I-Tubulovillous adenoma yamathumbu amakhulu

nguJason Wasserman MD PhD FRCPC
April 9, 2024

I-adenoma ye-tubulovillous iwuhlobo lwe i-polyp etholakala emathunjini amakhulu, kuhlanganise nekholoni kanye ne-rectum. Iqala kusuka amaseli wezindlala ezimboza ingaphakathi lamathumbu. I-Tubulovillous adenomas ibhekwa njengezimo eziyingozi ngoba, kuyilapho iningi likhona benign (ezingezona umdlavuza), zinamandla okuthi zikhule zibe umdlavuza wesikhumba obizwa ngokuthi i-adenocarcinoma ngokuhamba kwesikhathi uma ingelashwa.

Izimpawu ze-adenoma ye-tubulovillous

Ama-adenomas e-Tubulovilous ngokuvamile awabangeli noma yiziphi izimpawu, ikakhulukazi ezigabeni zokuqala, futhi ngokuvamile atholakala ngesikhathi sokuhlolwa kwe-colonoscopy evamile. Lapho kuvela izimpawu, zingase zihlanganisa:

• Igazi esitulweni noma ukopha kadoti.
• I-Mucus esitokisini.
• Ukushintsha kwemikhuba yamathumbu, njengokuhuda noma ukuqunjelwa.
• Ubuhlungu besisu noma ukungakhululeki.

Kwezinye izimo, i-adenomas enkulu ingaholela ezindabeni ezibaluleke kakhulu njengokuvinjwa kwamathumbu noma kube nomthelela ekuntulekeni kwe-iron anemia ngenxa yokulahleka kwegazi okungapheli.

Yini ebangela i-adenoma ye-tubulovillous

Ukuthuthukiswa kwe-tubulovillous adenomas kuthonywa inhlanganisela yezinto zofuzo nezemvelo, nakuba imbangela yangempela ingaqondwa ngokugcwele. Izinto eziyingozi ezaziwayo zihlanganisa:

• Ukuguga, okunobungozi obukhulu kubantu abangaphezu kweminyaka engama-50.
• Umlando womndeni womdlavuza we-colorectal noma ama-polyps adenomatous.
• Izici zendlela yokuphila, okuhlanganisa ukudla, ukungawuvivinyi umzimba, ukukhuluphala, nokubhema.
• Izimo ezithile zofuzo, njenge-familia adenomatous polyposis (FAP) kanye ne-Lynch syndrome.

Kwenziwa kanjani lokhu kuxilongwa?

Ukuxilongwa kwe-tubulovillous adenoma kungenziwa kuphela ngemva kokususwa kwengxenye noma yonke i-adenoma, futhi izicubu zihlolwa ngesibonakhulu ngudokotela wezifo. I-adenoma ingasuswa ibe yisiqephu esisodwa noma izingcezu eziningi.

Izici ze-Microscopic

I-adenoma ye-tubulovillous yamathumbu amakhulu ibonisa izici zakho zombili ishubhu futhi enonya i-adenoma. I-adenoma yenziwe i-dysplastic amaseli we-epithelial ukwakha ama-tubular (i-glandular) kanye nezakhiwo ezimbi (ezifana neminwe), yingakho igama. Uma kuqhathaniswa namaseli avamile, lawa maseli e-dysplastic abonisa ukwanda nyukliya usayizi, i-hyperchromasia (ukwanda kokuqina kwamabala), nangaphezulu nucleus-ku-icyoplasm isilinganiso.

I-Dysplasia yebanga eliphansi uma iqhathaniswa nephezulu ku-adenoma ye-tubulovillous

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

I-Tubulovilous adenoma ene-low grade dysplasia

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

I-Tubulovilous adenoma ene-high grade dysplasia

I-dysplasia yezinga eliphezulu wushintsho oluthuthuke kakhudlwana lwe-precancerous olubonakala enanini elincane lama-tubulovillous adenomas. Uma ingelashwa, i-tubulovillous adenomas ene-high grade dysplasia ingaphenduka uhlobo lomdlavuza wekoloni olubizwa ngokuthi. i-adenocarcinoma engavamile. Uma kungenzeka, wonke ama-adenomas e-tubulovillous ane-high grade dysplasia kufanele asuswe ngokuphelele.

Amamajini

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

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