Pituitary adenoma: kuyini, izimbangela eziyinhloko kanye nokwelashwa

-Delile

• Izimpawu eziyinhloko
• 1.I-Lactotrophic adenoma
• 2. Somatotrophic adenoma
• 3. I-Corticotrophic adenoma
• 4. I-adonoma ye-Gonadotrophic
• 5. I-adenoma ye-Thyrotrophic
• 6. I-adenoma engafihli
• Izimbangela ze-pituitary adenoma
• Ungakuqinisekisa kanjani ukuxilongwa
• Yelashwa kanjani
• Ukuhlinzwa
• Imithi

I-pituitary adenoma, eyaziwa nangokuthi i-pituitary adenoma, wuhlobo lwesimila se-benign pituitary, okuyindlala etholakala ebuchosheni futhi enesibopho sokulawula ukukhiqizwa kwamahomoni afana ne-cortisol, i-prolactin, i-hormone yokukhula kanye namahomoni akhuthaza ukusebenza kwamaqanda kanye namasende , Ngokwesibonelo.

Lolu hlobo lwesimila luyivelakancane futhi, ngoba lubucayi, alubeki impilo engcupheni, kepha lungadala izimpawu ezinciphisa izinga lempilo njengokuzala, ukuncipha kwe-libido, ukukhiqizwa ubisi noma izimpawu zezinzwa ezinjengekhanda noma ukulahleka okuncane umbono.

Noma nini lapho kuvela izimpawu ezingakhombisa i-adenoma endlaleni ye-pituitary, kubalulekile ukuxhumana nodokotela we-endocrinologist, udokotela wezinzwa noma we-oncologist ukwenza izivivinyo zokuxilonga, ukukhomba inkinga bese uqala ukwelashwa okufanele kakhulu.

Izimpawu eziyinhloko

Ezimweni eziningi, izimpawu ezivamile ze-pituitary adenoma yizinhlungu zekhanda, ukwehla kombono, ukwehla kwesifiso sobulili kanye nezinguquko kumjikelezo wokuya esikhathini kwabesifazane.

Kodwa-ke, zikhona ezinye izimpawu ezingabonakala futhi ezihluka ngohlobo lwehomoni oluthinteke yi-adenoma:

1.I-Lactotrophic adenoma

I-Lactotrophic pituitary adenoma ibonakala nge-hyperprolactinemia, okungukunyuka kwe-hormone prolactin, ebhekele ukukhiqizwa kobisi. Kulolu hlobo lwe-adenoma uphawu oluyinhloko ukukhiqizwa kobisi emabeleni amadoda noma abesifazane abangancelisi ibele.

Ngaphezu kwalokho, ezinye izimpawu ezingenzeka ukwehla kwesifiso sobulili, ukungabi nenzalo, izinguquko zokuya esikhathini noma ukungabi namandla emadodeni.

2. Somatotrophic adenoma

I-somatotrophic pituitary adenoma ibonakala ngokukhiqizwa okukhulayo kwe-hormone yokukhula futhi ingadala ukwanda ngosayizi nobukhulu beminwe nezinzwane, ngaphezu kokunyuka ebunzini, emhlathini nasekhaleni okuguqula ukwakheka kobuso. Lesi simo saziwa njenge-acromegaly, kubantu abadala, noma i-gigantism, ezinganeni.

Ngaphezu kwalokho, ezinye izimpawu ezingenzeka zibandakanya ubuhlungu obuhlangene, ubuthakathaka bemisipha, ukuncipha kwesifiso sobulili, izinguquko kumjikelezo wokuya esikhathini, ukukhiqizwa komjuluko okwandayo noma ukukhathala.

3. I-Corticotrophic adenoma

ICorticotrophic pituitary adenoma ihlobene nokukhiqizwa okukhulayo kwehomoni i-cortisol, enesibopho sokwandisa amazinga kashukela egazini nokufakwa kwamafutha ezicutshini nasezitho zomzimba.

Ngokuvamile, lolu hlobo lwe-pituitary adenoma lungadala i-Cushing's syndrome edala izimpawu zokuthola isisindo esisheshayo, ukuqongelela kwamafutha ebusweni nasemhlane, ubuthakathaka bemisipha, izinwele ezindlebeni nezinkinga zesikhumba ezifana nezinduna nokungapholi kahle, ngokwesibonelo.

Ngaphezu kwalokho, lolu hlobo lwe-pituitary adenoma lungadala ukucindezeleka nokushintshashintsha kwemizwelo.

4. I-adonoma ye-Gonadotrophic

IGonadotrophic pituitary adenoma ihlobene nokukhiqizwa okwengeziwe kwamahomoni alawula ukukhiqizwa kwe-ovulation kwabesifazane kanye nokukhiqizwa kwesidoda emadodeni. Kodwa-ke, lolu hlobo lwe-pituitary adenoma alunazo izimpawu ezithile.

5. I-adenoma ye-Thyrotrophic

I-Thyrotrophic adenoma uhlobo lwe-pituitary adenoma lapho kukhula khona ukukhiqizwa kwamahomoni wegilo angadala i-hyperthyroidism. Izimpawu zalolu hlobo lwe-pituitary adenoma zifaka phakathi ukukhuphuka kwenhliziyo, ukwethuka, ukukhathazeka, ukuncipha komzimba, ukuthuthumela noma ukuqagela kwenhlamvu yeso, isibonelo.

6. I-adenoma engafihli

I-non-secretory pituitary adenoma wuhlobo lwe-pituitary adenoma olungaphazamisi ukukhiqizwa kwamahomoni, alubangeli ukwanda kwamahomoni futhi ngokuvamile alubonisi zimpawu. Kodwa-ke, uma i-adenoma iqhubeka nokukhula, ingafaka ingcindezi endlaleni yebhinqa futhi iholele ekushintsheni kwamahomoni.

Izimbangela ze-pituitary adenoma

Izimbangela ze-pituitary adenoma azikaziwa, kepha ezinye izifundo zikhombisa ukuthi lolu hlobo lwesimila lungenzeka ngenxa yezinguquko ku-DNA yamaseli noma kubantu abanezinye izinto ezinobungozi ezinjenge:

• Ama-neoplasia amaningi endocrine: lesi sifo yisifo esingajwayelekile esizuzwe njengefa esidalwa izinguquko ku-DNA ezibangela isimila noma ukukhula okwandayo kwezindlala ezahlukahlukene emzimbeni, kufaka phakathi indlala yebhande, okungakhuphula ubungozi be-pituitary adenoma;
• Isifo seMcCune-Albright: lesi sifo esingajwayelekile sezakhi zofuzo senzeka ngenxa yezinguquko ku-DNA futhi singadala ushintsho ekukhiqizeni ama-hormone endlala yendlala futhi, ngaphezu kwezinkinga emathanjeni nasesikhunjeni;
• ICarney Complex: yisifo esingajwayelekile somndeni sofuzo esibi esingadala i-pituitary adenoma kanye neminye imidlavuza ehambisanayo efana ne-prostate noma i-thyroid kanye nama-cysts ama-ovarian.

Ngaphezu kwalokho, ukuvezwa ngemisebe kungakhuphula ubungozi bezinguquko ku-DNA kanye nasekwakheni i-pituitary adenoma.

Ungakuqinisekisa kanjani ukuxilongwa

Ukuxilongwa kwe-pituitary adenoma kwenziwa i-neurologist noma i-oncologist ngokusho kwezimpawu nokuhlolwa kwelabhoratri ukuhlaziya amazinga ama-hormone futhi kufaka:

• ICortisol emchameni, ematheni noma egazini;
• I-hormone ye-Luteotrophic ne-follicle evuselela i-hormone egazini;
• Iprolactin egazini;
• Ijika le-Glycemic;
• Amahomoni wegilo njenge-TSH, T3 ne-T4 egazini.

Ngaphezu kwalokho, ukuqinisekisa ukuxilongwa, udokotela angacela i-MRI yendlala yesifo.

Yelashwa kanjani

Ukwelashwa kwe-pituitary adenoma kungenziwa ngokusetshenziswa kwemithi noma ukuhlinzwa futhi kuya ngohlobo lwe-adenoma kanye nosayizi wesimila:

Ukuhlinzwa

Ukuhlinzwa kuboniswa lapho i-pituitary adenoma ingeyona eyimfihlo futhi ingaphezulu kwe-1 cm. Ngaphezu kwalokho, kulokhu ukwelashwa okuhlinzekwayo kuboniswa kuphela uma kwenzeka uphawu lokulahleka noma ushintsho kumbono.

Lapho isimila esingeyona imfihlo singaphansi kuka-1 cm noma ngaphandle kwezimpawu, ukwelashwa kwenziwa ngokuqapha okuvamile kwezokwelapha kanye nemifanekiso yamagnetic resonance yokuhlola ukukhula kwesimila ngokuhamba kwesikhathi. uma kunesidingo, udokotela angancoma ukusetshenziswa kwemithi noma ukuhlinzwa.

Ngaphezu kwalokho, kuma-pituitary adenomas lapho kuguquka khona i-hormone yokukhula noma i-cortisol, ukuhlinzwa kungakhonjiswa, kanye nokusetshenziswa kwemithi.

Imithi

Izidakamizwa ezisetshenziselwa ukwelapha i-adenoma ziyahluka ngohlobo lwe-adenoma futhi zifaka:

• I-Pegvisomanto, i-octreotide noma i-lanreotide: kuboniswe i-somatotrophic adenoma;
• I-ketoconazole noma i-mitotane: kuboniswe i-corticotrophic adenoma;
• I-Cabergoline noma i-bromocriptine: kuboniswe i-lactotrophic adenoma.

Ngaphezu kwalokho, udokotela angancoma i-radiotherapy ezimweni ze-somatotrophic noma i-corticotrophic adenoma.