Leukemoid siyana vari vana: mhando (kwemarudzi), zvinokonzera, chirwere algorithm kurapwa. Leukemoid siyana uye neleukemia: kusiyana

Leukemoid maitiro - anoshandura hematopoiesis, akafanana ropa mufananidzo mune neleukemia uye mamwe mapundu ose hematopoietic hurongwa. Zvinofanira kucherechedzwa kuti specificity kuti zvinokonzerwa izvi ndizvo zvavo zvevhiki vanoshingaira uye kushaya yokuchinjira mune kenza. Maitiro aya zvinogona kukonzerwa siyana mhando intoxications, namamota, zvirwere, metastatic kenza uropi.

Mashandiro okukura kunosiyana-siyana pamwe mhando dzakasiyana wanda: mune zvimwe zviitiko zviri goho mu saibva eropa okunze, vamwe - kwakawedzerwa masero eropa kana akavarambidza kuti goho masero ari zvinyama, kana kuvapo zvigadziriswe anoverengeka panguva imwe chete.

Chii chingava anokonzera chirwere?

Kune zvinhu zvizhinji zvingaitika zvakafanira leukemoid kuita. Zvikonzero kukura kwavo vari:

• simba ionizing mwaranzi;
• tiibhii;
• sepsis;
• purulent pezvakaitwa;
• manyoka;
• Hodgkin nehosha;
• cranial kunotevera;
• kugwinha;
• lobar nemabayo;
• erysipelas;
• diphtheria;
• nezvitsvuku fivhiri;
• chenjera chiropa dystrophy;
• corticoid kurapa;
• carbon monoxide chepfu.

mhando chirwere

Marudzi anotevera wanda leukemoid:

• Myeloid kuita.
• Lymphocytic.
• Psevdoblastnye.

Ngatikurukurei chimwe nechimwe chazvo zvizere.

myeloid

By kwakadai kuita anosanganisira akadai neutrophil, eosinophil uye promyelocytic. Leukemoid Migumisiro yakafanana chisingaperi myeloid neleukemia, achiperekedzwa kudhaka uye zvirwere zvikuru. Active leukocytosis kumboda nguva dzose ane yakaoma muitiro pamwe nokuvapo sepsis, anogumbura foci uye kwakawedzera muviri tembiricha.

Kuonana zvinopfuura eosinophils muropa zvinoodza kuitika apo sensitization kuti tupukanana uye zvinodhaka, sema diathesis, kashoma - panguva oncological zvirwere (Hodgkin nehosha uye lymphosarcoma). Maitiro aya leukemoid vanoda kuti misoro kuongorora kuti kero zvirwere kweropa ezvinhu, uye nehonye.

Vanoteerera masero akaita eritremii. polycythemia Zvinhu - kazhinji ndiyo vasanyanye zvirwere zvemapapu oxygenation (oxygenation) ropa, itsvo namamota, uye vachiberekwa mwoyo chirwere. Izvi zvinoda nekombiyuta uye Ultrasound.

Mielemiya kufanana rikwanise erythroleukemia, iyo yakasiyana chete kushaya Nokufema erythrocytes mu mwongo uye ropa. Kazhinji zvinoita kuti rione metastases mune mapfupa chirwere.

lymphocytic

Maitiro aya dzinoratidzwa kuwedzera uwandu lymphocytes mu peripheral ropa, iro kunowanzokonzera kuwedzera chiropa, node nodes uye chirwatata.

To ichi mhando ndezvomunhu mononucleosis, kutapuriranwa lymphocytosis, monocyte-macrophage leukemoid siyana mune vana vane utachiona uye kutapukirwa noutachiona, uye parasitic noutachiona uye BP eosinophilia (semuenzaniso, helminthiasis).

Lymphocytic kuitike:

• kutapukirwa noutachiona (huku pox, rubella, mumps, adenovirus noutachiona, gwirikwiti, kutapuriranwa mononucleosis);
• parasitic Zvirwere (rikketsiozah, toxoplasmosis, chlamydia);
• zvinokonzerwa noutachiona (njovhera, pertussis, tiibhii);
• siyana mycoses;
• autoimmune zvirwere (serum chirwere, chinonzi systemic lupus erythematosus).

Lymphocytic mhando zvakawanda zvakajairika macroglobulinemia Waldenstrom, kuzvimba, sarcoidosis. Zvose pamusoro zvirwere vabatwe inokoshesa chaizvo uye zvinogona kuvhiringidza kuti murwere pane gore.

Psevdoblastnye

Maitiro akadaro leukemoid kana murwere chete kutanga kubuda kubva masoja agranulocytosis, chikonzero izvo zvinogona kukonzerwa negashiro sulfonamides, "aminopyrine," "butadiene" uye zvimwe zvinodhaka.

Nokuti vakadaro Migumisiro boka inozivikanwa nokuvapo iri peripheral ropa uye mwongo vakawanda cellular zvinoriumba ane homogeneous chinoumba, uye zvitema kuroorwa nucleoli, mutete, isina granular cytoplasm.

Kusiyana nezvaiitwa Kurira erythrocytes mu network idzi vane chaiyo nyoro uye akayera chromatin fibers. Mugari blastosis kunyangarika pasina mishonga uye anoenderana leukemoid zvinofurira zvinowanikwa vana vachangoberekwa pamwe magene chromosomal zvinetso (semuenzaniso, syndrome).

Leukemoid maitiro mhando zvakatendeka kukurukurwa apa, izvo yakaumbwa pamusoro mamiriro upi zvokurwara, kazhinji regai kukonzera matambudziko ngozi. Dzimwe nguva chaizvo akazviratidza thrombocytopenia anogona zvisizvo ionekwe somumwe zviratidzo ose rikwanise neleukemia. The kuonekwa immunoblastic lymphadenites wandei kukosha ndiyo yakachengeteka zvakasikwa nemamiriro node raiva pedyo nebundu, uyewo zvakarurama kuona mutsara follicles.

Leukemoid siyana uye neleukemia: kusiyana

Pane zvimwe kusiyana pakati zvinokonzerwa uye neleukemia, kureva vakadaro:

1. Kana leukemoid rejuvenation siyana Offline nokukurumidza mumwongo ndiwo metamielotsitarnym uye padzakacherechedza kuwedzera neleukemia kwebhosvo siyana. Kana leukemoid Migumisiro akaponesa erythroid utachiona, pane zvinoitika leykoeritroblasticheskoe reshiyo - 3: 1, uye 4: 1.
2. Kwete kuratidzwa runoonekwa pakati anaplasia pamwe leukemoid mananara sezvo zvinoitika muna neleukemia kana paine bulging pamusoro protoplasm uye musimboti anomaly.
3. Muzana rokutanga musimboti, muna peripheral ropa yave kuwedzera yakakwana nhamba uye chikamu yakawedzera neutrophils vakura vari neleukemia kugutsikana zvinoderedza neutrophils vakura rinowanika kunyanya kuwanda vaduku, saibva siyana.
4. Kana leukemoid kuita kazhinji vakachengeta hunokachidza granularity pamusoro neutrophils.
5. Kana cytochemical yokudzidza leukocytes mu neleukemia vasanyanye kana kusavapo ane alkaline phosphatase, panguva leukemoid siyana - rakawedzerwa.
6. Panguva exacerbation echirwere myeloid neleukemia kwebhosvo dambudziko nhungamiri ndiko eosinophilic, basophilic kushamwaridzana leukemoid siyana nayo offline.
7. Kana myeloid neleukemia kazhinji ane mukuru thrombocytosis, pamwe leukemoid siyana platelet kuverenga mukati inowanzotorwa siyana.
8. In kwokutanga nzendo chisingaperi myeloid neleukemia kuwana guru gobvu chirwatata panguva leukemoid siyana dzimwe nguva zvinoitika splenomegaly, asi muviri nyoro uye haana nepaanogona guru chaizvo kukura.
9. Kana leukemoid kuita kuti neoplastic muitiro dzakaonekwa mu mumwongo kenza.

Leukemoid kuita vana: chirwere algorithm

Basa rinokosha chirwere chirwere anopiwa histopathology kuti rinoongorora biopsy zvinhu. Asi kuti kudzivisa irreparable zvikanganiso, iye pathologist anofanira kuunganidza mashoko echokwadi pamusoro murwere, umupe kutungamirirwa nemiedzo yakasiyana-siyana uye kugadza cytostatic kurapwa, iyo inobvisa zvose zvakaipira lymphadenitis. Kana izvi zvose hazvina kuitwa, chirwere chinoitwa nemazvo, uye saka kutsungirira chirwere achava zvakaoma chaizvo. Pashure pezvose, chirwere ichi ngozi chaizvo. Dzimwe nguva, nokuti kuguma mashoko anodiwa kuita wodzokorora biopsy.

Wandei kukosha mune diagnosing munhu zodzera nechitarisiko node raiva pedyo nebundu biopsies uye rupawo. Kana dzakawanda erythrocyte lymphosarcoma (Minimum 30 muzana) wakabura kugara kwebhosvo masero. With erythrocytes akadaro immunoblastic lymphadenitis, kazhinji asingasviki 10 muzana, vari akasiyana panyaya basophilia ose cytoplasm uye neerekitironi kukura.

Histopathological chirwere pamusoro kuongorora node raiva pedyo nebundu anofanira hwakadzama zvikuru uye dzakakudzingai kururama mhedziso. Nekuti histopathology yezvidzidzo ropa siyana vanofanira kutsanangura zvakajeka chirwere, uye izvi zvinoratidzwa mhedziso. Somuenzaniso, nokuti kutanga zvokuongorora pamusoro benign rwekenza yelymphoma, mune zvimwe zviitiko, nguva refu kuchengeta murwere uye kuongorora node nodes zvakare.

Chirwere leukemoid siyana vanofungidzirwa apo Detective monoclonal immunoglobulin dzimwe nguva kunoda inodzokororwa uye kwenguva refu zvaanorumbidza kuti mwongo ponji. Asati mvumo nechirwere kenza mishonga iri contraindicated.

kutsvodana chirwere

Chimwe chirwere rinonzi Filatov - Pfeyferra, glandular nefivha uye monocytic angina. Zviri nemavhairasi chirwere hwokuratidza lymphocyte kwebhosvo kusanduka, kuwedzere node nodes uye chirwatata, reactive lymphadenitis, panowanikwa dzakananga masero matsvuku eropa ari peripheral ropa. The causative mumiririri runoonekwa kuna Epstein-Barr utachiwana. Hwaro chirwere - kwebhosvo kusanduka lymphocytes kukonzerwa chaiwo chaikonzerwa noutachiona.

The kunotoda takasiyana. In munyoro siyana rhinitis nokuda kuputswa. Kuratidzira zvinhu:

• angina ( "mazimbe huro");
• akawedzera chirwatata uye node nodes uyewo marwadzo;
• nasal kufema zvakaoma mumazuva chirwere mangwanani nokuda mumatenhere mucosa.

Status ropa: yakawedzera chikamu eosinophils, lymphocytes uye monocytes.

yematambudziko

Zvakakodzera uye kwakakwanira kwemamiriro nechiidzo chirwere chiri pamberi muropa mononuclear chepakutanga (pamusoro 10-20%) - masero zvakasiyana lymphocyte neerekitironi guru uye rakapamhamha basophilic cytoplasm ane Lilac ruvara ane anzi perinuclear chiedza. Last leukemoid siyana mune vana uye vakuru kwevhiki dzinoverengeka, asi mwedzi anoramba ezvinhu, mashoko normalization kweropa ezvinhu.

Uye zvazvo vari kuchengetwa nounyoro, dzimwe nguva zvikamu anoverengeka makore yokutanga rikwanise nguva. Matambudziko zvingasanganisira:

• chenjera chiropa;
• encephalitis;
• agranulocytosis;
• splenic atsamwira anokonzerwa zvayo nokukurumidza kuwedzera;
• autoimmune hemolysis.

Therapy leukemoid siyana

Kazhinji, varwere regai zvinoda mushonga chaiwo, nokuti mazuva mashoma zvikuru zviratidzo chirwere zvachose uye mamiriro ropa kuti chakaipa. Kana mazhinji kurwara uye murwere anzwe kurwara kushandiswa pathogenetic kurapa - kunan'anura "prednisolone" pane imwe dose pamusoro 20-30 MG rimwe zuva kana zvimwe zvinodhaka glucocorticoid kuti kubvisa leukemoid kuita. Treatment chero zvazvingava, chete yakagadza mazvikokota.

mataridzikiro

Kazhinji zvakanaka: contagiousness haasi mukuru, saka murwere haisi kuzvireva kupatsanura varwere. Zvisinei, ngozi chaizvo atsamwira yacho chirwatata. Repairing vhoriyamu rutapudzo pakutsvaga nechitarisiko zviri muviri uye kunyangarika angina uye normalization kutonhorwa muviri. Kana kutapuriranwa mononucleosis kunoratidzwa muchimiro chiropa, murwere kuradzikwa muchipatara.