I-central atypical cartilaginous tumor

ngu-Jason Wasserman MD PhD FRCPC kanye no-Bibianna Purgina MD FRCPC
September 5, 2022


Yini i-central atypical cartilaginous tumor?

I-central atypical cartilaginous tumor (ACT) uhlobo lomdlavuza wamathambo. Lesi simila sibizwa ngokuthi “i-cartilaginous” ngoba sakhiwe amangqamuzana akhiqiza uqwanga. I-cartilage wuhlobo lwezicubu ezixhumeneyo ezivame ukutholakala kuwo wonke umzimba. Lezi zimila ziqala ngaphakathi ethanjeni endaweni ebizwa ngokuthi “medulla”. Elinye igama lalesi simila yi-low-grade central chondrosarcoma.

Ingabe i-central atypical cartilaginous tumor iwuhlobo lomdlavuza?

Yebo, i-ACT emaphakathi wuhlobo lomdlavuza olubizwa ngokuthi a i-sarcoma. Isimila sithathwa njengesinolaka endaweni okusho ukuthi singasakazekela ezithweni nasezithweni ezizungezile. Kodwa-ke, kuyivelakancane kakhulu ukuthi i-ACT emaphakathi isabalale kwezinye izingxenye zomzimba.

Uyini umehluko phakathi kwe-central atypical cartilaginous tumor kanye ne-grade 1 central chondrosarcoma?

I-Central ACT kanye ne-grade 1 central chondrosarcoma yizimila ezifanayo kakhulu. Umehluko omkhulu phakathi kwalezi zimila ukuthi izenzo ezimaphakathi zitholakala kuhlaka lwamathambo e-appendicular oluhlanganisa amathambo ezingalo, imilenze, izandla nezinyawo. Ngokuphambene, i-chondrosarcomas ephakathi yebanga 1 itholakala ku-axial skeleton ehlanganisa amathambo e-pelvis, i-scapula, ne-skull.

Yiziphi izimpawu ze-central atypical cartilaginous tumor?

Izimpawu ze-ACT emaphakathi zihlanganisa ubuhlungu nokuvuvukala phezu kwethambo elihilelekile. Kodwa-ke, iziguli eziningi ezinalesi simila ngeke zibe nazimpawu futhi isimila sizotholakala ngengozi lapho kwenziwa isithombe ngesinye isizathu.

Yini ebangela i-central atypical cartilaginous tumor?

Abantu abane-genetic syndrome enchondromatosis abanokuguqulwa kwesakhi sofuzo i-IDH1 noma i-IDH2 basengozini enkulu yokuthuthukisa i-ACTs emaphakathi. Kubantu, ngaphandle kwe-enchondromatosis abathuthukisa i-ACT emaphakathi, imbangela ayikaziwa.

Ingabe i-central atypical cartilaginous tumor ibukeka kanjani ngaphansi kwe-microscope?

Uma ihlolwa ngaphansi kwe-microscope, i-ACT emaphakathi yenziwe ngamaseli akhiqiza uhlobo lwezicubu ezixhumeneyo ezibizwa ngokuthi i-cartilage. Amaseli wesimila avame ukukhula abe ngamaqembu ayindilinga abizwa ngokuthi ama-lobules. I-Central ACT ingabukeka ifana kakhulu nohlobo lwesimila esingenawo umdlavuza esibizwa ngokuthi i- i-enchondroma (esinye isimila esakhiwe amangqamuzana akhiqiza uqwanga), nokho, ngokungafani ne-enchondroma, amaseli wesimila ku-ACT emaphakathi angabonakala ekhula abe ithambo elizungezile.

I-central atypical cartilaginous tumor
I-Central atypical cartilaginous tumor. Isimila sakhiwe amangqamuzana akhiqiza uqwanga.
Ingabe isimila sisabalele ezithweni noma ezicutshini ezizungezile?

I-ACTS emaphakathi emikhulu ingadabula ithambo futhi ikhule ibe yizitho ezizungezile noma izicubu ezinjengemisipha, imisipha, noma isikhala esihlangene. Uma lokhu kwenzekile, kungase kufakwe embikweni wakho futhi ngokuvamile kuchazwa njengesandiso esimangalisayo. Uma isimila sesikhule saba enye ingxenye yethambo, lokho kuzobuye kuchazwe embikweni wakho. Ukunwetshwa kwesimila kubalulekile ngoba kusetshenziselwa ukunquma isigaba se-pathologic tumor (pT).

Iyini imajini?

A wekhasi yinoma yisiphi isicubu esasikwa udokotela ohlinzayo ukuze akhiphe ithambo (noma ingxenye yethambo) nesimila emzimbeni wakho. Kuye ngohlobo lokuhlinzwa oye wabhekana nakho, izinhlobo zamaphethelo, ezingase zihlanganisa i-proximal (ingxenye yethambo eliseduze nendawo ephakathi komzimba wakho) kanye ne-distal (ingxenye yethambo ekude kakhulu phakathi nomzimba wakho) amamajini, amaphethelo ezicubu ezithambile, amaphethelo emithambo yegazi, namaphethelo emizwa.

Wonke ama-margins azobhekwa ngokucophelela ngaphansi kwe-microscope udokotela wakho wezifo ukuze kutholakale isimo se-margin. Imajini ibhekwa njengenegethivu uma engekho amaseli omdlavuza emaphethelweni ezicubu ezisikiwe. Imajini ibhekwa njengenhle uma kunamaseli omdlavuza emaphethelweni ezicubu ezisikiwe. Imajini ephozithivu ihlotshaniswa nengozi enkulu yokuthi isimila sizophinde sikhule endaweni efanayo ngemva kokwelashwa (ukuphindaphinda kwendawo).

margin

Siyini isigaba se-pathologic se-central atypical cartilaginous tumor?

Isigaba se-pathologic se-central ACT sisekelwe ohlelweni lwesiteji lwe-TNM, uhlelo olwaziwayo emhlabeni wonke olwasungulwa I-American Joint Committee on Cancer. Lolu hlelo lusebenzisa ulwazi mayelana nesimila esiyinhloko (T), ama-lymph node (N), futhi kude i-metastatic isifo (M) ukucacisa isigaba esiphelele se-pathologic (pTNM). I-pathologist yakho izohlola izicubu ezithunyelwe bese inika ingxenye ngayinye inombolo. Ngokuvamile, inani eliphakeme lisho isifo esithuthuke kakhulu kanye nesibi kakhulu isibikezelo. Isigaba se-pathologic sizofakwa kuphela embikweni wakho ngemva kokuba isimila sesisusiwe. Ngeke ifakwe ngemva kwe-biopsy.

Isiteji se-Tumor (pT) se-central atypical cartilaginous tumor

I-Central ACT inikezwa isigaba se-pathologic tumor (pT) ukusuka ku-T1 kuya ku-T3 ngokusekelwe kusayizi wesimila kanye nenani lezimila ezitholakala ethanjeni.

  • pT1: Isimila ≤ 8 cm ngobukhulu obukhulu.
  • pT2I-Tumor> 8 cm ngobukhulu obukhulu.
  • pT3: Izimila ezingaqhubeki endaweni yamathambo ayisisekelo.
Isiteji se-Nodal (pN) se-central atypical cartilaginous tumor

I-Central ACT inikezwa isigaba se-pathologic nodal (pN) se-N0 noma i-N1 ngokusekelwe ekuhlolweni kwe ama-lymph node.

  • Nx - Awekho ama-lymph node athunyelwe ku-pathology ukuze ahlolwe.
  • N0 – Awekho amaseli omdlavuza atholakala kunoma iyiphi i-lymph nodes ehloliwe.
  • N1 - Amangqamuzana omdlavuza atholakala okungenani ku-lymph node eyodwa.
Isiteji se-Metastasis (pM) se-central atypical cartilaginous tumor

UMTHETHO Omaphakathi unikezwa isigaba se-metastatic kuphela uma ubukhona be i-metastasis kuqinisekiswe udokotela wezifo. Kunezigaba ezimbili ze-metastatic ze-ACT emaphakathi, i-M1a ne-M1b. Uma kune-metastasis yamaphaphu eqinisekisiwe, khona-ke isigaba se-tumor metastatic singu-1a.

Isigaba se-metastatic singanikezwa kuphela uma izicubu ezivela endaweni ekude zithunyelwa ukuze zihlolwe ukugula. Ngenxa yokuthi lesi sicubu asivamile ukuba khona, isigaba se-metastatic asikwazi ukunqunywa, futhi ngokuvamile asifakwa embikweni wakho.

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