Leukemoid Jeremaya mere na ụmụ: ụdị (umu), na-akpata, nchoputa algọridim ọgwụgwọ. Leukemoid Jeremaya mere na leukemia: iche

Leukemoid mmeghachi omume - agbanwe hematopoiesis, yiri ọbara picture na-arịa ọrịa leukemia na ndị ọzọ na etuto ahụ nke hematopoietic usoro. Ọ ga-kwuru na specificity nke ihe ndị a bụ na ha nọ n'ọrụ nghazi na enweghị mgbanwe na cancer. Mmeghachi omume ndị a nwere ike triggered site iche iche na ụdị intoxications, etuto ahụ, na-efe efe, metastatic kansa ụbụrụ.

Usoro mmepe dịgasị na dị iche iche nke Jeremaya mere: na ụfọdụ na ọ bụ mmepụta na ọmụmụ akabeghị aka ọbara cell ọcha, na ndị ọzọ - ụba mmepụta nke mkpụrụ ndụ ọbara ma ọ bụ mmachi nke mmepụta mkpụrụ ndụ na a anụ ahụ, ma ọ bụ ọnụnọ nke ọtụtụ usoro n'out oge.

Gịnị nwere ike ịbụ isi iyi nke ọrịa?

E nwere ọtụtụ ihe nke nwere ike ime n'ihi leukemoid mmeghachi omume. Ihe mere ha mmepe bụ:

• mmetụta nke ionizing radieshon;
• ụkwara nta;
• sepsis;
• purulent Filiks;
• ọnyụnyụ ọbara;
• Hodgkin ọrịa;
• cranial trauma;
• ujo;
• lobar oyi baa;
• erysipelas;
• diphtheria;
• acha uhie uhie ahụ ọkụ;
• nnukwu imeju dystrophy;
• corticoid ọgwụ;
• carbon monoxide nsi.

iche ọrịa

Ndị na-esonụ ụdị nke Jeremaya mere leukemoid:

• Myeloid mmeghachi omume.
• Lymphocytic.
• Psevdoblastnye.

Ka anyị tụlee nke ọ bụla n'ime ha zuru ezu.

myeloid

Site na nke a ụdị mmeghachi omume na-agụnye ndị dị otú ahụ dị ka neutrophil, eosinophil na promyelocytic. Leukemoid mmetụta yiri ndị nke na-adịghị ala myeloid leukemia, esonyere igbu egbu na oké-efe efe. Active leukocytosis ihu ọma mgbe niile nwere a mgbagwoju anya usoro so site ọnụnọ nke sepsis, mgbu foci na ụba ahu okpomọkụ.

Ikpughe na ngafe nke eosinophils n'ime ọbara agbasaghị-eme mgbe uche na nje ndị ọzọ na ọgwụ ọjọọ, anabata diathesis, adịkarịghị - na oncological ọrịa na (Hodgkin ọrịa na lymphosarcoma). Ndị a Jeremaya mere leukemoid mkpa maka a mbara nnyocha e mere ka adreesị ọrịa nke ọbara usoro, na ikpuru.

Responsive mkpụrụ ndụ dị ka eritremii. polycythemia ihe - bụ mgbe a ọnụ ke akpa ume ọrịa oxygenation (oxygenation) ọbara, akụrụ etuto ahụ, na congenital ọrịa obi. Ọnọdụ a na-achọ a na kọmputa na ultrasound.

Mielemiya yiri nnukwu erythroleukemia, nke dị iche na naanị na enweghị gbawara erythrocytes na ụmị ọkpụkpụ na ọbara. Ọtụtụ mgbe ọ bụ ike ịchọpụta metastases na ọkpụkpụ ọrịa.

lymphocytic

Mmeghachi omume ndị a na-ji a ịrịba abawanye na ọnụ ọgụgụ nke lymphocytes na elu ọbara, nke bụ mgbe ahụ maka onye na-abawanye na imeju, Lymph na splin.

Iji ụdị iso mononucleosis, na-efe efe lymphocytosis, monocyte-macrophage leukemoid Jeremaya mere na ụmụ nje na malitere ịrịa ọrịa, na parasitic na-efe efe na elu ọbara eosinophilia (e.g., helminthiasis).

Lymphocytic Jeremaya mere ime:

• malitere ịrịa nje (kịtịkpa, Rubella, mumps, adenovirus ọrịa, Measles, na-efe efe mononucleosis);
• parasitic na-efe efe (rikketsiozah, toxoplasmosis, chlamydia);
• nje na-efe efe (syphilis, pertussis, ụkwara nta);
• dị iche iche mycoses;
• autoimmune ọrịa na (ọbara ọrịa, systemic lupus erythematosus).

Lymphocytic ụdị ihe nkịtị na macroglobulinemia Waldenstrom, mbufụt, sarcoidosis. All nke n'elu ọrịa na-emeso kpọrọ ihe nke ukwuu na ike ịdị mgbagwoju anya n'ihi ọrịa karịa otu afọ.

Psevdoblastnye

Omume dị otú ahụ na-leukemoid ma ọ bụrụ na onye ọrịa na-na-amalite iputa si dịghịzi agranulocytosis, ihe kpatara nke a nwere ike triggered site n'ikuku nke sulfonamides, "aminopyrine," "butadiene" na ndị ọzọ ọgwụ ọjọọ.

N'ihi na ndị dị otú ahụ na mmetụta otu ji ọnụnọ ke elu ọbara na ụmị ọkpụkpụ ọnụ ọgụgụ nke cellular mmiri na a homogeneous isi, na-acha anụnụ anụnụ otu nucleoli, na mkpa, ọ bụghị inwe a granular cytoplasm.

N'adịghị ka typical gbawara erythrocytes na netwọk ndị a nwere kpọmkwem nro na tụrụ chromatin emep uta eri. Oge ufodu blastosis n'anya enweghị ọgwụ na yiri leukemoid mmetụta na-hụrụ na ụmụ ọhụrụ na mkpụrụ ndụ ihe nketa chromosomal ọrịa (eg, Down syndrome).

Leukemoid mmeghachi omume na ụdị nke a n'ihu n'elu, nke na-guzobere na ndabere nke ọ bụla daa ọrịa, na-emekarị anaghị eme ka ize ndụ nsogbu. Mgbe ụfọdụ, n'ụzọ dị ịrịba ama pụtara thrombocytopenia nwere ike erroneously-ahuta ka otu n'ime ihe mgbaàmà nke nnukwu leukemia. The nchọpụta immunoblastic lymphadenites bukwanu mkpa bụ nchekwa nke eke Ọdịdị nke ahụ Lymph ọnụ, nakwa dị ka n'ụzọ ziri ezi chọpụta akara nke follicles.

Leukemoid Jeremaya mere na leukemia: iche

E nwere ụfọdụ ndị ọdịiche dị n'etiti ndị dị otú ahụ na mmetụta na-arịa ọrịa leukemia, ya bụ:

1. Mgbe leukemoid rejuvenation Jeremaya mere offline ngwa ụmị ọkpụkpụ, ọ bụ metamielotsitarnym na achọpụtara na-abawanye na-arịa ọrịa leukemia gbawara iche-iche. Mgbe leukemoid mmetụta zọpụta erythroid izizi, e nwere a nkịtị leykoeritroblasticheskoe ruru - 3: 1 na 4: 1.
2. Ọ bụghị ịhụ anya ngosipụta nke anaplasia na leukemoid phenomena dị ka ọ na-eme na-arịa ọrịa leukemia mgbe e nwere bulging nke protoplasm na ntọala anomaly.
3. Ke akpa n'onwe, na elu ọbara kemgbe na-abawanye na ndị zuru ọgụgụ na pasent nke na-abawanye na tozuru okè neutrophils na leukemia ọdịnaya mbelata tozuru okè neutrophils emee oké mmụba nke-eto eto, ọmụmụ akabeghị aka iche-iche.
4. Mgbe leukemoid Jeremaya ugboro ugboro hụrụ nsí granularity nke neutrophils.
5. Mgbe cytochemical ọmụmụ leukocytes na leukemia a ọnụ ma ọ bụ enweghị ihe alkaline phosphatase, na leukemoid Jeremaya mere - ubara ọrụ.
6. N'oge exacerbation nke ala ala myeloid leukemia gbawara nsogbu obu ụzọ bụ eosinophilic, basophilic mkpakọrịta na leukemoid Jeremaya mere ya offline.
7. Mgbe myeloid leukemia-enwekarị a elu thrombocytosis, na leukemoid Jeremaya mere platelet gụọ n'ime nkịtị nso.
8. Na mbụ nkebi nke-adịghị ala ala myeloid leukemia chọta a nnukwu oké splin na leukemoid Jeremaya mere eme mgbe ụfọdụ splenomegaly, ma ahụ bụ nro na mgbe esịmde a nnọọ nnukwu size.
9. Mgbe leukemoid Jeremaya mere na neoplastic usoro achọpụtara na ụmị ọkpụkpụ cancer mkpụrụ ndụ.

Leukemoid Jeremaya mere na ụmụ: achọpụta ọrịa algọridim

Ọrụ dị mkpa nchoputa nke ọrịa na-enye histopathology na explores biopsy ihe onwunwe. Ma iji zere irreparable njehie, na pathologist ga na-anakọta ihe ọmụma ziri ezi banyere onye ọrịa, nye ya ntụziaka nke dị iche iche na ule na ndimek a cytostatic ọgwụgwọ, nke no na-ewepu niile ndị na-esi nke lymphadenitis. Ọ bụrụ na ihe niile a na-adịghị mere, nchoputa na-mere n'ụzọ ziri ezi, ya mere iji nagide ọrịa ga-esi nnọọ ike. Mgbe niile, na ọrịa a dị nnọọ ize ndụ. Mgbe ụfọdụ, n'ihi na ọgwụgwụ nke nkọwa dị mkpa iji mee megharịa biopsy.

Agachoputa mkpa Ịchọpụta Otú Nsogbu a iteto ọdịdị Lymph ọnụ biopsies na akara. Mgbe ọtụtụ ndị erythrocyte lymphosarcoma (kacha nta 30 percent) ikere mgbe nile gbawara mkpụrụ ndụ. Dị otú ahụ na erythrocytes immunoblastic lymphadenitis, na-emekarị ihe na-erughị pasent 10, ha na-dị iche iche na usoro nke basophilia nke cytoplasm na ntọala ntozu okè.

Histopathological nchoputa na analysis of Lymph ọnụ na-enwe obi zuru ezu na ewepu etịbe ọgwụgwụ. N'ihi histopathology nke dị iche iche ọmụmụ nke ọbara kọwaa n'ụzọ doro anya na nchoputa, na nke a na-egosi na ọgwụgwụ. Dị ka ihe atụ, n'ihi na ndị mbụ nchoputa nke benign lymphoma, mgbe ụfọdụ, a ogologo oge na-edebe ndidi na-enyocha Lymph ọzọ.

Diagnosis leukemoid Jeremaya mere enyo enyo mgbe ịchọputa monoclonal immunoglobulin mgbe ụfọdụ na-achọ ugboro ugboro na ogologo okwu kwuru nke ụmị ọkpụkpụ mgbapu. Tupu nnwapụta nke nchoputa nke cancer na-anara ọgwụ a na-contraindicated.

isusu ọnụ ọrịa

Ọzọ ọrịa ahụ a kpọrọ Filatov - Pfeyferra, glandular fever na monocytic rịaworo. Ọ bụ a malitere ịrịa ọrịa ji lymphocyte gbawara mgbanwe, ikpọ Lymph na splin, reactive lymphadenitis, omume nke kpọmkwem mkpụrụ ndụ ọbara uhie na elu ọbara. The causative gị n'ụlọnga na-atụle Epstein-Barr virus. The ndabere nke ọrịa - gbawara mgbanwe nke lymphocytes mere site pụrụ iche malitere ịrịa ọrịa.

The adakarị ọnọdụ dị iche iche. Na milder forms of rhinitis ruru ka a na-agbaji. Ngosipụta atụmatụ:

• rịaworo ( "ọkụ akpịrị");
• ịmụba ọnụ ọgụgụ nke splin na Lymph nakwa dị ka ihe mgbu;
• gọzie gị na-eku ume ike ná mmalite nke ọrịa n'ihi na ọzịza nke mucosa.

Status of ọbara: abawanye na pasent nke eosinophils, lymphocytes na monocytes.

nsogbu

Dị Mkpa na zuru ezu maka ọgwụgwụ nke egosi nke ọrịa bụ ọnụnọ ke ọbara mononuclear mbụ (ihe karịrị 10-20%) - mkpụrụ ndụ ndị dị iche lymphocyte ntọala nnukwu na obosara basophilic cytoplasm na a lilac na agba ya na a akpọ perinuclear ọmụma. Ikpeazụ leukemoid Jeremaya mere na ụmụaka na ndị okenye ọtụtụ izu, ma ọnwa na-aga n'ihu na ọnọdụ ụfọdụ, ndị normalisation ọbara ọnọdụ.

Na nlọghachi na-hụrụ na a nwayọọ, mgbe ụfọdụ, na etiti oge nke ọtụtụ afọ mgbe mbụ nnukwu oge. Nsogbu nwere ike na-agụnye:

• nnukwu ịba ọcha n'anya;
• ụbụrụ;
• agranulocytosis;
• splenic agbawa kpatara ya ngwa ngwa abawanye;
• autoimmune hemolysis.

Agwọ leukemoid Jeremaya mere

Dị ka a na-achị, ndị ọrịa na-adịghị achọ pụrụ iche ọgwụ, n'ihi na a ụbọchị ole na ole isi mgbaàmà nke ọrịa na-apụ n'anya na ala nke ọbara nkịtị. Mgbe ogologo oge ọrịa na-enwe ndidi na-enwe adịchaghị eji pathogenetic ọgwụ - ikpo "prednisolone" na a dose nke 20-30 mg a ụbọchị ma ọ bụ ndị ọzọ glucocorticoid ọgwụ ọjọọ iji kpochapụ leukemoid mmeghachi omume. Ọgwụgwọ ọ bụla ikpe, na-ahọpụta onye ọkachamara.

ele ihe anya

Na-emekarị mma: contagiousness bụghị elu, n'ihi ọrịa na-adịghị chọrọ kwarantaini. Otú ọ dị, dị nnọọ ize ndụ -agbawa nke splin. Ịrụzi olu Mbelata kpebisiri ike site n'ile atụmatụ nke a ahụ na ofufe nke rịaworo na normalisation nke ahu okpomọkụ. Ọ bụrụ na-efe efe mononucleosis egosipụta na ụdị ịba ọcha n'anya, ọrịa chọrọ ụlọ ọgwụ.