Isimila sangaphakathi

Izicubu eziphakathi nendawo ukukhula okuvela ku-mediastinum. Le ndawo maphakathi nesifuba ehlukanisa amaphaphu.

I-mediastinum yingxenye yesifuba esilele phakathi kwe-sternum nekholomu yomgogodla, naphakathi kwamaphaphu. Le ndawo iqukethe inhliziyo, imithambo yegazi emikhulu, i-windpipe (i-trachea), i-thymus gland, i-esophagus, nezicubu ezihlangene. I-mediastinum ihlukaniswe izigaba ezintathu:

• Ngaphambili (ngaphambili)
• Ephakathi
• Ngemuva (emuva)

Izimila zangaphakathi azivamile.

Indawo ejwayelekile yamathumba ku-mediastinum incike kubudala bomuntu. Ezinganeni, izicubu zivame kakhulu ku-posterior mediastinum. Lezi zicubu zivame ukuqala ezinzwa futhi azinomdlavuza (ezinobungozi).

Iningi lezicubu zomzimba kubantu abadala zenzeka kwi-anterior mediastinum. Imvamisa i-lymphomas yomdlavuza (ebulalayo), izicubu zesifo segciwane, noma i-thymomas. Lezi zicubu zivame kakhulu kubantu abadala abaneminyaka ephakathi nangaphezulu.

Cishe ingxenye eyodwa yezicubu zomzimba azibangeli zimpawu futhi zitholakala ku-x-ray yesifuba kwenziwe esinye isizathu. Izimpawu ezenzeka ngenxa yengcindezi (kokucindezelwa) kwezakhiwo zasendaweni futhi zingafaka:

• Ubuhlungu besifuba
• Umkhuhlane namakhaza
• Khwehlela
• Ukukhwehlela igazi (hemoptysis)
• Ukungahambi kahle
• Ukujuluka ebusuku
• Ukuphelelwa umoya

Umlando wezokwelapha nokuhlolwa komzimba kungakhombisa:

• Imfiva
• Umsindo wokuphefumula ophakeme (stridor)
• I-lymph node evuvukile noma yethenda (i-lymphadenopathy)
• Ukwehla kwesisindo ngokungenhloso
• Ukuqhuma

Ukuhlolwa okwengeziwe okungenziwa kufaka phakathi:

• I-x-ray yesifuba
• Inaliti eqondiswa yi-CT
• I-CT scan yesifuba
• I-Mediastinoscopy ene-biopsy
• I-MRI yesifuba

Ukwelashwa kwezimila zangaphakathi kuya ngohlobo lwesimila nezimpawu:

• Umdlavuza we-Thymic welashwa ngokuhlinzwa. Kungalandelwa yimisebe noma i-chemotherapy, kuya ngesigaba sesimila kanye nempumelelo yokuhlinzwa.
• Izimila zamangqamuzana amaGerm zivame ukwelashwa ngamakhemikhali.
• Kwi-lymphomas, i-chemotherapy yindlela yokwelashwa oyikhethayo, futhi kungenzeka ilandelwe yimisebe.
• Ngezicubu ze-neurogenic ze-posterior mediastinum, ukuhlinzwa kuyindlela yokwelashwa eyinhloko.

Umphumela uncike ohlotsheni lwesimila. Izicubu ezahlukahlukene ziphendula ngokuhlukile ekhemotherapy kanye nemisebe.

Izinkinga zezicubu zangaphakathi zihlanganisa:

• Ukucindezelwa kwentambo yomgogodla
• Spread ezakhiweni eziseduze njengenhliziyo, ulayini nxazonke zenhliziyo (pericardium), nemikhumbi emikhulu (aorta ne vena cava)

Imisebe, ukuhlinzwa nokwelashwa ngamakhemikhali konke kungaba nezinkinga ezinkulu.

Xhumana nomhlinzeki wakho wezokunakekelwa kwempilo uma ubona izimpawu zesimila sangaphakathi.

I-Thymoma - imaphakathi; I-Lymphoma - imaphakathi

• Amaphaphu

I-Cheng GS, i-Varghese TK, iPaki DR. Izimila zangaphakathi kanye nama-cysts. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 83.

UMcCool FD. Izifo ze-diaphragm, udonga lwesifuba, i-pleura, ne-mediastinum. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 92.