mus rau lwm qhov ntawm lub cev thaum cirrhosis nyob rau hauv daim siab. Qhov no yog qhov sib txawv tseem ceeb ntawm cirrhosis thiab mob qog noj ntshav siab. Ib qho tseem ceeb uas yuav tsum tau muab sau tseg yog tias tsis yog cov neeg haus cawv nkaus xwb muaj kev pheej hmoo ntawm kev tsim mob cirrhosis. Yog li ntawd, nws yog ib qho tseem ceeb kom ua tib zoo saib xyuas koj lub siab ua haujlwm yog tias koj muaj ib qho ntawm cov kev pheej hmoo uas paub tias muaj kev koom tes nrog rau cirrhosis lossis mob qog noj ntshav.
Download PDF Version of Liver Cirrhosis vs Liver Cancer
Koj tuaj yeem rub tawm PDF version ntawm kab lus no thiab siv nws rau offline hom phiaj raws li daim ntawv ceeb toom. Thov download PDF version ntawm no Qhov txawv Ntawm Daim Siab Cirrhosis thiab Liver Cancer.
