Okudingeka Ukwazi Nge-Lung Granulomas

-Delile

• Ziyini izimpawu?
• Ziyini izimbangela?
• I-Histoplasmosis
• I-mycobacteria engasebenzi (NTM)
• I-Granulomatosis ene-polyangiitis (GPA)
• Isifo samathambo (RA)
• I-Sarcoidosis
• Kutholakala kanjani?
• Ilashwa kanjani?
• Uyini umbono?

Ukubuka konke

Kwesinye isikhathi lapho izicubu ezithweni zivutha - imvamisa kuphendula ukutheleleka - amaqembu amaseli abizwa ngokuthi yiqoqo lama-histiocyte akha amaqhubu amancane. La maqoqo amancane amile njengobhontshisi abizwa ngama-granulomas.

AmaGranulomas angakha noma yikuphi emzimbeni wakho kepha avame ukukhula ku:

• isikhumba
• ama-lymph node
• amaphaphu

Lapho ama-granulomas enza ifomu lokuqala, athambile. Ngokuhamba kwesikhathi, bangaba lukhuni futhi babalwe. Lokhu kusho ukuthi i-calcium yakha amadiphozithi kuma-granulomas. Ukufakwa kwe-calcium kwenza lezi zinhlobo zama-granulomas amaphaphu zibonakale kalula ekuhlolweni kwe-imaging, njenge-X-ray yesifuba noma ama-CT scan.

Kwi-X-ray yesifuba, amanye ama-granulomas wamaphaphu angabukeka njengokukhula okungenzeka kube nomdlavuza. Kodwa-ke, ama-granulomas awanomdlavuza futhi kaningi abangela zimpawu futhi awadingi ukwelashwa.

Ziyini izimpawu?

Kunezimpawu ezingavamile ezihlotshaniswa nama-granulomas amaphaphu uqobo. Kodwa-ke, ama-granulomas akha ukuphendula izimo zokuphefumula, njenge-sarcoidosis noma i-histoplasmosis, ngakho-ke imbangela eyisisekelo ivame ukuletha izimpawu. Lokhu kungafaka:

• ukukhwehlela okungapheli
• ukuphelelwa umoya
• ubuhlungu besifuba
• umkhuhlane noma amakhaza

Ziyini izimbangela?

Izimo ezivame ukuhlotshaniswa ne-lung granulomas zingahlukaniswa ngezigaba ezimbili: ukutheleleka nezifo zokuvuvukala.

Phakathi kwezifo kukhona:

I-Histoplasmosis

Enye yezimbangela ezivame kakhulu zama-granulomas amaphaphu uhlobo lokutheleleka kwefungal okwaziwa njenge-histoplasmosis. Ungathuthukisa i-histoplasmosis ngokuphefumula ezinhlamvini zomoya zesikhunta esivame ukutholakala emgqonyeni wezinyoni namalulwane.

I-mycobacteria engasebenzi (NTM)

I-NTM, etholakala ngokwemvelo emanzini nasemhlabathini, iphakathi kwemithombo ejwayelekile yokutheleleka ngamagciwane okuholela kuma-lung granulomas.

Ezinye izimo ezingatheleleki, ezivuthayo zifaka:

I-Granulomatosis ene-polyangiitis (GPA)

I-GPA ukuvuvukala okungajwayelekile kodwa okungathi sína kwemithambo yegazi emakhaleni akho, emphinjeni, emaphashini nasezinsweni. Akucaci ukuthi kungani lesi simo sikhula, yize sibonakala siyindlela engavamile yokusabela kumasosha omzimba ekutheleleni.

Isifo samathambo (RA)

I-RA kungenye impendulo engavamile yesistimu yomzimba eholela ekuvukeleni. I-RA ithinta kakhulu amalunga akho kepha ingadala ama-lung granulomas, abizwa nangokuthi amaqhuqhuva e-rheumatoid noma amaqhuqhuva amaphaphu. La ma-granulomas ngokuvamile awanabungozi, kodwa kunengozi encane yokuthi i-nodule yamathambo ingaqhuma futhi ilimaze iphaphu lakho.

I-Sarcoidosis

I-Sarcoidosis yisimo sokuvuvukala esivame ukuthinta amaphaphu akho nama-lymph node. Kubonakala sengathi kubangelwa yimpendulo engavamile yesistimu yomzimba, noma kunjalo abacwaningi kusamele bakhombe ukuthi yini ebangela le mpendulo. Kungenzeka ukuthi kuhlobene nokutheleleka kwebhaktheriya noma kwegciwane, kodwa abukho ubufakazi obucacile okwamanje bokusekela leyo mbono.

Ama-granulomas emaphaphu ahlobene ne-sarcoidosis angaba yingozi, kepha amanye angathinta ukusebenza kwamaphaphu akho.

Kutholakala kanjani?

Ngoba mincane futhi imvamisa ayibangeli zimpawu, ama-granulomas avame ukutholakala ngengozi. Isibonelo, uma une-X-ray yesifuba noma i-CT scan ejwayelekile ngenxa yenkinga yokuphefumula, udokotela wakho angathola amabala amancane emaphashini akho aphenduka ama-granulomas. Uma zibalwa, kulula kakhulu ukuzibona kwi-X-ray.

Ekubukeni kokuqala, ama-granulomas afana nezicubu ezinomdlavuza. Iskena se-CT singathola amaqhuqhuva amancane futhi sinikeze umbono onemininingwane eminingi.

Amaqhuqhuva amaphaphu omdlavuza ajwayele ukwakheka ngokungajwayelekile futhi abe makhulu kunama-granulomas anobungozi, alinganiselwa kumamilimitha ayi-8 kuye kwayi-10 ububanzi. Amaqhubu aphakeme phezulu emaphashini akho nawo maningi amathuba okuba izicubu zomdlavuza.

Uma udokotela wakho abona okubonakala kuyigranuloma encane futhi engenabungozi ku-X-ray noma nge-CT scan, bangayiqapha isikhashana, bathathe izithombe ezengeziwe esikhathini seminyaka ukubona ukuthi iyakhula yini.

I-granuloma enkulu ingahlolwa ngokuhamba kwesikhathi kusetshenziswa ukuskena kwe-positron emission tomography (PET). Lolu hlobo lokucabanga lusebenzisa umjovo wento enemisebe ukukhomba izindawo zokuvuvukala noma zokubulala.

Udokotela wakho futhi angathatha i-biopsy ye-lung granuloma ukuthola ukuthi inomdlavuza yini. I-biopsy ifaka phakathi ukukhipha ucezu oluncane lwezicubu ezisolisayo ngenaliti ezacile noma nge-bronchoscope, ithubhu elincanyana elifakwe emphinjeni wakho langena emaphashini akho.Isampula lezicubu bese lihlolwa ngaphansi kwesibonakhulu.

Ilashwa kanjani?

Ama-granulomas emaphaphu ngokuvamile awadingi ukwelashwa, ikakhulukazi uma ungenazo izimpawu.

Ngoba ama-granulomas imvamisa angumphumela wesifo esingaxilongwa, ukwelashwa kwesimo esibucayi kubalulekile. Isibonelo, ukutheleleka kwamagciwane emaphashini akho okubangela ukukhula kwe-granuloma kufanele kulashwe ngama-antibiotic. Isimo sokuvuvukala, njenge-sarcoidosis, singaphathwa nge-corticosteroids noma eminye imithi elwa nokuvuvukala.

Uyini umbono?

Lapho usuphethe imbangela eyisisekelo yama-lung granulomas ngaphansi kokulawulwa, ungahle ungabi nefomu elengeziwe lamaqhubu emaphashini akho. Ezinye izimo, njenge-sarcoidosis, azikho ikhambi, kepha zingaphathwa kahle. Ngenkathi ungagcina amazinga okuvuvukala phansi, kungenzeka ukuthi ama-granulomas amaningi angakha.

Ama-granulomas emaphaphu nokunye ukukhula emaphashini akho kuvame ukubonakala lapho udokotela wakho efuna ezinye izinkinga zokuphefumula. Lokho kusho ukuthi kubalulekile ukubika izimpawu ezinjengokukhwehlela, ukuphefumula okuncane, nobuhlungu besifuba ngokushesha kudokotela wakho. Ngokushesha lapho izimpawu zihlolwa futhi zatholakala, ngokushesha ungathola ukwelashwa okuwusizo.