Liphetoho Leukemoid ka bana: mefuta e sa (mefuta e), bakang, phumano-tharabololo kalafo. liphetoho Leukemoid le kankere ea mali: ho se tšoane

Leukemoid karabelong - fetola hematopoiesis, tšoanang ho ea setšoantšong mali ka kankere ea mali le lihlahala tse ling tsa tsamaiso ea hematopoietic. Re lokela ho hlokomela hore le khethehileng la liphello tsena ke dikamano bona a sebetsang a le ho se phetoho ka kankere. liphetoho tsena li ka bakoa ke mefuta intoxications tse sa tšoaneng, lihlahala, tšoaetso, metastatic bakeng sa kankere bokong.

Mochine oa ntshetsopeleng fapana le mefuta e fapaneng a itšoare: maemong a mang e le khumo ka likarolo immature seleng ea mali, ho ba bang - eketseha tlhahiso ea lisele tsa mali kapa thibelo ea lisele khumo ka dinama tse nyenyane tse, kapa ho ba teng ha mekgwa 'maloa ka nako.

Ke eng e ka ba mohloli oa lefu lena le?

Ho na le lintho tse ngata tseo a ka li etsahala ka lebaka la leukemoid itšoara joang. Mabaka a bakeng sa ntshetsopele bona ke tsena:

• tšusumetso ea ionizing mahlaseli;
• lefuba;
• sepsis;
• purulent dithulaganyo;
• letšollo;
• lefu Hodgkin ya;
• sithabela cranial;
• tšoha;
• lobar serame sa matšoafo;
• erysipelas;
• metso o mosoeu;
• sekareleta feberu;
• hlobaetsang sebete dystrophy;
• corticoid phekolo;
• k'habone monoxide chefo.

lefu mefuta e sa tsoaneng

The mefuta e latelang a itšoare leukemoid:

• Myeloid itšoara joang.
• Lymphocytic.
• Psevdoblastnye.

A re hlahlobeng e mong le ba bona ba ka ho qaqileng.

myeloid

Ke mofuta ona wa itšoara joang kenyeletsa tse kang neutrophil, eosinophil le promyelocytic. litla Leukemoid tse tšoanang le tsa foleng myeloid kankere ea mali, a tsamaea le botahoa le tšoaetso ea matla. Active leukocytosis ha e le hantle kamehla e na le tshebetso rarahaneng tsamaea le ho ba teng ha sepsis, a hlabang foci le eketseha mocheso oa 'mele.

Kgahlamelo ya maqhubu a fetang eosinophils maling le tšekamelo ea ho ba teng ha sensitization ho likokoana-hloko le ho sebelisa lithethefatsi, alejiki diathesis, ka seoelo - ka mafu oncological (lefu Hodgkin le lymphosarcoma). liphetoho tsena leukemoid hloka bakeng sa phuputso e entsoeng akaretsang ho mafu aterese ea tsamaiso ho potoloha ha mali, 'me liboko.

lisele tse arabelang joaloka eritremii. polycythemia lintlha - hangata ea fokotseha ka matšoafo maloetse oxygenation (oxygenation) ea mali, a liphio lihlahala, 'me lefu le congenital pelo. Boemo bona bo hloka k'homphieutha le tsa ultrasound.

Mielemiya tšoanang le erythroleukemia hlobaetsang, e fapane feela ka lebaka la ho hloka ho phatloha hoo erythrocytes ka lesapo moko le mali. Hangata e ka khona ho lemoha metastases ka lefu masapo.

lymphocytic

liphetoho tsena ba tšoauoa ka e le koketsego ya bohlokoa ka palo ea lymphocytes ka mali pheriferale, e leng hoo hangata ho nang le boikarabelo bakeng sa ho eketseha ha sebete, lisele tsa mmele nodes le spleen.

Ho mofuta ona e matleng a hae mononucleosis, tšoaetsanoang lymphocytosis, monocyte-macrophage liphetoho leukemoid ka bana ba nang le tšoaetso ea baktheria le ea vaerase, le mafu a tsoaetsanang parasitic le e phahameng ea mali eosinophilia (mohlala, helminthiasis).

liphetoho Lymphocytic etsahala:

• tsoaetsanang bongata ba kokwanahloko (khoho pox, rubella, mumps, adenovirus tšoaetso, maselese, tšoaetsanoang mononucleosis);
• tsoaetsanang parasitic (rikketsiozah, toxoplasmosis, chlamydia);
• tsoaetsanang baktheria (mokaola, mokhokhothoane, lefuba);
• mycoses tse sa tšoaneng;
• mafu autoimmune (serum lefu, systemic lupus erythematosus).

mofuta Lymphocytic ho feta tloaelehileng macroglobulinemia Waldenstrom, ho ruruha, sarcoidosis. All ea mafu a ka holimo ba tšoaroa ka ho teba haholo le e ka ba tse ferekanyang tsa mokuli ho feta selemo.

Psevdoblastnye

liphetoho tse joalo li leukemoid haeba mokuli e qalang feela ho hlaha ho tswa ho agranulocytosis boitshireletso, sesosa sa e ka bakoa ke baeti ba fihlelang ho ea sulfonamides, "aminopyrine," "butadiene" le ho sebelisa lithethefatsi tse ling.

Bakeng sa litla joalo sehlopha tšoauoa ka ho ba teng ha ho e pheriferale mali le masapo moko haholo palo ya dikarolo lisele le liboto homogeneous, 'me' mala o moputsoa le 'ngoe nucleoli, a masesaane, ho se be le ea cytoplasm granular.

Ho fapana le tloaelehileng la pululo erythrocytes ka dinetweke tseo bana ba itseng le bonolo 'me lekanya chromatin likhoele. Tsoeng blastosis nyamela ntle le phekolo ea lik'hemik'hale le tse amanang litšusumetso leukemoid li fumanoa masea a sa tsoa tsoaloa le maloetse a liphatsa tsa lefutso chromosomal (mohlala, Down syndrome).

Mefuta itšoara joang Leukemoid eo li 'nile tsa fanoa ka hodimo, tse thehoa ka semelo sa malwetse efe kapa efe, hangata u se ke ua etsa hore mathata a kotsi. Ka linako tse ling ka tsela e hlollang ha hlaha thrombocytopenia a ka phoso ho nkuwa jwalo ka e mong oa matšoao a sa kankere ea mali a hlobaetsang. The bonoa immunoblastic lymphadenites bohlokwa haholo ke polokeho ya sebopeho ea tlhaho ea ho noute lisele tsa mmele, hammoho le ho ka tsela e nepahetseng beha mocheng oa follicles le.

liphetoho Leukemoid le kankere ea mali: ho se tšoane

Ho na le ba bang ba phapang pakeng tsa liphello tse joalo le kankere ea mali, e leng:

1. Ha leukemoid rejuvenation liphetoho Offline potlako lesapo moko, e metamielotsitarnym le lemoha keketseho ea ka mefuta kankere ea mali pululo. Ha litla leukemoid bolokoa erythroid kokoana-hloko, ho na le ntho e tloaelehileng leykoeritroblasticheskoe karo-karolelano - 3: 1 le 4: 1.
2. Se bonoang liponahatso tsa anaplasia le liketsahalo leukemoid ha e ntse e se etsahala ka kankere ea mali ha ho na le ke bulging ea protoplasm le khubung anomaly.
3. Ka mothofatso pele, maling pheriferale e bile ho eketseha ha palo e feletseng le peresente ya ho eketseha ha neutrophils hōlileng tsebong ka dikahare kankere ea mali decreases neutrophils ba hōlileng tsebong le hlaha ata ka tsela e feteletseng ea mocha, liforomo immature.
4. Ha liphetoho leukemoid hangata a hlokomela granularity chefo ea neutrophils.
5. Ha leukocytes cytochemical ithuta ka kankere ea mali ea fokotseha kapa ho ba sieo ha le phosphatase alkaline, ka liphetoho leukemoid - eketsehile ka makhetlo mosebetsi.
6. Nakong exacerbation ea sa foleng myeloid kankere ea mali pululo maqakabetsi pula-maliboho e eosinophilic, ho tloaelana basophilic le liphetoho leukemoid e, offline.
7. Ha myeloid kankere ea mali, hangata e na le thrombocytosis phahameng, le itšoare ka leukemoid platelet bala ka hare ho fapaneng tloaelehileng.
8. Ka mekhahlelo ea pele ea sa foleng myeloid kankere ea mali fumana kholo le letšo-letšo spleen ka liphetoho leukemoid ka linako tse ling etsahala splenomegaly, empa 'mele ke le bonolo' me ha ho mohla a fihla boholo kgolo haholo.
9. Ha liphetoho leukemoid ho tshebetso neoplastic lemoha ka lisele bakeng sa kankere lesapo moko.

liphetoho Leukemoid ka bana: tekotshupo-tharabololo

karolo ea bohlokoa ho ea phumano ya lefu lena le o fuoa histopathology hore hlahloba biopsy lintho tse bonahalang. Empa e le ho qoba liphoso irreparable, ho pathologist lokela bokella boitsebiso bo nepahetseng mabapi le mamello, u se fe tataiso ea liteko tse fapa-fapaneng le hore a khethe e le kalafo cytostatic, eo tlosa liphello tsohle tsa lymphadenitis. Ha sena sohle e sa entseng, phumano e entsoeng ka nepo, 'me ka hona ho sebetsana ka katleho le le lefu lena e tla ba ho le thata haholo. Ka mor'a hore tsohle, lefu lena ke ho le kotsi haholo. Ka linako tse ling, bakeng sa qetello ea lintlha hlokahalang ho etsa se bale biopsy.

bohlokwa haholo ka diagnosing le smear 'ponahalo ea biopsies noute lisele tsa mmele le hatisa mohopolo. Ha boholo ba erythrocyte lymphosarcoma (bonyane karolo ea 30 lekholong) tšoana le lisele tse sa khaotseng ho phatloha hoo. Ka erythrocytes joalo immunoblastic lymphadenitis, hangata ba etsang liphesente tse ka tlase ho 10, ba ile ba ba e fapaneng ya ka dipehelo tsa basophilia tsa cytoplasm le khubung matla khōlong e feletseng.

Histopathological tepelletse maikutlong ka ho hlahloba lisele tsa mmele noute e lokela ho ba tse qaqileng haholo le ho sa kenyeletswe nepahalang sephetho. Hobane histopathology tsa lithuto tse fapa-fapaneng tsa mali lokela ho hlalosa ka ho hlaka tepelletse maikutlong, 'me sena se bonahala ka ho etsa qeto ea. Ka mohlala, bakeng sa fumanoe ea pele ea nang kotsi lymphoma, maemong a mang, nako e telele ho boloka le mamello 'me u hlahlobe lisele tsa mmele nodes hape.

Tepelletse maikutlong leukemoid liphetoho belaela ha e batlang monoclonal immunoglobulin ka linako tse ling hloka hore ka makhetlo-khetlo le hlokometse'ng ka nako e telele ya bone bone moko puncture. Pele ho mo amohela e le fumanoe ke kankere ka chemotherapy e contraindicated.

kissing lefu

lefu le leng bitsoa Filatov - Pfeyferra, glandular feberu le monocytic angina. Ke lefu le bongata ba kokwanahloko tšoauoa ka lymphocyte pululo phetoho, atolositsoeng lisele tsa mmele nodes le spleen, arabelang lymphadenitis, le ketsahalo e sa lisele tse itseng e khubelu ea mali ka maling pheriferale. The moemeli causative e nkoa Epstein-Barr vaerase eo. Motheong oa lefu - pululo phetoho ya lymphocytes bakoang ke tšoaetso ea khethehileng bongata ba kokwanahloko.

Boemo litleleniki tsa e fapaneng. Ka mefuta bate haholo tsa rhinitis ka lebaka la ho ntse robehile. Pontšo makgetheng:

• angina ( "tukang 'metso");
• kholiso ea spleen le lisele tsa mmele nodes hammoho le bohloko;
• nasal hema thata ka matsatsi a pele tsa lefu lena ka lebaka la ho ruruha ya mucosa le.

Boemo ba mali: keketseho e ka peresente ya eosinophils, lymphocytes le monocytes.

mathata

Hlokahala le lekaneng bakeng sa qetello ea e pontshi tsa lefu lena le ke ho ba teng ha ka mali mononuclear pele (ba fetang 10-20%) - lisele fapana lymphocyte khubung kgolo le lohle basophilic cytoplasm le 'mala o lilac le bitsoa perinuclear leseli. Ho qetela liphetoho leukemoid ka bana ba le batho ba baholo ka libeke tse 'maloa, empa likhoeli tse o tsoela pele ka maemo a itseng, ho tlwaelegileng a boemo ba mali.

Le relapses ba hlokometse ka le bonolo, e ka linako tse ling ka dikgao tsa lilemo tse 'maloa ka mor'a ea pele nako hlobaetsang. Mathata a ka 'na a akarelletsa:

• hlobaetsang lefu la sebete;
• ho ruruha ha boko;
• agranulocytosis;
• splenic otlile bakoa ke keketseho ea lona ka potlako;
• autoimmune hemolysis.

Therapy liphetoho leukemoid

E le busa, bakuli ba se hlokang meriana e khethehileng, hobane bakeng sa matsatsi a 'maloa matšoao se ka sehloohong sa lefu lena le nyamela le boemo ba mali a ka ho tloaelehileng. Ha nako e telele ho kula le mamello ikutloa se monate sebediswa phekolo pathogenetic - kgetha "prednisolone" ka lethal dose ea la 20-30 mg, ka letsatsi kapa lithethefatsi tse ling glucocorticoid e le hore ho felisa leukemoid itšoara joang. Phekolo ka Leha ho le joalo, feela beha setsebi.

pono

Hangata o positive: contagiousness hase phahameng kateng, ho ba le mamello e sa hlokahala arola batho. Leha ho le joalo, kotsi haholo otlile ea spleen ena. Lokisa phokotso bophahamo ba modumo laolwang ke likarolo ponahalo ea 'mele le ho nyamela ha angina le tlwaelegileng a ea mocheso oa' mele. Ha a tšoaetsanoang mononucleosis e bontšoa ka sebōpeho sa lefu la sebete, mokuli hlokahala bookelong.