I-colitis engapheli

nguJason Wasserman MD PhD FRCPC
Mashi 7, 2023

Kuyini i-colitis engapheli?

I-Chronic colitis yisimo lapho amangqamuzana omzimba omzimba ehlasela futhi alimaza izicubu ezimboze ingaphakathi lekholoni. Isifo sohudo esingamahlalakhona sibonakala esifweni esivuvukalayo samathumbu okuhlanganisa nesifo sikaCrohn kanye ne-ulcerative colitis.

Yiziphi izimpawu ze-colitis engapheli?

Ukuvuvukala kukholoni kulimaza amaseli amboze ingaphakathi lekholoni. Lokhu kuvimbela ikholoni ekusebenzeni ngendlela evamile. Amangqamuzana alimele awakwazi ukumunca amanzi futhi iziguli ezinesifo sohudo esingamahlalakhona zivame ukuba nesifo sohudo. Ezinye izimpawu ze-colitis engapheli zihlanganisa ubuhlungu besisu, ukuqunjelwa, indle enegazi, nokuncipha kwesisindo.

Yini ebangela i-colitis engapheli?

Isizathu esivame kakhulu se-colitis engapheli i-inflammatory bowel disease (IBD). Kunezinhlobo ezimbili zezifo zamathumbu okuvuvukala, i-ulcerative colitis, nesifo sikaCrohn. Ngenxa yokuthi zombili izinhlobo ze-IBD zingabukeka zifana lapho zihlolwa ngaphansi kwesibonakhulu, udokotela wakho wezifo angase angakwazi ukusho ukuthi izinguquko ezibonwa kusampula yakho yezicubu zibangelwa yi-ulcerative colitis noma isifo sikaCrohn.

Odokotela bakho bazosebenzisa ulwazi olusembikweni wakho we-pathology kanye nolunye ulwazi abaluqoqile (isb abakubona ngesikhathi se-colonoscopy nezinye izimpawu ozibikile) ukuze banqume ukuthi kungenziwa yini ukuhlonzwa kohlobo oluthile lwe-IBD. Ngezinye izikhathi lapho ukuvuvukala kusebenza, kungaba nzima ukuhlukanisa phakathi kwezinhlobo ezimbili ze-IBD.

Izazi ze-pathologists zikwenza kanjani ukuxilonga kwe-colitis engapheli?

Uma udokotela wakho esola ukuthi unayo ukuvuvukala kukholoni yakho, bazokwenza i-colonoscopy. I-colonoscopy iyinqubo lapho kusetshenziswa ikhamera encane ukubona ingaphakathi lekholoni yakho. Ukunquma ukuthi ukuvuvukala kukhona yini, bazothatha amasampula ezicubu, abizwa biopsies. Ngenxa yokuthi i-colitis engapheli ingenzeka engxenyeni eyodwa yekholoni kodwa hhayi kwenye, cishe bayothatha ama-biopsies amaningi kuwo wonke ubude bekholoni. I-pathologist yakho izobe isihlola lawa ma-biopsies ngaphansi kwesibonakhulu ukuze anqume ukuthi ukuqunjelwa okungapheli kukhona yini.

Kusho ukuthini ukungapheli embikweni we-pathology we-colitis engapheli?

Lapho behlola i-biopsy ephuma kukholoni, izazi zezifo zisebenzisa igama elithi chronicity ukuchaza izinguquko ezibangelwa ukuhlala isikhathi eside noma ukuvuvukala okungapheli. Lezi zinguquko zihlanganisa ukuhlanekezela kwe-crypt, i-basal lymphoplasmacytosis, ne-Paneth cell metaplasia. Lezi zinguquko zichazwe kabanzi ezigabeni ezingezansi.

Kusho ukuthini umsebenzi embikweni we-pathology we-colitis engapheli?

Lapho behlola i-biopsy ephuma kukholoni, izazi ze-pathologists zisebenzisa amagama athi umsebenzi noma osebenzayo ukuchaza ukulimala kwezicubu noma ukulimala okudalwe ukuqhubeka noma ukuvuvukala okukhulu. Izazi ze-pathologist zivame ukuhlukanisa umsebenzi ube amazinga amathathu - athambile, amaphakathi, futhi aqinile - ngokusekelwe ohlotsheni lokuvuvukala nokulimala okubonwa kusampula yethishu. Izinguquko ezihlotshaniswa nomsebenzi noma i-colitis esebenzayo zihlanganisa i-cryptitis, amathumba e-crypt, nezilonda. Lezi zinguquko zichazwe kabanzi ezigabeni ezingezansi.

Isho ukuthini i- quiescent colitis?

Iziguli ezithola ukwelashwa kwe-IBD zizobonisa izimpawu zokuqunjelwa okungapheli. I-colitis engapheli ngaphandle kokulimala okuqhubekayo noma ukuqunjelwa okusebenzayo kubizwa ngokuthi "i-quiescent colitis". Elinye igama le-quescent colitis i-inactive colitis.

Izinguquko ezihlobene nokuhlala isikhathi eside

Ukuhlanekezelwa kwe-Crypt

Ingaphakathi lekholoni limbozwe izindlala ezinde ezimise okweshubhu ezibizwa ngokuthi ama-crypts. Izazi ze-pathologists zisebenzisa igama elithi ukuhlanekezela ukuchaza izinguquko kusayizi nokuma kwe-crypts uma kuqhathaniswa nokujwayelekile. Ukuphazamiseka kwe-Crypt kubhekwa njengophawu lomonakalo wesikhathi eside. Lokhu kusho ukuthi ukuhlanekezela kwe-crypt kubonakala kuphela lapho ukuvuvukala sekuphele izinyanga noma iminyaka ekhona.

Ukuhlanekezela kwe-Crypt Architectural kungafaka okulandelayo:

• I-Atrophy - I-Atrophy ukulahlekelwa kwezicubu uma kuqhathaniswa nokujwayelekile. Ku-colon, i-atrophy isho ukuthi ama-crypts abonwayo mancane kune-crypts evamile, enempilo.
• Ukulahleka kwe-Crypt - Kukhona ukulahlekelwa okuphelele kwama-crypts kwezinye izindawo ze-mucosa.
• Ukuhlanganisa - Esikhundleni sokuba made futhi aqonde, lawa ma-crypts ahlukana ukuze akhe amagatsha amaningi.

I-Paneth cell metaplasia

Amaseli e-paneth ayingxenye evamile yomgudu wokugaya ukudla. Zivame ukutholakala emathunjini amancane kanye nohlangothi lwesokudla lwekholoni. Kodwa-ke, uma udokotela wakho wezifo ebona amaseli e-Paneth kusampula yezicubu ukusuka kwesokunxele sekholoni yakho, ayichaza njenge-Paneth cell metaplasia. Lokhu ukutholakala okungavamile okusho ukuthi kunomonakalo ongapheli ku- mucous kwekholoni yakho. I-Paneth cell metaplasia ibhekwa njengophawu lomonakalo wesikhathi eside. Kubonwa kuphela uma ukuvuvukala sekuphele izinyanga noma iminyaka ekhona.

I-Basal lymphoplasmacytosis

Ama-Lymphocyte futhi amaseli e-plasma amangqamuzana omzimba akhethekile asiza ukuvikela umzimba ekungenweni izifo. Izinombolo ezinkulu zama-lymphocyte namaseli e-plasma azivamile ukubonakala kukholoni enempilo. I-basal lymphoplasmacytosis igama elithi pathologists elisetshenziswa ukuchaza inani elikhulu lama-lymphocyte namaseli e-plasma ku-mucosa ezungeze ama-crypts. Uma udokotela wakho wezifo ebona eziningi zalezi zinhlobo zamaseli zicindezela futhi zifinyeza ama-crypts, kusho ukuthi amasosha omzimba awasebenzi kahle. I-basal lymphoplasmacytosis ibhekwa njengophawu lomonakalo wesikhathi eside. Kubonakala kuphela lapho ukuvuvukala sekunezinyanga noma iminyaka.

ama-granulomas

A i-granuloma iqoqo elihlelekile lamaseli omzimba. I-Granulomas iwuphawu lwe-colitis engapheli. Ukuba khona kwabo kubonisa ukuthi lesi simo sibangelwa isifo sikaCrohn kune-ulcerative colitis (lapho ama-granulomas engavamile ukubonakala). Amaseli omzimba aphakathi nendawo yegranuloma abizwa ama-hitiocyte futhi ngokuvamile ahlangana ndawonye akhe amangqamuzana amakhulu. Amanye ama-granulomas anongqimba olungaphandle luka-lama-ymphocyte, olunye uhlobo olukhethekile lwamangqamuzana omzimba omzimba asebenza ndawonye nama-histiocyte.

Izinguquko ezihlobene nomsebenzi

I-Cryptitis

I-Cryptitis igama elithi pathologists elisebenzisa ukuchaza okusebenzayo noma okuqhubekayo ukuvuvukala kukholoni. Ukuvuvukala okusebenzayo kuyimpendulo yokuqala yomzimba yokuzivikela ekulimaleni noma ezifweni futhi kuholwa amaseli omzimba akhethekile abizwa ama-neutrophils. Lapho ama-neutrophils ehlasela ama-crypts omzimba, abizwa ngokuthi i-cryptitis.

I-Cryptitis ingabonakala ezigabeni zokuqala zesifo ngaphambi kokuba kuvele ezinye izici zomonakalo wesikhathi eside (isb., ukuhlanekezelwa kwe-crypt, basal lymphoplasmacytosis, kanye ne-Paneth cell metaplasia). Ezigulini ezine-IBD, kungasho futhi ukuthi ukwelashwa okusetshenziswayo akusebenzi.

I-Crypt ithumba

I-Crypt ithumba elinye igama elithi pathologists elisetshenziswa ukuchaza elisebenzayo noma eliqhubekayo ukuvuvukala kukholoni. Kuyiqoqo le ama-neutrophils ezibonakala maphakathi ne-crypt (okungukuthi ngaphakathi kweshubhu yokuhlola). Amathumba ama-Crypt angabonakala ezigabeni zokuqala zesifo ngaphambi kokuba kuvele ezinye izici zomonakalo wesikhathi eside (isb., ukuhlanekezela kwe-crypt, basal lymphoplasmacytosis, kanye ne-Paneth cell metaplasia). Ezigulini ezine-IBD, kungasho futhi ukuthi ukwelashwa okusetshenziswayo akusebenzi.

Isilonda

Isilonda ichaza umonakalo omkhulu ohlobene nokulahlekelwa okuphelele kongqimba lwangaphakathi lwekholoni (i-mucosa). Kuwuphawu lokuthi ukuvuvukala idala umonakalo oqhubekayo kukholoni. Izilonda zingabonakala ezigabeni zokuqala zesifo ngaphambi kokuba kuvele ezinye izici zomonakalo wesikhathi eside (isb., ukuhlanekezelwa kwe-crypt, basal lymphoplasmacytosis, kanye ne-Paneth cell metaplasia). Ezigulini ezine-IBD, kungasho futhi ukuthi ukwelashwa okusetshenziswayo akusebenzi. Kuvame kakhulu ku-ulcerative colitis, kodwa kungabonakala nasesifo sikaCrohn.