Leukemoid tshua nyob hauv cov me nyuam: lub hom (hom), ua, mob algorithm kev kho mob. Leukemoid tshua thiab leukemia: sib txawv

Leukemoid cov tshuaj tiv thaiv - hloov hematopoiesis, zoo ib yam li cov ntshav duab nyob rau hauv leukemia thiab lwm yam qog ntawm lub hematopoietic system. Nws yuav tsum tau muab sau tseg tias tseem ntawm cov teebmeem yog lawv active orientation thiab tsis muaj kev hloov nyob rau hauv cancer. Cov tshua yuav tau triggered thaum uas ntau hom intoxications, hlav, kab mob, metastatic hlwb mob cancer.

Mechanism ntawm txoj kev loj hlob txawv nrog rau ntau hom kev tshua: nyob rau hauv tej zaum nws yog tso zis nyob rau hauv tsis paub qab hau cov ntshav cell hais, nyob rau hauv lwm tus neeg - muaj zog zus ntawm cov ntshav los yog txwv tsis pub tso zis hlwb nyob rau hauv ib tug ntaub so ntswg, los yog hauv lub xub ntiag ntawm ob peb mechanisms ib txhij.

Yuav ua li cas yuav ua tau rau qhov chaw ntawm tus kab mob?

Muaj ntau ntau yam uas tej zaum yuav tshwm sim vim cov tshuaj tiv thaiv leukemoid. Vim li cas rau lawv txoj kev loj hlob yog:

• tus ntawm ionizing tawg;
• tuberculosis;
• sepsis;
• purulent dab;
• dysentery;
• Hodgkin tus kab mob;
• cranial kev poob plig;
• poob siab;
• lobar mob ntsws;
• erysipelas;
• diphtheria;
• kub taub hau;
• mob siab dystrophy;
• corticoid txoj kev kho;
• carbon monoxide lom.

ntau ntau yam kab mob

Cov nram qab no txoj kev tshua leukemoid:

• Myeloid cov tshuaj tiv thaiv.
• Lymphocytic.
• Psevdoblastnye.

Cia peb xav txog txhua yam uas lawv nyob rau hauv kom meej.

myeloid

Los ntawm no hom ntawm cov tshuaj tiv thaiv xws li xws li Neutrophil, eosinophil thiab promyelocytic. Leukemoid los zoo ib yam li cov neeg ntawm mob myeloid leukemia, nrog intoxication thiab mob kab mob. Active leukocytosis yeej ib txwm muaj ib tug tham cov txheej txheem nrog lub xub ntiag ntawm sepsis, inflammatory foci thiab muaj zog lub cev kub.

Raug nyob rau hauv excess ntawm eosinophils nyob rau hauv cov ntshav yuav tshwm sim thaum sensitization rau cab thiab tshuaj, allergic diathesis, tsis tshua - ntawm oncological cov kab mob (Hodgkin tus kab mob thiab lymphosarcoma). Cov tshua leukemoid xav tau rau kev daim ntawv ntsuam xyuas rau qhov chaw nyob cov kab mob ntawm lub plawv system, thiab cua nab.

Noog hlwb zoo li eritremii. polycythemia yam - yog feem ntau ib tug txo nyob rau hauv lub ntsws ailments oxygenation (oxygenation) cov ntshav, mob raum hlav, thiab congenital plawv tus kab mob. Qhov no qhov teeb meem no yuav tsum tau ib lub computer thiab ultrasound.

Mielemiya zoo xws li cov mob erythroleukemia, uas txawv xwb nyob rau hauv cov tsis muaj moj tej tawg erythrocytes nyob rau hauv hlwb pob txha thiab cov ntshav. Feem ntau nws yog ua tau rau ntes metastases nyob rau hauv cov pob txha kab mob.

lymphocytic

Cov tshua yog yus muaj los ntawm ib tug tseem ceeb nce nyob rau hauv tag nrho cov ntawm lymphocytes nyob rau hauv peripheral cov ntshav, uas yog feem ntau lub luag hauj lwm rau ib qho kev nce nyob rau hauv daim siab, cov qog ntshav hauv thiab po.

Yuav kom qhov no hom yuav mononucleosis, mob lymphocytosis, monocyte-macrophage leukemoid tshua nyob hauv cov me nyuam nrog kab mob thiab kis kab mob, thiab cab kab mob thiab ntshav eosinophilia (e.g., helminthiasis).

Lymphocytic tshua tshwm sim:

• kab mob (chicken pox, rubella, mumps, adenovirus kab mob, qhua pias, kab mob mononucleosis);
• cab kab mob (rikketsiozah, toxoplasmosis, chlamydia);
• kab mob kab mob (syphilis, pertussis, tuberculosis);
• ntau yam mycoses;
• cov kab mob autoimmune (ntshiab kab mob, mauj lupus erythematosus).

Lymphocytic hom ntau muaj nyob rau macroglobulinemia Waldenstrom, o, sarcoidosis. Tag nrho cov saum toj no ailments kho heev tiag thiab yuav ua tau ruam tag rau tus neeg mob tshaj li ib lub xyoo.

Psevdoblastnye

Tej tshua yog leukemoid yog hais tias tus neeg mob yog tsuas yog thaum pib los mus muaj los ntawm lub cev agranulocytosis, qhov ua rau ntawm uas yuav tau triggered thaum uas txais tos ntawm sulfonamides, "aminopyrine," "butadiene" thiab lwm yam tshuaj.

Rau xws li los pab pawg neeg tsiag ntawv los ntawm muaj nyob rau hauv lub peripheral cov ntshav thiab cov pob txha loj tus naj npawb ntawm cellular Cheebtsam nrog ib tug homogeneous tub ntxhais, thiab xiav ib nucleoli, nyias, tsis muaj ib tug granular cytoplasm.

Tsis zoo li raug moj tej tawg erythrocytes nyob rau hauv cov tes hauj lwm muaj kev mos mos thiab ntsuas chromatin fibers. Lus blastosis disappearing tsis muaj cov kws khomob thiab lwm yam kev leukemoid influences yog pom nyob rau hauv cov me nyuam mos cov me nyuam mos nrog caj chromosomal mob (xws li, Down syndrome).

Leukemoid cov tshuaj tiv thaiv hom uas tau raug hais saum toj no, uas yog tsim nyob rau hauv lub keeb kwm yav dhau ntawm tej pathology, feem ntau tsis ua rau yus mob. Tej zaum dramatically nyob thrombocytopenia yuav erroneously yuav ntshai ua ib tug ntawm cov tsos mob ntawm mob leukemia. Cov nrhiav kom tau immunoblastic lymphadenites loj tseem ceeb yog txoj kev ruaj ntseg ntawm lub ntuj qauv ntawm cov mob qog, raws li zoo raws li los yog txiav txim ntawm txoj kab ntawm lub hauv paus.

Leukemoid tshua thiab leukemia: sib txawv

Muaj ib co sib txawv ntawm zoo li no los thiab leukemia, namely:

1. Thaum leukemoid rejuvenation tshua offline sai hloov hlwb pob txha, nws yog metamielotsitarnym thiab kuaj nce nyob rau hauv leukemia moj tej tawg cov ntaub ntawv. Thaum leukemoid los rua erythroid kab, muaj ib tug ib txwm leykoeritroblasticheskoe piv - 3: 1 thiab 4: 1.
2. Tsis observable ces anaplasia nrog leukemoid phenomena raws li nws tshwm sim nyob rau hauv leukemia thaum muaj ib tug su ntawm lub protoplasm thiab nucleus anomaly.
3. Nyob rau hauv thawj embodiment, nyob rau hauv lub peripheral ntshav tau ib qho kev nce rau hauv lub meej tooj thiab feem pua ntawm cov kev nce rau hauv mature qe nyob rau hauv leukemia cov ntsiab lus txo mature qe tshwm sim ntev loj hlob ntawm cov tub ntxhais, tsis paub qab hau cov ntaub ntawv.
4. Thaum leukemoid tshua nquag cai lom granularity qe.
5. Thaum cytochemical txoj kev tshawb no leukocytes nyob rau hauv leukemia ib tug txo los yog tsis tuaj kawm ntawv ntawm ib tug alkaline phosphatase, ntawm leukemoid tshua - nce ua si.
6. Thaum lub sij hawm exacerbation ntawm tus kab mob myeloid leukemia moj tej tawg ntsoog forerunner yog eosinophilic, basophilic lub koom haum nrog leukemoid tshua nws offline.
7. Thaum myeloid leukemia feem ntau muaj ib tug high thrombocytosis, nrog leukemoid tshua platelet suav nyob rau hauv lub cev ntau.
8. Nyob rau hauv thawj zaug rau theem ntawm mob myeloid leukemia nrhiav tau ib tug loj tuab po ntawm leukemoid tshua zaum kuj tshwm sim splenomegaly, tab sis lub cev yog mos mos thiab yeej tsis nce mus txog ib tug heev loj loj.
9. Thaum leukemoid tshua mus rau lub neoplastic txheej txheem kuaj nyob rau hauv lub hlwb pob txha mob hlwb.

Leukemoid tshua nyob hauv cov me nyuam: diagnostic algorithm

Tseem ceeb luag hauj lwm nyob rau hauv lub mob ntawm tus kab mob no yog muab histopathology uas explores me khoom. Tab sis nyob rau hauv kom tsis txhob muaj teeb uas tsis, lub pathologist yuav tsum sau ntaub ntawv hais txog tus neeg mob, muab nws cov kev taw qhia txog ntau yam kev ntsuam xyuas thiab xaiv ib tug cytostatic kev kho mob, uas tshem tawm tag nrho ntawm qhov yuav tshwm ntawm lymphadenitis. Yog hais tias tag nrho cov no yog tsis ua li, tus mob no yog ua los kom raug, thiab yog li ntawd kom tiv nrog tus kab mob no yuav nyuaj heev. Tom qab tag nrho, tus kab mob no yog heev txaus ntshai. Tej zaum, rau lub xaus ntawm lub ntsiab lus tsim nyog yuav ua rau rov me.

Txiav txim siab tseem ceeb nyob rau hauv diagnosing ib smear tsos ntawm cov qog ntawm biopsies thiab imprint. Thaum feem ntau ntawm cov erythrocyte lymphosarcoma (yam tsawg kawg nkaus 30 feem pua) li qhov moj tej tawg hlwb. Nrog xws erythrocytes immunoblastic lymphadenitis, feem ntau yog tsawg tshaj li 10 feem pua, lawv yog cov sib txawv nyob rau hauv cov nqe lus ntawm basophilia ntawm cytoplasm thiab nucleus kom loj hlob.

Histopathological mob rau lub tsom xam ntawm cov qog ntawm yuav tsum tau heev ncauj lus kom ntxaws thiab tsis suav tsis muaj tseeb xaus. Vim hais tias histopathology ntawm ntau yam kev tshawb fawb ntawm cov ntshav yuav tsum txhais kom meej meej rau tus mob, thiab qhov no yog thaws rov los nyob rau hauv lub xaus. Piv txwv li, rau cov thawj zaug mob ntawm benign nqaij hlav, nyob rau hauv tej rooj plaub, ib tug ntev lub sij hawm mus soj ntsuam tus neeg mob thiab tshuaj xyuas cov qog ntshav hauv dua.

Mob leukemoid tshua xav tias thaum tebchaws monoclonal immunoglobulin tej zaum yuav tsum tau rov thiab ntev-lub sij hawm cov tswvyim ntawm pob txha tsim muaj tej. Ua ntej yuav pom zoo los ntawm tus mob ntawm cancer kws khomob yog txhob.

hnia tus kab mob

Lwm tus kab mob hu ua Filatov - Pfeyferra, glandular ua npaws thiab monocytic angina. Nws yog ib tug kis tus kab mob yus lymphocyte moj tej tawg transformation, ua qog thiab tus po, reactive lymphadenitis, qhov tshwm sim ntawm kev ntshav liab nyob rau hauv lub peripheral cov ntshav. Lub causative tus neeg saib xyuas yog pom tias yuav Epstein-Barr virus. Lub hauv paus ntawm tus kab mob - lub moj tej tawg transformation ntawm lymphocytes tshwm sim los ntawm tshwj xeeb kab mob.

Cov kev soj ntsuam qhov teeb meem no sib txawv. Nyob rau hauv yam ntaub ntawv ntawm cov txhaws ntswg vim raug tawg. Ua qauv qhia nta:

• angina ( "hlawv caj pas");
• o ntawm tus po thiab cov qog ntshav raws li mob;
• qhov ntswg ua tsis taus pa nyuaj nyob rau hauv lub hnub thaum ntxov ntawm tus kab mob vim o ntawm lub mucosa.

Raws li txoj cai ntawm cov ntshav: nce nyob rau hauv qhov feem pua ntawm eosinophils, lymphocytes thiab monocytes.

teeb meem

Tsim nyog thiab txaus rau lub xaus ntawm ib tug taw qhia ntawm tus kab mob yog muaj nyob rau hauv cov ntshav mononuclear thawj (tshaj 10-20%) - hlwb uas txawv lymphocyte nucleus loj thiab dav basophilic cytoplasm nrog ib tug lilac xim nrog ib tug cov lus hais perinuclear enlightenment. Xeem leukemoid tshua nyob hauv cov me nyuam thiab cov laus rau ob peb lub lis piam, tab sis lub hlis tseem nyob rau hauv tej lub sijhawm, cov normalization ntawm cov ntshav mob.

Thiab rov muaj cai nrog ib tug me me, tej zaum nyob rau ntawm lub Team sib ntawm ob peb xyoo tom qab thawj zaug mob lub sij hawm. Mob tej zaum yuav muaj xws li:

• mob kab mob siab;
• encephalitis;
• agranulocytosis;
• splenic rupture tshwm sim los ntawm nws ceev ceev nce;
• autoimmune hemolysis.

Therapy leukemoid tshua

Raws li txoj cai, cov neeg mob tsis yuav tsum tau tshwj xeeb cov tshuaj noj, vim hais tias ib tug ob peb hnub lub ntsiab tsos mob ntawm tus kab mob ploj thiab hauv lub xeev ntawm cov ntshav mus rau li qub. Thaum lub caij nyoog muaj mob thiab tus neeg mob xav tias unwell siv pathogenetic txoj kev kho - xaiv "prednisolone" nyob rau hauv ib koob tshuaj 20-30 mg ib hnub twg los yog lwm yam glucocorticoid tshuaj nyob rau hauv thiaj li yuav tshem tawm leukemoid cov tshuaj tiv thaiv. Kev kho mob nyob rau hauv txhua rooj plaub, tsuas xaiv ib tug kws muaj txuj.

outlook

Feem ntau zoo: contagiousness yog tsis siab, ces tus neeg mob yog tsis yuav tsum tau cais tawm. Txawm li cas los, heev txaus ntshai rupture ntawm tus po. Repairing volume txo txiav txim los ntawm cov tsos nta ntawm ib lub cev thiab lub disappearance ntawm angina thiab normalization ntawm lub cev kub. Yog hais tias cov kab mononucleosis yog manifested nyob rau hauv daim ntawv ntawm cov kab mob siab, tus neeg mob yuav tsum tau pw tsev kho mob.