Lipoma: Ukuqonda Iimpawu Ezithambileyo Zefama Phantsi KweSkin Yakho

I-lipoma yi-tumor engalunganga (engakhange ibangele umhlaza) eyakhiwe ngama-adipose (i-fat) cells aphumileyo athuthukayo kwi-subcutaneous tissue — umqolo we-fat phakathi kwesikhumba kunye nemisipha engaphantsi. I-lipomas ziitumo ezithambileyo ezivamile kwiingcuka, kunye neprevalence ethathwa ukuba malunga nephesenti elinye labantu bonke, nangona inani langempela lihlala liphakamile njengoko iilipo ezincinci ezininzi zihlala zingabhalwanga. Zihlala ziveliswa njenge miphunga ethambileyo, efana nerubbery, enobume be-dome obulula ukuhamba phantsi kwesikhumba xa icinezwa — umphumo ochazwa njengomgangatho we-doughy okanye we-fluctuant.

I-lipomas zihlala zincinci, zilingana phakathi kwe-centimeter enye kunye ne-five, nangona zihlala zikhula zibe zikhulu, kunye ne-lipomas ezinkulu ezidlula i-centimeter eziyi-10 zibalwe kwiincwadi. I-lipomas ziveliswa kakhulu kwi-trunk, kwiindawo eziphezulu, kwiindawo eziphezulu ze-thighs, kunye neebhodi, kodwa zingavela naphi na emzimbeni apho i-fat tissue ikhona. Zihlala zingabuhlungu kwaye zifumaneka ngokungaqondile xa umntu eqaphela umphunga omtsha ngexesha lokuhlamba okanye lokugqoka.

I-lipomas zihlala ziveliswa kwiingcuka phakathi kweminyaka engama-40 kunye ne-60, nangona zingavela naphi na emntwaneni. Amadoda nabafazi bahlala bephazamiseka ngokufanayo, kunye nezifundo ezithile zicebisa ukuba amadoda angama-ntoni. I-lipomas zihlala zihlala zodwa, kodwa malunga ne-5 ukuya kwi-15 pesenti yabantu abachaphazelekayo bavelisa i-lipomas ezininzi, umphumo obizwa ngokuba yi-lipomatosis. Ngaphandle kokuba zihlala ziqwalaselwa njengeetumo, i-lipomas ziqinisekisiwe ukuba azinabungozi — zikhula kancinci, azingeni kwi-tissue ezikufutshane, kwaye zineengozi ezincinci zokuguqulwa kokuba umhlaza.

Imbangela ethile ye-lipomas ayiqondwanga ngokupheleleyo, kodwa uphando luveze izinto ezininzi ezinomthelela ekwakhiweni kwazo. Ukuphosa kwemvelaphi yinto enkulu — i-lipomas zihlala ziqhuba kwiimfuno, kwaye iimeko ezithile zefamilia ziquka i-lipomas ezininzi njengomphumo ophambili. I-familial multiple lipomatosis yimeko ye-autosomal dominant apho abantu abachaphazelekayo bavelisa i-lipomas ezininzi ukuya kwiikhadi.

I-Dercum's disease (adiposis dolorosa) yimeko echazwe ngama-lipomas amaninzi abuhlungu, ikakhulu ibandakanya abafazi abaphuma kwi-menopause. I-Madelung's disease (multiple symmetric lipomatosis) ibangela i-fat deposits ezimele ngokufanayo emqolo nasemahlathini kwaye ibandakanya ukusebenzisa i-alcohol kunye neengxaki ze-metabolic. I-Bannayan-Riley-Ruvalcaba syndrome ibandakanya i-lipomas, i-macrocephaly, kunye ne-polyps ye-intestinal kwaye ixhaphake kwi-mutations kwi-PTEN tumor suppressor gene.

Kwizinga le-cellular, i-lipomas zihlala zine-chromosomal rearrangements, ngakumbi ezibandakanya i-chromosome 12q13-15 kunye ne-HMGA2 gene, i-transcription factor ebandakanyekayo ekukhuleni nasekuhlukaniseni kwee-cell. Lezi zi-mutations ze-somatic ezenzeka kwi-fat cells ezithile kunokuba zibe zi-mutations ezithathwe, kwaye zikholelwa ukuba ziqhuba ukukhula kwe-adipocytes okukhawulezayo okuvelisa i-lipoma. I-trauma iboniswe njengomgca wokukhula kwe-lipoma kwezinye iimeko — i-theory ye-posttraumatic lipoma ibonisa ukuba ukulimala okukhulu kwi-subcutaneous tissue kungakhuthaza ukukhula kwe-adipocyte okanye kukhulule i-lobules ze-fat ezikhona kwi-fascial constraints.

Nangona kunjalo, le ngxaki ihlala ixoxwa. I-obesity ayibangeli i-lipomas — zenzeka ngokuqhelekileyo kwiingcuka ezincinci kunye nezingcuka ezinzima — nangona i-lipomas zingase zibe nzima ukufumaneka ngokwenene kwiingcuka ezine-fat engaphezulu.

I-lipomas zineempawu ezininzi ezichanekileyo ezivumela ukuchonga ngokukhawuleza ngokusekelwe kwi-physical examination kuphela. Iphawu eliphambili yi-mass ethambileyo, efana nerubbery, engacinywanga eyenzelwe ukunyuka phantsi kwesikhumba.!! Xa ucinezela kwi-lipoma, ibonakala ifana ne-doughy kwaye ingahamba phantsi koxinzelelo lwezandla — ibhampa kwaye ihamba phantsi kwesikhumba ngenxa yokuba ibekwe kwaye ayixhomi kwiindawo ezikufutshane.

Le mobility iyahlula i-lipomas kwezinye i-masses ze-subcutaneous. Isikhumba esiphezulu siza kubonakala sisenziwe kakuhle — akukho mguquko, ukuncipha, okanye utshintsho lwesikhumba ngaphandle kokuba i-lipoma ibonakale kakhulu okanye ikwazile ukulimala. I-lipomas zihlala ziqhelekile okanye zihlala zifana ne-oval, zihlala zineemida ezicacileyo ezilungileyo onokuzilandelela ngezandla zakho.

Zikhula kancinci kwiinyanga ukuya kwiminyaka kwaye zihlala zingabuhlungu, nangona i-subtype ebizwa ngokuba yi-angiolipoma ibandakanya iivenkile eziphambili zegazi kwaye ingaba buhlungu xa icinezwa, ngakumbi kwiingalo zabantu abatsha. Kwimifanekiso, i-lipomas zineempawu ezichanekileyo ezinceda ukuchonga xa i-physical examination ingaqinisekanga. I-Ultrasound ibonisa i-mass echaziweyo, i-elliptical, i-homogeneously hyperechoic (bright) kwi-subcutaneous tissue.

I-MRI yindlela ye-gold standard yokufumanisa, ibonisa i-mass efakwe kakuhle eyilandelelayo i-fat signal intensity kwi-sequence zonke — ibonakale ifana ne-bright kwi-T1-weighted images kunye ne-intermediate kwi-T2-weighted images kunye ne-suppression kwi-fat-saturated sequences. Le mifanekiso ibonisa iimpawu ezichanekileyo ze-lipoma kwaye inceda ukwahlula kwi-masses ezithile ezikhathazayo ze-soft tissue.

Ingxaki ephambili yokuxilonga nayiphi na i-mass entsha engaphantsi kwesikhumba kukwahlula i-lipoma engalunganga kwi-liposarcoma — i-tumor eyingozi yeefestile ze-fat. Ngenxa yokuba i-liposarcomas zihlala zingaveli (zibandakanya malunga neepesenti eziyi-15 ukuya kweziyi-20 ze-sarcomas ezithambileyo, kunye ne-incidence engama-100,000 ngonyaka), zikhangela i-lipomas kwaye iimpembelelo zokuphosa i-liposarcoma zibalulekile. Iimpawu ezininzi ziza kunceda ukuhlula phakathi kwabo bobabini.

Ubungakanani bubalulekile — i-lipomas zihlala zingaphantsi kweesentimitha ezinhlanu, ngelixa i-liposarcomas zihlala zikhulu ngexesha lokuboniswa, zihlala zidlula iisentimitha ezinhlanu. Ukukhula ngokukhawuleza akuvamile kwi-lipomas, ezikhula kancinci ngexesha; i-mass ekhula ngokucacileyo kwiiveki ukuya kwiinyanga kufuneka ibangele ukungabaza. Indawo ibalulekile: i-lipomas zihlala zifumaneka kwi-tissue engaphantsi kwesikhumba, ngelixa i-liposarcomas zihlala ziveliswa kwi-tissues ezinzulu ezithambileyo ze-thigh, retroperitoneum, kunye ne-trunk.

Ukuma kunganika iimpawu — i-lipomas zihlala zikhululekile kwaye zicinywa, ngelixa i-liposarcomas zingaba ziqinile, ziqinile, okanye ziquka iindawo ezineendlela ezahlukeneyo. I-lipomas zihlala zikhululekile; i-liposarcomas zingabandakanywa kwiindawo ezinzulu. Ubuhlungu abuvamile kwi-lipomas (ngaphandle kwe-angiolipomas); ubuhlungu obujolise okanye obuqhubekayo kwi-mass ye-fat kufuneka bahlolwe.

Ku-MRI, i-liposarcomas zihlala zibonisa i-heterogeneity — iindawo ze-tissue engengafatyisi, i-septa ezinzima, ukwandiswa kwe-nodular kunye ne-contrast — kungekhona i-fat signal eyodwa ye-lipoma engalunganga. Umgaqo ophambili wezempilo ngu: nayiphi na i-mass engaphantsi kwesikhumba enkulu kuneesentimitha ezinhlanu, ejolise kwi-fascia, ekhula ngokukhawuleza, eqinile okanye eqinile, ebambekile, okanye ebuhlungu kufuneka ibonwe kwaye mhlawumbi ibhiyozwe ukuze kuqinisekiswe i-sarcoma, kungakhathaliseki ukuba ibonakala njani kwi-lipoma ejolise kwi-standard.!!

Ngenxa yokuba i-lipomas zihlala zingalunganga, uphuhliso alufuneki. Abaninzi babaguli abanama-lipomas amancinci, angaboni, bakhetha ukulinda kunye nokuhlola rhoqo. Nokuba kunjalo, ukususwa kungafuneka okanye kufunwa ngezizathu ezininzi: iingxaki zokubukeka, ngakumbi kwi-lipomas ezindaweni ezibonakalayo ezifana ne-nyawo, iingalo, okanye i-forehead; ubuhlungu okanye ukungonwabi, ngakumbi kwi-angiolipomas okanye i-lipomas ezicindezela kwiimithambo; ukungasebenzi kakuhle ukuba i-lipoma ivimba ukuhamba okanye icindezela iindawo ezikufutshane; ukukhula okuqhubekayo okukhupha ukukhathazeka okanye kubangela iingxaki zomzimba; ukungaqinisekisi kokuxilongwa apho i-biopsy ifunekayo ukuze kuqinisekiswe uxilongo kwaye kuhlulwe i-liposarcoma; okanye ukhetho lomguli lokususa ngokupheleleyo kunokuhlola okuqhubekayo.

Ukususwa kwe-surgical kukuphuhliso okujolise kwaye kunika ukulungiswa okugqibeleleyo kunye nezinga eliphantsi lokuphinda (malunga neepesenti eziyi-1 ukuya kweziyi-2). Le ndlela ibandakanya ukwenza i-incision phezu kwe-lipoma, ukucoca ngokucophelela i-mass ehlanganisiweyo kwi-tissues ezikufutshane, kwaye uyisuse intact. I-lipomas ezininzi ezingaphantsi kwesikhumba zingasuswa phantsi kwendawo yokuthintela njengemisebenzi yokuphuma.

I-tissue esuswe ithunyelwa kwi-histopathological examination ukuze kuqinisekiswe uxilongo. I-liposuction ingasetyenziselwa i-lipomas ezinkulu, ifaka i-cannula ngaphezulu kwe-incision encinci ukuze ikhiphe i-tissue ye-fat. Ngelixa le ndlela ishiyela i-scar encinci, ayisusi i-capsule kwaye inezinga eliphezulu lokuphinda.

Iphinde inganiki i-tissue engapheliyo yokuhlola, eyingxaki enkulu ukuba kukho nayiphi na ukungaqinisekisi kokuxilongwa. Ukususwa okuncinci (i-squeeze technique) kuhlanganisa i-incision encinci kunye nokukhupha ngesandla kwe-lipoma, kunika i-scar encinci kunezokuphuma ezidala. I-steroid injections (i-triamcinolone acetonide efakwe ngqo kwi-lipoma) inganciphisa ubungakanani be-lipoma kodwa ngokungavakali iyayisusa ngokupheleleyo. Le ndlela ingathathwa ngabaguli abafuna ukugwema ukususwa.

Ukufumanisa i-lump entsha ngaphantsi kwesikhumba sakho kuza neengxaki kwaye ngokuqhelekileyo kukhokelela kwiingxaki. Ngaba yi-lipoma? Ingaba ingaba yinto engaphezulu?

I-Skinscanner inika uvavanyo lokuqala olusekelwe kwi-AI xa uthatha umfanekiso kwaye uchaza i-lump engaphantsi kwesikhumba, ihlola iimpawu ezibonakalayo ezifana nokubukeka kwesikhumba esiphezulu, umda we-mass, kunye nendawo yayo emzimbeni. Ngelixa i-lumps ezingaphantsi kwesikhumba zivelisa umngeni oyingqayizivele kwi-analyzing ye-mifanekiso — inxalenye enkulu yolwazi lokuxilonga ivela kwi-palpation (ukuba i-lump ibonakala njani) kunokubukeka kuphela — i-Skinscanner ingasiza ukuhlola iimpawu ze-surface kunye neepateni zokwabelana ezibonisa i-lipoma engalunganga ngokuchasene neempawu ezifunekayo ukuhlolwa ngokunzulu. I-app inika umxholo wemfundo malunga ne-lumps ezingaphantsi kwesikhumba, ikunceda uqonde ukuba zeziphi iimpawu okufuneka uzihlolisise xa uziva i-lump entsha — ukuhamba, ukuma, ubungakanani, ubuhlungu, kunye nesantya sokukhula — kunye neempawu ezithile ezimele zifune ukuhlolwa ngochwepheshe.

Kubantu abaziwayo nge-lipomas, ukurekhoda rhoqo nge-Skinscanner kunceda ukulandelela utshintsho lobungakanani ngokuhamba kwexesha, kunika ubungqina obungqinelanayo bokuzinza (okukhuthazayo) okanye ukukhula (okufuneka kucwangcisiwe). Le rekodi yokuhlola umfanekiso ibaluleke kakhulu ukwabelana nomgqirha wakho ngexesha leengxoxo. I-Skinscanner ayikhuphe ukuhlola kweklinikhi kwi-masses ezingaphantsi kwesikhumba — ukuhlolwa okufanelekileyo kwe-lumps ngaphantsi kwesikhumba kudinga i-palpation, kwaye i-masses ezikhathazayo zidinga imifanekiso (i-ultrasound okanye i-MRI) kwaye mhlawumbi i-biopsy. Kodwa njengemathiriyeli yolwazi yokuqala, i-Skinscanner ikunceda uqonde ukufumanisa kwakho kwaye wenze isigqibo esinengqiqo sokuba nini ukufuna ukuhlolwa ngochwepheshe.