I-central atypical cartilaginous tumor

ngu-Jason Wasserman MD PhD FRCPC kanye no-Bibianna Purgina MD FRCPC
February 29, 2024

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.

Yiziphi izimpawu ze-central atypical cartilaginous tumor?

Izimpawu ze-central atypical cartilaginous tumor 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 izimila ze-cartilaginous ezimaphakathi. Kubantu, ngaphandle kwe-enchondromatosis abahlakulela lolu hlobo lwesimila, imbangela ayikaziwa.

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

I-central atypical cartilaginous tumor kanye grade 1 chondrosarcoma amathumba afana kakhulu. Umehluko omkhulu phakathi kwalezi zimila ukuthi izimila ezimaphakathi ze-atypical cartilaginous 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.

Izici ezincane zalesi simila

Lapho ihlolwa ngaphansi kwe-microscope, isimila esimaphakathi se-atypical cartilaginous sakhiwe amaseli akhiqiza uhlobo lwezicubu ezixhumeneyo ezibizwa ngokuthi uqwanga. Amaseli wesimila avame ukukhula abe ngamaqembu ayindilinga abizwa ngokuthi ama-lobules. Izimila ze-cartilaginous ezimaphakathi zingabukeka zifana kakhulu nohlobo lwesimila esingenawo umdlavuza okuthiwa 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.

Ukunwetshwa kwe-Tumor

Izimila ezinkulu ze-atypical cartilaginous zingadabula ithambo futhi zikhule zibe izitho 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).

Amanqamu

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).

Imajini yesimila

Isigaba se-Pathologic (pTNM)

Isigaba se-pathologic se-central ACT sisekelwe ohlelweni lwesiteji lwe-TNM, uhlelo olwaziwayo emhlabeni wonke olwakhiwe 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 futhi esibi kakhulu isibikezelo. Isigaba se-pathologic sizofakwa kuphela embikweni wakho ngemva kokuba isimila sesisusiwe. Ngeke ifakwe ngemva kwe-biopsy.

Isiteji se-Tumor (pT)

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 seNodal (pN)

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.

Mayelana nalesi sihloko

Lesi sihloko sabhalwa odokotela ukuze bakusize ufunde futhi uqonde umbiko wakho we-pathology we-ACT. Izigaba ezingenhla zichaza imiphumela etholakala emibikweni eminingi ye-pathology, nokho, yonke imibiko ihlukile futhi imiphumela ingahluka. Okubalulekile, okunye kwalokhu kwaziswa kuzochazwa kuphela embikweni wakho ngemva kokuba sonke isimila sesikhishiwe ngokuhlinzwa futhi sahlolwa udokotela wezifo. Xhumana nathi uma unemibuzo mayelana nalesi sihloko noma umbiko wakho we-pathology. Funda lesi sihloko ukuze uthole isingeniso esijwayelekile ezingxenyeni zombiko we-pathology ojwayelekile.

Ezinye izinsiza eziwusizo

I-atlas ye-Pathology
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