I-Adenomegaly ukukhuliswa kwama-lymph nodes, ukwanda okungabangelwa izifo ezibangelwa amagciwane noma amagciwane, noma okuxhunyaniswa nokuba khona kwezimila, ikakhulukazi.

Uma kukhulunywa nge-ganglia ye-mediastinum, iyi-lymphadenopathy yangaphakathi, i-lymphadenopathy yomlomo wesibeletho uma ukukhuphuka kwevolumu kuthinta ama-lymph node entanyeni, noma i-axillary lymphadenopathy lapho kungama-lymph node (elinye igama i-lymph node) elisendaweni. amakhwapha akhulisiwe. Kungaba futhi inguinal, futhi kuthinte ama-node atholakala emgodini. I-Adenomegaly ivame ukuvela ekucindezelekeni okukhulu kumasosha omzimba, lapho ama-lymph node ayingxenye ebalulekile.

I-Adenomegaly, kuyini?

Ngokwesayensi, i-adenomegaly isho ukwanda kosayizi wezindlala: leli gama livela kwelesiGreki, "adên" elisho "indlala" nelithi "mega" elisho okukhulu. I-Adenomegaly ngakho-ke ukwandiswa kwama-lymph node, kwesinye isikhathi abizwa nangokuthi ama-lymph node, kulandela ukutheleleka ngegciwane, amabhaktheriya noma amagciwane, noma okubangelwa isimila, ikakhulukazi.

Ama-lymph node angamaqhubu atholakala ezitsheni ze-lymphatic ezindaweni ezithile zomzimba:

• Ama-lymph node ku-mediastinum atholakala ku-mediastinum, indawo emaphakathi yezimbambo (ephakathi kwamaphaphu amabili, eduze kwenhliziyo, i-trachea, i-bronchi ne-esophagus). Uma zikhulisiwe, sizokhuluma nge-mediastinal lymphadenopathy.
• Ama-lymph nodes omlomo wesibeletho atholakala entanyeni: lapho ubukhulu bawo bukhula, kukhona i-lymphadenopathy yomlomo wesibeletho.
• Uma i-adenomegaly ithinta ama-lymph node atholakala ngaphansi kwamakhwapha, ibizwa nge-axillary lymphadenopathy.
• Ekugcineni, lapho le hypertrophy ithinta ama-lymph node, angaba khona emgodini, sizovusa i-inguinal lymphadenopathy.

Ungayibona kanjani i-adenomegaly?

Ama-lymph nodes akhulisiwe avame ukugqanyiswa ngudokotela ngesikhathi sokuhlolwa komtholampilo. Kuku-palpation ngempela lapho udokotela ekwazi ukubona izigaxa ezingavamile kulawa ma-lymph nodes.

Isiguli ngezinye izikhathi singase sizizwe sisodwa ukubonakala “kwesigaxa” esincane noma “ubuningi” emakhwapheni, entanyeni noma embelekweni, ngezinye izikhathi kuhambisane nomkhuhlane.

Ezinye izindlela zingaqinisekisa ukuxilongwa, njenge-ultrasound nezinye izinhlobo zokuhlolwa kwe-imaging. Esikhathini somgogodla, ikakhulukazi, la ma-lymphadenopathies angaphakathi azokwenziwa asendaweni kusetshenziswa i-thoracic computed tomography, futhi ukuxilongwa kungatholakala, ngokuya ngendawo okuyo, nge-mediastinoscopy (ukuhlolwa kwe-mediastinum nge-endoscope), i-mediastinotomy (incision ye-mediastinum) noma i-thoracoscopy. I-Histology yenza ukuthi, ngokutadisha amaseli, ukuthola ukuthi ngabe i-lymphadenopathy iyingozi yini noma cha.

Izici zengozi

Abantu abangazinikeli ebungozini basengozini enkulu yokutheleleka, ngakho-ke bakhulisa i-adenomegaly: isibonelo, iziguli ezine-HIV, noma iziguli ezikwelashwa ngokuzivikela komzimba. 

Ukutheleleka uqobo kuyingozi ye-adenomegaly.

Izimbangela zama-lymph node akhulisiwe: zixhumanisa nendima yazo ekuvikeleni umzimba

Ama-lymph node ama-nodules asetshenziselwa ukuhlunga i-lymph. Baphinde badlale indima ebalulekile ekuphenduleni kwamasosha omzimba, ngakho-ke nasekuzivikelweni kwawo.

Ngakho-ke, kula ma-ganglia lapho kwethulwa khona ama-antigen emizimba yangaphandle (okuyizinto ezincane ezithathelwanayo, ezingaba ngama-bacterium, ama-virus noma ama-parasites), kumaseli amasosha omzimba abizwa nge-T and B lymphocyte. (okungukuthi, amangqamuzana amhlophe egazi).

Ukulandela lesi sethulo se-antigenic, impendulo yomzimba yokuzivikela emzimbeni izongena kuma-virus, noma amaseli angajwayelekile omzimba (imvamisa izicubu). Le mpendulo ibandakanya noma ukukhiqizwa kwamasosha omzimba ngama-lymphocyte e-B (okubuye kubizwe ngokuthi i-humoral immunity) noma impendulo yeselula, ebizwa nangokuthi i-cytotoxic response, ebandakanya i-CD8 T lymphocytes (impendulo ebizwa nangokuthi i-cell immunity). 

Kungenxa yalokhu kusebenze kokuphendula kwamasosha omzimba ngaphakathi kweqembu lezigelekeqe lapho kuchazwa khona i-hypertrophy esimweni se-adenomegaly: empeleni, inani lama-lymphocyte (okungukuthi amaseli e-ganglion) elandayo likhiqiza kakhulu ukwanda. ubukhulu be-lymph node. Ngaphezu kwalokho, kwenzeka futhi ukuthi amangqamuzana omdlavuza angene ku-lymph node, aphinde andise usayizi wawo. Amaseli okuvuvukala nawo angaphindaphindeka lapho, ngisho namaseli omzimba weqembu, okuholela kumdlavuza we-ganglia.

Izimbangela zeBenign

Ezinye izimbangela ezinobungozi besayizi ye-lymph node ekhulisiwe zifaka:

• i-sarcoidosis (isifo esijwayelekile somzimba wesizathu esingaziwa);
• isifo sofuba, sitholakale ikakhulukazi ngokulandela i-lymphadenopathy yangaphakathi;
• nezinye izifo ezithathelwanayo eselaphekayo, njenge-mononucleosis ebangelwa igciwane le-Epstein-Barr, njll.

Izimbangela ezimbi

Kunezimbangela eziyingozi, phakathi kwazo:

• izicubu, umdlavuza kanye nama-metastases, njenge-Hodgkin's noma i-non-Hodgkin's lymphomas, nayo evame ukutholakala nge-mediastinal lymphadenopathy (kulandela isifuba x-ray);
• izifo ezizimele: ikakhulukazi i-lupus, noma i-rheumatoid arthritis;
• izifo ezinzima kakhulu, njengalezo ezixhumene negciwane lengculazi, i-HIV, noma i-viral hepatitis, njll.

Izingozi eziyinhloko zezinkinga ze-adenomegaly, empeleni, zixhunywe ku-etiologies yayo:

• Endabeni yamathumba, i-pathology ingaphenduka ibe ngamathumba amabi noma ngisho nokuvela kwe-metastases, okungukuthi ukusatshalaliswa kwamangqamuzana omdlavuza kude ne-lymphadenopathy.
• Endabeni yokutheleleka nge-HIV, igciwane lengculazi, izinkinga yilezo zokuntuleka kokuzivikela komzimba, okungukuthi ukwanda kwengozi yokuthola zonke izinhlobo zezifo.
• Izifo ezizimele nazo zinokuziphendukela kwemvelo okunengozi yezinkinga ezinkulu, ezingadala ubuhlungu obukhulu kakhulu nokukhubazeka okukhulu.

Ukwelashwa kuzoba yileso sifo esitholwe maqondana ne-lymph node ekhulisiwe:

• ama-antibiotic noma ukwelashwa kwe-antiviral, noma ngisho ne-antiparasite, uma ukuba khona kwe-lymph node ekhulisiwe kungenxa ye-agent ye-pathogenic (amagciwane, igciwane noma i-parasite);
• ukwelashwa okulwa nomdlavuza esimweni se-tumor, esingase sihlanganise i-radiotherapy kanye ne-chemotherapy;
• ama-immunosuppressants, isibonelo esimweni sezifo ezizimele.
• Ukuhlinzwa, kwezinye izimo, kuzosusa i-node.

Ngakho-ke i-Adenomegaly iyisibonakaliso sokuthi kubalulekile ukuthola ngokushesha okukhulu, futhi ubike ngokushesha kudokotela wakho oya khona: owokugcina angenza ukuhlolwa kwemitholampilo ngokushaya izandla ngokushesha lapho kutholakala isisindo esingajwayelekile ezifundeni zomlomo wesibeletho, i-axillary noma inguinal, noma kutholwe ku-x-ray yesifuba sokulawula, ye-mediastinal lymphadenopathy. Lo chwepheshe wezokunakekelwa kwempilo anganquma ukuthi ikuphi ukwelashwa okufanele akuqale noma yimuphi uchwepheshe okufanele abonane naye. Ngakho-ke, lapho kulashwa imbangela ye-adenomegaly, maningi amathuba okuthi alulame.