Leukemoid a cikin halayen yara: da iri (jinsin), haddasawa, ganewar asali algorithm magani. Leukemoid halayen da kuma cutar sankarar bargo: bambance-bambance

Leukemoid dauki - canjãwa hematopoiesis, kama da jini hoto a sankarar bargo da sauran ciwace-ciwacen daji na hematopoietic tsarin. Ya kamata a lura da cewa bayani dalla-dalla na wadannan effects ne su aiki fuskantarwa da rashin mika mulki a ciwon daji. Wadannan halayen za a iya jawo da daban-daban iri intoxications, marurai, cututtuka, metastatic kwakwalwa ciwon daji.

Inji na ci gaba dabam tare da daban-daban na halayen: a wasu lokuta yana da fitarwa a m jini cell abubuwa, a wasu - ƙara samar da maikacin jini ko ƙuntatawa na fitarwa Kwayoyin a wani nama, ko gaban da dama sunadaran lokaci guda.

Abin da zai iya zama tushen da cutar?

Akwai da yawa abubuwan da za su iya faruwa saboda leukemoid dauki. Dalilan da su ci gaba su ne:

• rinjayar ionizing radiation;
• da tarin fuka.
• sepsis.
• surkin jini matakai.
• dysentery.
• Hodgkin ta cutar.
• girman kwanyar rauni.
• bugu.
• lobar ciwon huhu.
• erysipelas.
• diphtheria.
• mulufi zazzabi.
• m hanta dystrophy.
• corticoid far.
• carbon monoxide guba.

iri da cuta

Wadannan iri halayen leukemoid:

• Myeloid dauki.
• Lymphocytic.
• Psevdoblastnye.

Bari mu bincika kowane daga cikinsu a cikin daki-daki.

myeloid

By irin wannan dauki hada da kamar neutrophil, eosinophil da promyelocytic. Leukemoid effects kama da wadanda daga na kullum myeloid cutar sankarar bargo, tare da maye, kuma mai tsanani cututtuka. Active leukocytosis m ko da yaushe yana mai rikitarwa aiwatar tare da gaban sepsis, kumburi foci kuma Ya ƙãra yanayin jiki.

Exposure a wuce haddi na eosinophils a cikin jini ayan faruwa a lokacin da wayar zuwa parasites da kwayoyi, rashin lafiyan diathesis, da wuya - at oncological cututtuka (Hodgkin ta cutar da lymphosarcoma). Wadannan halayen leukemoid bukatar for cikakken binciken zuwa adireshin cututtuka na jijiyoyi, da tsutsotsi.

M Kwayoyin kamar eritremii. polycythemia dalilai - shi ne sau da yawa wani karu a cikin huhu ailments oxygenation (oxygenation) da jini, koda marurai, kuma nakasar zuciya cuta. Wannan halin da ake ciki na bukatar kwamfuta da duban dan tayi.

Mielemiya kama m erythroleukemia, wanda ya bambanta kawai a cikin rashin tsãwa erythrocytes a bargo da jini. Sau da yawa yana yiwuwa a gane metastases a kashi cuta.

lymphocytic

Wadannan halayen ne halin da wani gagarumin karuwa a jimlar yawan lymphocytes a gefe jini, wanda shi ne sau da yawa alhakin wani karuwa a hanta, Lymph nodes da baƙin ciki.

Don irin wannan ne mononucleosis, dauke da kwayar cutar lymphocytosis, monocyte-macrophage leukemoid a cikin halayen yara da kwayan da kwayar cututtuka, da kuma parasitic cututtuka da kuma high jini eosinophilia (msl, helminthiasis).

Lymphocytic halayen faruwa:

• kwayar cututtuka (kaza pox, rubella, mumps, adenovirus kamuwa da cuta, kyanda, dauke da kwayar cutar mononucleosis).
• parasitic cututtuka (rikketsiozah, toxoplasmosis, chlamydia).
• kwayan cututtuka (syphilis, pertussis, da tarin fuka).
• daban-daban mycoses.
• autoimmune cututtuka (magani cuta, tsari lupus erythematosus).

Lymphocytic irin more kowa a macroglobulinemia Waldenstrom, kumburi, sarcoidosis. Duk na sama ailments suna bi ƙwarai da gaske, kuma zai iya zama da rudani ga mãsu haƙuri fiye da wani shekara.

Psevdoblastnye

Irin wannan halayen ana leukemoid idan haƙuri ne kawai fara fita daga rigakafi agranulocytosis, a cikin hanyar wanda za a iya jawo da liyafar na sulfonamides, "aminopyrine," "butadiene" da sauran kwayoyi.

Domin irin wannan illa da kungiyar halin da gaban a gefe jini da bargo babba yawan salon salula aka gyara tare da yi kama da zuciyar, da kuma shudi guda nucleoli, bakin ciki, ba da ciwon granular cytoplasm.

Ba kamar hankula tsãwa erythrocytes a wadannan cibiyoyin sadarwa da takamaiman taushi da kuma auna chromatin zaruruwa. Sababbu blastosis bace ba tare da jiyyar cutar sankara da kuma related leukemoid tsoma da ake samu a jariri jariran da kwayoyin cuta chromosomal (misali, Down ciwo).

Leukemoid dauki iri da mukayi a sama, wanda ake kafa a kan bango na wani Pathology, yawanci ba su sa m rikitarwa. Wani lokaci da cika fuska bayyana thrombocytopenia iya karyata a matsayin daya daga cikin cututtuka na m cutar sankarar bargo. A ganewa immunoblastic lymphadenites babba muhimmanci shi ne aminci daga cikin halitta tsarin da Lymph kumburi, kazalika a daidai ƙayyade layi na follicles.

Leukemoid halayen da kuma cutar sankarar bargo: bambance-bambance

Akwai wasu bambance-bambance tsakanin irin wannan illa da kuma cutar sankarar bargo, wato:

1. Lokacin da leukemoid rejuvenation halayen offline m bargo, shi ne metamielotsitarnym da kuma gano karuwa a sankarar bargo tsãwa siffofin. Lokacin da leukemoid effects ajiye erythroid jam, akwai wata al'ada leykoeritroblasticheskoe rabo - 3: 1 da kuma 4: 1.
2. Ba observable manifestations anaplasia da leukemoid mamaki kamar yadda ya faru a sankarar bargo a lokacin da akwai wani bulging na protoplasm da kuma tsakiya anomaly.
3. A farko embodiment, a gefe jini An yi wani karuwa a cikin cikakkar yawan da yawan karuwa a balagagge neutrophils a sankarar bargo abun ciki rage-rage balagagge neutrophils auku wuce kima yaduwa na matasa, m siffofin.
4. Lokacin da leukemoid halayen akai-akai lura mai guba granularity na neutrophils.
5. Lokacin da cytochemical nazari leukocytes a sankarar bargo a rage ko babu wani alkaline phosphatase, a leukemoid halayen - da karin aiki.
6. A lokacin exacerbation na kullum myeloid cutar sankarar bargo tsãwa rikicin riga ne eosinophilic, basophilic tarayya, tare da leukemoid halayen shi offline.
7. Lokacin da myeloid cutar sankarar bargo sau da yawa yana da babban thrombocytosis, tare da leukemoid halayen platelet ƙidaya a cikin al'ada kewayo.
8. A matakin farko na kullum myeloid cutar sankarar bargo sami babban m baƙin ciki a leukemoid halayen wani lokacin da ya faru splenomegaly, amma jiki ne taushi da kuma bã mai kaiwa da manya-manyan size.
9. Lokacin da leukemoid halayen da neoplastic aiwatar gano a cikin bargo ciwon daji Kwayoyin.

Leukemoid a cikin halayen yara: bincike algorithm

Muhimmiyar rawa a cikin ganewar asali na cutar da ake ba histopathology cewa duba biopsy abu. Amma domin kauce wa irreparable kurakurai, da sani akan cututtuka dole ne tattara m bayanai game da haƙuri, ba shi da shugabanci na daban-daban gwaje-gwaje da kuma sanya wani cytostatic magani, wadda ta kawar da duk sakamakon da lymphadenitis. Idan duk wannan ba a yi, da ganewar asali an yi daidai, kuma haka a magance da cutar zai zama da wuya sosai. Bayan duk, da wannan cuta ne mai hadarin gaske. Wani lokaci, domin cikar bayani wajibi ne don yin sake biopsy.

Da irin muhimmancin a diagnosing a shafa bayyanar Lymph kumburi biopsies kuma bugu. Lokacin da mafi yawan erythrocyte lymphosarcoma (m kashi 30 cikin dari) adadin m tsãwa Kwayoyin. Tare da irin wannan erythrocytes immunoblastic lymphadenitis, yawanci kasa da kashi 10, su ne daban-daban cikin sharuddan basophilia na cytoplasm da kuma tsakiya balaga.

Histopathological lifiya a kan bincike na Lymph kumburi dole ne sosai cikakken kuma ban da m ƙarshe. Saboda histopathology na daban-daban karatu na jini kamata ayyana a fili da ganewar asali, da kuma wannan da aka nuna a cikin ƙarshe. Alal misali, domin da farko ganewar asali na kirki lymphoma, a wasu lokuta, a dogon lokaci don tsayar da haƙuri da kuma nazarin Lymph nodes sake.

Ganewar asali leukemoid halayen da ake zargi a lokacin da ganowa monoclonal immunoglobulin wani lokacin bukatar maimaita kuma dogon lokacin da suka lura da bargo huda. Kafin amincewa da ganewar asali na ciwon daji jiyyar cutar sankara ne contraindicated.

sumbatan cuta

Wani cuta kira Filatov - Pfeyferra, glandular zazzabi da kuma monocytic angina. Yana da wani kwayar cutar halin da lymphocyte tsãwa canji, kara girman Lymph nodes da baƙin ciki, mai amsawa lymphadenitis, da ya faru na musamman ja jini Kwayoyin a gefe jini. A causative wakili ne dauke Epstein-Barr cutar. Dalili na cuta - tsãwa canji na lymphocytes sa ta musamman kwayar cutar.

A halin da ake ciki na asibiti ne daban-daban. A milder siffofin rhinitis saboda ake karya. Zanga-zanga fasali:

• angina ( "kona makogwaro");
• kara girma daga cikin baƙin ciki, kuma Lymph nodes kazalika da zafi.
• hanci numfashi wuya a farkon kwanaki da cutar saboda kumburi daga cikin mucosa.

Status of jini: karuwa a yawan eosinophils, lymphocytes da kuma monocytes.

rikitarwa

Dole kuma isa ga cikar wani nuna alama da cutar ne gaban a jini mononuclear asali (a kan 10-20%) - Kwayoyin cewa bambanta lymphocyte tsakiya manyan da fadi da basophilic cytoplasm da Lilac launi tare da furta perinuclear haskakarka. Last leukemoid a cikin halayen yara da kuma manya for makonni da dama, amma watanni ci gaba a wasu yanayi, da daidaita da jini yanayin.

Kuma dakwai, komowan cutar ne kiyaye tare da wani m, wani lokacin a kan jinkiri na shekaru da dama bayan da farko m lokaci. Matsalolin iya sun hada da:

• m hepatitis.
• encephalitis.
• agranulocytosis.
• splenic katsewa ya sa ta ta m karuwa.
• autoimmune hemolysis.

Far leukemoid halayen

Matsayin mai mulkin, marasa lafiya ba ya bukatar musamman magani, saboda a 'yan kwanaki da babban bayyanar cututtuka da cutar bace da kuma jihar na jini ga al'ada. Lokacin da tsawo rashin lafiya da kuma haƙuri ji unwell amfani pathogenetic far - designate "prednisolone" a wani kashi na 20-30 MG a rana ko wasu glucocorticoid kwayoyi domin kawar da leukemoid dauki. Magani a wani hali, kawai nada wani gwani.

Outlook

Yawancin lokaci tabbatacce: contagiousness ba high, don haka da haƙuri ba a bukata rigakafi. Duk da haka, matukar hatsari katsewa da baƙin ciki. Gyarawa girma rage m da bayyanar siffofin na jiki da kuma bacewar angina da kuma daidaita yanayin jiki. Idan dauke da kwayar cutar mononucleosis aka bayyana a cikin nau'i na hepatitis, da mãsu haƙuri bukata asibiti.