Adenomegaly yog qhov loj ntawm cov qog nqaij hlav, qhov loj tuaj yeem tshwm sim los ntawm cov kab mob los yog kab mob, los yog txuas nrog cov qog nqaij hlav, tshwj xeeb.

Thaum nws cuam tshuam cov ganglia ntawm mediastinum, nws yog mediastinal lymphadenopathy, lub ncauj tsev menyuam lymphadenopathy yog tias qhov nce hauv ntim cuam tshuam rau cov qog ntshav ntawm lub caj dab, lossis cov qog ntshav qog ntshav thaum cov no yog cov qog ntshav qab zib (lwm lub npe lymphadenopathy) nyob hauv armpits uas yog enlarged. Nws tuaj yeem yog inguinal, thiab cuam tshuam rau cov nodes nyob hauv puab tais. Adenomegaly feem ntau tshwm sim los ntawm ib qho tseem ceeb ntawm lub cev tiv thaiv kab mob, uas cov qog nqaij hlav yog ib feem tseem ceeb.

Adenomegaly, yog dab tsi?

Etymologically, adenomegaly txhais tau hais tias qhov loj ntawm cov qog: lo lus no los ntawm Greek, "adên" uas txhais tau tias "gland" thiab "mega" uas txhais tau tias loj. Adenomegaly yog li ntawd ib qho loj ntawm cov qog nqaij hlav, qee zaum kuj hu ua lymph nodes, tom qab kis los ntawm tus kab mob, kab mob los yog cab, los yog tshwm sim los ntawm qog, tshwj xeeb.

Lymph nodes yog cov nodules nyob rau hauv cov hlab ntsha lymphatic hauv qee qhov chaw ntawm lub cev:

• Lymph nodes nyob rau hauv lub mediastinum nyob rau hauv lub mediastinum, nruab nrab cheeb tsam ntawm lub tav tawb (nyob nruab nrab ntawm ob lub ntsws, nyob ze lub plawv, trachea, bronchi, thiab txoj hlab pas). Yog tias lawv loj, peb yuav hais txog mediastinal lymphadenopathy.
• Cov qog nqaij hlav hauv tsev menyuam nyob hauv caj dab: thaum lawv loj tuaj, muaj cov qog nqaij hlav hauv tsev menyuam.
• Yog hais tias tus adenomegaly txhawj xeeb txog cov qog nqaij hlav hauv qab ntawm caj npab, nws hu ua axillary lymphadenopathy.
• Thaum kawg, thaum qhov hypertrophy no cuam tshuam rau cov qog nqaij hlav inguinal, txawm nyob hauv puab tais, peb yuav ua rau inguinal lymphadenopathy.

Yuav ua li cas paub txog adenomegaly?

Cov qog nqaij hlav loj no feem ntau tau hais qhia los ntawm tus kws kho mob thaum kuaj mob. Nws yog qhov tseeb ntawm palpation uas tus kws kho mob tuaj yeem kuaj pom cov qog txawv txav hauv cov qog ntshav no.

Tus neeg mob tej zaum yuav hnov ​​​​ntawm nws tus kheej qhov tsos ntawm "pob" me me los yog "ntau" nyob rau hauv ob txhais tes, caj dab los yog puab tais, qee zaum nrog kub taub hau.

Lwm txoj hauv kev tuaj yeem lees paub qhov kev kuaj mob, xws li ultrasound thiab lwm yam kev kuaj pom. Nyob rau hauv lub thorax, tshwj xeeb tshaj yog, cov mediastinal lymphadenopathies yuav nyob hauv cheeb tsam siv thoracic xam tomography, thiab kev kuaj mob kuj tuaj yeem tau txais, nyob ntawm lawv qhov chaw, los ntawm mediastinoscopy (kev tshuaj xyuas ntawm mediastinum los ntawm kev siv endoscope), mediastinotomy (kev txiav ntawm mediastinum). los yog thoracoscopy. Histology ua rau nws ua tau, los ntawm kev kawm cov hlwb, los txiav txim seb puas los yog tsis yog lymphadenopathy malignant.

Risk yam tseem ceeb

Immunocompromised cov neeg muaj kev pheej hmoo ntau dua ntawm kev kis kab mob, thiab yog li ntawm kev txhim kho adenomegaly: cov neeg mob HIV, piv txwv li, los yog cov neeg mob ntawm kev siv tshuaj tiv thaiv kab mob. 

Tus kab mob nws tus kheej yog qhov muaj feem cuam tshuam rau adenomegaly.

Ua rau cov qog ntshav loj: txuas rau lawv lub luag haujlwm hauv kev tiv thaiv kab mob

Lymph nodes yog cov nodules siv los lim cov qog ntshav. Lawv kuj ua lub luag haujlwm tseem ceeb hauv lub cev tiv thaiv kab mob, thiab yog li ntawd hauv nws cov kev tiv thaiv.

Yog li, nws yog nyob rau hauv cov ganglia uas nthuav tawm cov antigens ntawm txawv teb chaws lub cev (uas yog cov kab mob sib kis, uas tuaj yeem yog cov kab mob, kab mob lossis kab mob cab), rau cov hlwb ntawm lub cev tiv thaiv kab mob hu ua T thiab B lymphocytes. (xws li cov qe ntshav dawb).

Tom qab qhov kev nthuav qhia antigenic no, lub cev lub cev tiv thaiv kab mob yuav tawm tsam cov kab mob sib kis, lossis lub cev tsis zoo ntawm cov hlwb (feem ntau cov qog). Cov lus teb no suav nrog kev tsim cov tshuaj tiv thaiv los ntawm B lymphocytes (tseem hu ua humoral immunity) lossis cov lus teb ntawm tes, tseem hu ua cytotoxic teb, uas suav nrog CD8 T lymphocytes (ib qho lus teb tseem hu ua cellular immunity). 

Nws yog los ntawm qhov kev ua kom lub cev tiv thaiv kab mob hauv lub ganglion uas qhov hypertrophy pom nyob rau hauv cov ntaub ntawv ntawm adenomegaly yuav piav qhia: qhov tseeb, tus naj npawb ntawm lymphocytes (xws li cov hlwb ntawm ganglion) kev sib tw ua kom muaj zog ntxiv. qhov loj ntawm lymph node. Tsis tas li ntawd, nws kuj tshwm sim tias cov qog nqaij hlav qog nqaij hlav nkag mus rau cov qog nqaij hlav, rov ua kom nws loj dua. Cov kab mob o tuaj yeem ua rau muaj ntau ntxiv, txawm tias ganglion tus kheej lub cev tiv thaiv kab mob, ua rau mob qog noj ntshav ntawm ganglia.

Benign ua

Qee qhov ua rau mob qog nqaij hlav loj hlob tuaj xws li:

• sarcoidosis (ib kab mob dav dav ntawm lub cev tsis paub txog qhov ua rau);
• tuberculosis, pom tshwj xeeb tshaj yog tom qab mediastinal lymphadenopathy;
• thiab lwm yam kab mob uas kho tau, xws li mononucleosis tshwm sim los ntawm Epstein-Barr tus kab mob, thiab lwm yam.

Malignant ua rau

Muaj cov laj thawj malignant, ntawm cov uas:

• qog nqaij hlav, qog nqaij hlav thiab metastases, xws li Hodgkin's lossis non-Hodgkin's lymphomas, kuj feem ntau kuaj tau los ntawm mediastinal lymphadenopathy (ua raws hauv siab x-ray);
• kab mob autoimmune: tshwj xeeb lupus, lossis mob caj dab rheumatoid;
• Cov kab mob hnyav dua, xws li txuas rau tus kab mob AIDS, HIV, lossis kab mob siab, thiab lwm yam.

Cov kev pheej hmoo tseem ceeb ntawm cov teeb meem ntawm adenomegaly yog, qhov tseeb, txuas rau nws cov etiologies:

• Nyob rau hauv cov ntaub ntawv ntawm cov qog, cov pathology tuaj yeem hloov mus rau hauv cov qog qog nqaij hlav lossis txawm tias cov tsos mob ntawm metastases, uas yog hais txog kev nthuav tawm ntawm cov qog nqaij hlav cancer ntawm qhov deb ntawm lymphadenopathy.
• Nyob rau hauv cov ntaub ntawv ntawm kev kis tus kab mob HIV, tus kab mob AIDS, cov teeb meem yog cov kis tau tus kab mob immunodeficiency, piv txwv li, muaj kev pheej hmoo ntawm kev cog lus rau txhua hom kab mob.
• Cov kab mob autoimmune kuj muaj kev hloov pauv nrog kev pheej hmoo ntawm cov teeb meem tseem ceeb, uas tuaj yeem ua rau mob hnyav thiab xiam oob qhab loj.

Kev kho mob yuav yog tus kab mob kuaj pom nyob rau hauv kev sib txuas nrog cov qog nqaij hlav loj:

• tshuaj tua kab mob los yog tshuaj tua kab mob, lossis txawm tias tshuaj tua kab mob, yog tias muaj cov qog nqaij hlav loj vim yog tus kab mob (cov kab mob, kab mob lossis kab mob cab);
• anti-cancer kho mob nyob rau hauv cov ntaub ntawv ntawm ib tug qog, uas yuav ua ke nrog radiotherapy thiab chemotherapy;
• immunosuppressants, piv txwv li, nyob rau hauv cov ntaub ntawv ntawm autoimmune kab mob.
• Kev phais, qee zaum, yuav tshem tawm cov node.

Adenomegaly yog cov tsos mob uas nws yog ib qho tseem ceeb kom kuaj tau sai li sai tau, thiab qhia sai sai rau koj tus kws kho mob uas tuaj koom: tom kawg tuaj yeem ua qhov kev kuaj mob los ntawm palpation sai li sai tau thaum muaj qhov txawv txav ntawm lub ncauj tsev menyuam, axillary lossis inguinal cheeb tsam, los yog kuaj pom ntawm lub hauv siab x-ray, rau mediastinal lymphadenopathy. Tus kws kho mob no tuaj yeem txiav txim siab seb qhov kev kho mob twg yuav pib lossis tus kws kho mob tshwj xeeb los sab laj. Yog li, qhov ua kom sai ntawm adenomegaly raug kho, lub sijhawm rov qab ntau dua.