Ithumba lelungu lobufazi

Ithumba lesikhumba kukukhula okungaqhelekanga kwindlala yebhinqa. I-pituitary yindlala encinci emazantsi engqondo. Ilawula umlinganiso womzimba wehomoni ezininzi.

Uninzi lwamathumba e-pituitary alunomdlavuza (ubungozi). Ukuya kuthi ga kwiipesenti ezingama-20 zabantu abanezilonda zepituitary. Uninzi lwezi tumors azibangeli zimpawu kwaye azikaze zifunyaniswe ngexesha lokuphila komntu.

I-pituitary yinxalenye yenkqubo ye-endocrine. I-pituitary inceda ukulawula ukukhutshwa kwehomoni kwamanye amadlala endocrine, anje nge-thyroid, amadlala esini (iimvavanyo okanye amaqanda), kunye namadlala eadrenal. Indawo yonyango ikhupha iihomoni ezichaphazela ngokuthe ngqo izicubu zomzimba, ezinje ngamathambo kunye namadlala obisi lwebele. Iihomoni zepituitary zibandakanya:

• Ihomoni yeadrenocorticotropic (ACTH)
• Ukukhula kwehomoni (GH)
• IProlactin
• Ihomoni evuselela idlala lengqula (TSH)
• Ihomoni ye-Luteinizing (LH) kunye ne-follicle evuselelayo yehomoni (FSH)

Njengoko ithumba lelungu likhula, iiseli eziqhelekileyo ezikhupha iihomoni zepituitary zinokonakala. Oku kubangela ukuba i-pituitary gland ingavelisi ngokwaneleyo iihomoni zayo. Le meko ibizwa ngokuba yi-hypopituitarism.

Izizathu zamathumba e-pituitary awaziwa. Ezinye izicubu zibangelwa kukuphazamiseka kwilifa njenge-endocrine neoplasia I (MEN I).

I-pituitary gland inokuchaphazeleka ngamanye amathumba obuchopho akhula kwinxalenye efanayo yengqondo (isiseko sokhakhayi), nesiphumo seempawu ezifanayo.

Amanye amathumba e-pituitary avelisa kakhulu ihomoni enye okanye nangaphezulu. Ngenxa yoko, iimpawu zenye okanye ngaphezulu kwezi meko zilandelayo zinokwenzeka:

• Hyperthyroidism (idlala lengqula lenza iihomoni ezininzi kakhulu, le yimeko enqabileyo kakhulu yamathumba esibeleko)
• I-Cushing syndrome (umzimba unenqanaba eliphezulu kuneliqhelekileyo lehomoni yecortisol)
• I-Gigantism (ukukhula okungaqhelekanga ngenxa yokuphakama kwinqanaba eliqhelekileyo lokukhula kwehomoni ngexesha lobuntwana) okanye i-acromegaly (ephezulu kuneqondo eliqhelekileyo lokukhula kwehomoni kubantu abadala)
• Ukukhutshwa kwengono kunye nokungaqhelekanga okanye ukungabikho exesheni kwabasetyhini
• Ukuncipha kokusebenza ngokwesondo emadodeni

Iimpawu ezibangelwa luxinzelelo kwi-pituitary tumor enkulu inokubandakanya:

• Utshintsho kumbono onje ngombono ophindwe kabini, ukulahleka kwentsimi ebonakalayo (ukulahleka kombono), iinkophe ezijingayo okanye utshintsho kumbono wombala.
• Intloko ebuhlungu.
• Ukungabikho kwamandla.
• I-Nasal drainage ecacileyo, enamanzi anetyuwa.
• Isicaphucaphu nokugabha.
• Iingxaki ngengqondo yokujoja.
• Kwiimeko ezinqabileyo, ezi mpawu zenzeka ngesiquphe kwaye zinokuba nzima (pituitary apoplexy).

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba. Umboneleli uya kuqaphela naziphi na iingxaki ngombono ophindwe kabini kunye nembonakalo yentsimi, njengokulahleka kombono osecaleni (kwipheripherali) okanye ukukwazi ukubona kwiindawo ezithile.

Uvavanyo luya kujonga iimpawu ze-cortisol eninzi kakhulu (i-Cushing syndrome), i-hormone yokukhula kakhulu (i-acromegaly), okanye i-prolactin eninzi kakhulu (i-prolactinoma).

Uvavanyo lokujonga ukusebenza kwe-endocrine lunoku-odolwa, kubandakanya:

• Amanqanaba eCortisol -ukuvavanywa koxinzelelo lwe-dexamethasone, uvavanyo lwe-urine ye-cortisol, uvavanyo lwe-salivary cortisol
• Inqanaba le-FSH
• Inqanaba lokukhula kwe-insulin-1 (IGF-1)
• LHlevel
• Inqanaba leprolactin
• Amanqanaba e-testosterone / estradiol
• Amanqanaba ehomoni ye-thyroid-uvavanyo lwe-T4 yasimahla, uvavanyo lwe-TSH

Uvavanyo olunceda ukuqinisekisa ukuxilongwa lubandakanya oku kulandelayo:

• Iindawo ezibonakalayo
• I-MRI yentloko

Utyando lokususa ithumba kuhlala kufuneka, ngakumbi ukuba ithumba licinezela kwiimbilini ezilawula umbono (i-optic nerves).

Ixesha elininzi, izilonda zepituitary zinokususwa ngotyando nangeempumlo. Ukuba ithumba alinakususwa ngale ndlela, lisuswa ngekakayi.

Unyango ngemitha lungasetyenziselwa ukunciphisa ithumba kubantu abangakwaziyo ukwenza utyando. Inokusetyenziswa kwakhona ukuba ithumba libuya emva kotyando.

Ngamanye amaxesha, amayeza amiselwe ukunciphisa ezinye iintlobo zamathumba.

Ezi zixhobo zinokubonelela ngolwazi oluthe kratya kwizidumba zepituitary:

• IZiko leSizwe loMhlaza-www.cancer.gov/types/pituitary
• Umbutho weNethiwekhi yePituitary-pituitary.org
• Umbutho wePituitary- www.pituitarysociety.org

Ukuba ithumba linokususwa ngotyando, imbonakalo ilungile ukuya kokulungileyo, kuxhomekeke ekubeni lisuswe lonke ithumba.

Eyona ngxaki inkulu kukungaboni. Oku kunokwenzeka ukuba i-optic nerve yonakele kakhulu.

I-tumor okanye ukususwa kwayo kunokubangela ukungalingani kwehomoni ebomini. Iihormoni ezichaphazelekayo zinokufuna ukuba zitshintshwe, kwaye kuya kufuneka uthathe amayeza ubomi bakho bonke.

Amathumba kunye notyando ngamanye amaxesha kungonakalisa indawo yangasemva (inxalenye engasemva yelungu). Oku kunokukhokelela kwisifo seswekile i-insipidus, imeko eneempawu zokuchama rhoqo kunye nokunxanwa okugqithisileyo.

Tsalela umnxeba umboneleli wakho ukuba uphuhlisa naziphi na iimpawu zethumba.

Tumor - yebhinqa; Indawo yokuhlala adenoma

• Amadlala endocrine
• Indawo yolwimi lamathe

UDorsey JF, uSalinas RD, uDang M, et al. Umhlaza we-nervous system. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahl. 63.

I-Melmed S, i-Kleinberg D. Ubunzima bePituitary kunye nezihlunu. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-13. IPhiladelphia, PA: Elsevier; 2016: isahluko 9.