I-adenoma ye-tubular yamathumbu amakhulu

nguJason Wasserman MD PhD FRCPC
April 8, 2024

I-adenoma ye-tubular iwuhlobo lwe i-polyp etholakala emathunjini amakhulu ahlanganisa ikholoni kanye ne-rectum. Iqala kusuka amaseli wezindlala ezimboza ingaphakathi lethumbu elikhulu. I-adenomas ye-tubular ibhekwa njengezimo eziyingozi ngoba, kuyilapho iningi likhona benign (ezingezona umdlavuza), zinamandla okuthi zikhule zibe umdlavuza wesikhumba obizwa ngokuthi i-adenocarcinoma ngokuhamba kwesikhathi uma ingelashwa. I-tubular adenomas ingenye yezinhlobo ezivame kakhulu zama-polyps ezitholakala ngesikhathi sokuhlolwa kwe-colonoscopy.

Izimpawu ze-adenomas ye-tubular

Iningi lama-tubular adenomas awabangeli zimpawu futhi avame ukutholwa ngengozi phakathi ne-colonoscopy evamile noma ucwaningo lokuthwebula olwenziwa ngenxa yesinye isizathu. Lapho kuvela izimpawu, zingase zihlanganisa:

• Igazi esitulweni noma ukopha kadoti.
• Ukushintsha kwemikhuba yamathumbu, njengokuqunjelwa noma isifo sohudo.
• Ubuhlungu besisu.

Yini ebangela i-adenoma ye-tubular?

Imbangela eqondile ye-tubular adenomas ayiqondwa ngokugcwele, kodwa kucatshangwa ukuthi ibangelwa inhlanganisela yezici zofuzo kanye nemvelo. Izinto eziyingozi ezingase zandise amathuba okuthuthukisa i-adenomas ye-tubula zifaka:

• Iminyaka yobudala (ivame kakhulu kubantu abangaphezu kweminyaka engama-50).
• Umlando womndeni womdlavuza we-colorectal noma ama-polyps.
• Ama-syndromes athile ofuzo, njenge-familia adenomatous polyposis (FAP).
• Izici zendlela yokuphila njengokudla, ukubhema, nokuntuleka kokuzivocavoca umzimba.

Kwenziwa kanjani lokhu kuxilongwa?

Ukuxilongwa kwe-adenoma ye-tubula kungenziwa kuphela ngemva kokuba ingxenye noma yonke i-adenoma isusiwe, futhi izicubu zihlolwe ngaphansi kwe-microscope yi-pathologist. I-adenoma ingasuswa ibe yisiqephu esisodwa noma izingcezu eziningi.

Ibukeka kanjani i-adenoma ye-tubular ngaphansi kwe-microscope?

Ngaphansi kwe-microscope, i-adenoma ye-tubular yamathumbu amakhulu ngokuvamile ibonakala njenge-polyp phezu kwesiqu (i-pedunculated), eyakhiwe i-dysplastic amaseli we-epithelial ukwakha izindlala ezimise okweshubhu. Uma kuqhathaniswa namaseli avamile, lawa maseli e-dysplastic abonisa ukwanda nyukliya usayizi, i-hyperchromasia (ukwanda kokuqina kwamabala), nangaphezulu nucleus-ku-icyoplasm isilinganiso. Ngokuphambene, a i-adenoma ye-tubulovillous iqukethe ingxube yazo zombili izakhiwo ezinonya kanye ne-tubular, kanye a i-adenoma embi yakhiwe kakhulukazi izakhiwo ezinonya.

I-Dysplasia yebanga eliphansi nephezulu ku-adenoma ye-tubular

Wonke ama-tubular adenoma akhombisa iphethini yokukhula engavamile ebizwa umabhebhana. I-Dysplasia ibalulekile ngoba iwushintsho oluyingozi olungase lube umdlavuza ngokuhamba kwesikhathi. Lapho uhlola i-adenoma ye-tubular, izazi ze-pathologists zihlukanisa i-dysplasia zibe amazinga amabili: i-dysplasia yebanga eliphansi kanye ne-high grade dysplasia.

I-adenoma ye-tubular ene-low grade dysplasia

I-dysplasia yezinga eliphansi ushintsho lwangaphambi komdlavuza olubonakala kuma-adenomas amaningi. Uma ishiywe ingalashwa, i-dysplasia yebanga eliphansi ingashintsha ibe yi-dysplasia yebanga eliphezulu noma umdlavuza ngokuhamba kwesikhathi. Nokho, ingozi iyonke yalolu shintsho incane.

I-adenoma ye-tubular ene-high grade dysplasia

I-dysplasia yezinga eliphezulu inguquko ethuthuke kakhudlwana ye-precancerous ebonwa abambalwa be-tubular adenomas. Uma ingelashwa, i-tubular adenomas ene-high grade dysplasia ingaphenduka uhlobo lomdlavuza wekoloni olubizwa ngokuthi. i-adenocarcinoma. Uma kunokwenzeka, zonke i-adenomas ye-tubular ene-high grade dysplasia kufanele isuswe ngokuphelele.

Amamajini

A wekhasi yinoma yisiphi izicubu udokotela ohlinzayo asika ukuze akhiphe i-adenoma eshubhu emzimbeni wakho. I-Dysplasia onqenqemeni lwesicubu kusho ukuthi izicubu ezingavamile kungenzeka ukuthi azizange zikhishwe ngokuphelele emzimbeni.

Amanye ama-tubular adenoma akhula esiqeshini sethishu okuthiwa isiqu, futhi i-adenoma isuswa ngokusika isiqu. Kulezi zimo, umkhawulo uyingxenye yesiqu esisikiwe. Kodwa-ke, ama-adenomas amaningi ashubhu ayasuswa futhi athunyelwe ku-pathology njengezicucu eziningi (izingcezu) zezicubu. Kulezi zimo, kungase kungenzeki ngodokotela wakho wezifo ukuthi anqume ukuthi yiluphi ucezu oluwumkhawulo wangempela futhi izinguquko ezibonwa emaphethelweni ngeke zichazwe embikweni wakho.