
myeloid sarcoma

myeloid sarcoma (chloroma, granulocytic sarcoma, extramedulary myeloid tumour) ack thhos tumour haye joe aparipakva shwet rakt koshikaon seey banaa hotaa haye jise myeloblast kahaa jaataa haye. chloroma teevra myeloid leukemia kii ack baahya abhivyakti haye; dusare shabdon mein, yeh asthi majja key baahar honey vaali leukemic koshikaon kaa ack thhos sangrah haye.
prakaar.
teevra leukemia mein.
chloroma durlabh hain; unake prasaar key sateek anumaanon kii kamee haye, lekin way asamanya roop seey leukemia key upchaar mein visheshagyata rakhane vaale chikitsakon dwara bhee dekhe jaate hain. nimnalikhit roga visheshtaon vaale rogiyon mein chloroma kuchh adhik aam hoe sakata haih
haalaanki, uparokt jokhim karakon vaale rogiyon mein bhee, chloroma teevra myeloid leukemia kii ack asamanya jatilata bunny hui haye.
shayed hii kabhi, ack chloroma teevra myeloid leukemia key spasht roop seey safal upchaar key baad punaravritti kii ekmatra abhivyakti key roop mein vikasit hoe sakata haye. chloroma key samanya vyavhaar koo dhyaan mein rakhate hue, iss tarah kii ghatana koo ack sthaaniyakrit prakriya key bajaay ack pranaaleegat punaravritti kii praarambhik shuruat maanaa jaanaa chaahiye. 24 rogiyon kii ack sameeksha mein, jinhone teevra myeloid leukemia key upchaar key baad alag-alag chloroma vikasit kiya, asthi majja key phir seey honey taka kaa ausat antaral 7 maheene (seema, 1 seey 19 maheene) thaa.
myeloproliferative yaa myelodysplastic syndrome mein.
chloroma myelodysplastic syndrome (aim. dee. aiss.) yaa myeloproliferative syndrome (aim. pee. aiss.) (ee.) key nidan vaale rogiyon mein hoe sakata haye.jee. chronic milogenous leukemia (see. aim. ell.), polycythemia vera, aavashyak thrombocytosis, yaa myelophybrosis). chloroma kaa pataa lagaane koo "vaastavik" pramaan maanaa jaataa haye kii yeye poorv-rogsoochak sthitiyaan ack teevra leukemia mein badal gaee hain jisake liye uchit upchaar kii aavashyakta hoti haye. udaaharan key liye, chloroma kii upasthiti yeh ingit karane key liye paryaapt haye kii purana milogenous leukemia apane 'visfot sankat' charan mein pravesh curr gayaa haye.
eosynophilic leukemia mein.
myeloid sarcoma aur eosynophilia key saath prastut "fip1ell1-pdgfra" sanlayan jeane-prerit eosynophilic leukemia kaa cumm seey cumm ack mamla saamane aaya haye. myeloid sarcoma kaa yeh roop adhik aakramak aur vishaakt chikitsa key bajaay imatinib ("fip1ell1-pedigra" sanlayan jeane-prerit eosynophilic leukemia key liye anushansit upchaar) key saath isake atyadhik safal upchaar seey pratishthit haye.
praathamik chloroma.
bahut cumm hii, chloroma teevra leukemia, teevra promilocytic leukemia yaa aim. dee. aiss./aim. pee. aiss. key gyaat poorv-maujood yaa sahavarti nidan key binaa hoe sakata haye; ise praathamik chloroma key roop mein jaanaa jaataa haye. iss sthiti mein nidan vishesh roop seey chunautipurna haye (neeche dekhein). praathamik chloroma key lagbhag sabhi report kiye gaye mamalon mein, teevra leukemia jald hii vikasit hoe gayaa haye (teevra leukemia key vikas kaa ausat samay 7 maheene, seema 1-25 maheene). isaliye, praathamik chloroma koo ack sthaaniya prakriya key bajaay teevra leukemia kii praarambhik abhivyakti maanaa jaa sakata haye, aur iska ilaaj iss tarah kiya jaa sakata haye. jahan roga kaa vikas yaa marker teevra promilocytic leukemia (aeye. aim. ell. 3) upchaar kii or badhane kaa sanket dete hain, vahaan iss prakaar kii bimari key anuroop upchaar kiya jaanaa chaahiye.
sthaan aur lakshan.
chloroma lagbhag kissy bhee anga yaa ootak mein hoe sakata haye. shamil honey key sabse aam kshetra twacha (jise "leukemia cutis" key roop mein bhee jaanaa jaataa haye) aur masoode hain. twacha kii sanliptata aamtaur parr violesius, ubhari hui, gair-komal pattikaon yaa gaanthon key roop mein dikhaai detee haye, joe biopsy parr myeloblast key saath ghuspaith karate paae jaate hain.aine. see. bee. aaee..aine. ell. aim.naah.sarkaar/pubmed/26063639 ">
</dhyaan dein kii leukemia cutis sweets syndrome seey alag haye, jisamen twacha ack paranoplastic prakriya mein paripakva neutrophil dwara ghuspaith kii jaati haye. masoodon kii sanliptata (gingival hypertrophy) soojan, kabhi-kabhi dardanaak masoodon kii or leey jaati haye joe daanton koo brush karane aur anya mamuli aghaat key saath aasaani seey khoon beh jaati haye.
anya ootak joe shamil hoe sakate hain unamen lymph nodes, chhoti aant, mediastinum, fefde, epidural site, garbhashay, andashay aur aankh kii kaksha shamil hain. inn sthalon parr chloroma key lakshan unake shaaririk sthaan seey sambandhit hain; chloroma bhee lakshanheen hoe sakate hain aur aakasmik roop seey teevra myeloid leukemia vaale vyakti key mulyankan key dauran khoje jaa sakate hain.
kendriya tantrika tantra kii bhagidari, jaisa kii oopar varnit haye, aksar "meningial leukemia" kaa roop letee haye, yaa leukemic koshikaon dwara sub-arachnoid sthaan parr aakraman karati haye. iss sthiti koo aamtaur parr chloroma seey alag maanaa jaataa haye, kyonki isake liye vibhinn upchaar vidhiyon kii aavashyakta hoti haye. vaastavik chloroma (i.ee. kendriya tantrika tantra key thhos leukemic tumour) bahut durlabh hain, lekin inca varnan kiya gayaa haye.
nidan.
chloroma key nishchit nidan key liye aamtaur parr vicharadhin ghaav kii biopsy kii aavashyakta hoti haye. aitihaasik roop seey, ootak biopsy key saath bhee, pathological galat nidan ack mahatvapurna samasya thee, vishesh roop seey rogiyon mein pathologist kaa margadarshan karane key liye teevra myeloid leukemia key spasht poorv-maujood nidan key binaa. chloroma parr ack prakaashit shrinkhala mein, lekhakon ney kahaa kii 47 pratishat rogiyon kaa shuru mein galat nidan kiya gayaa thaa, aksar ack ghaatak lymphoma honey key roop mein.
haalaanki, naidaanik takneekon mein pragati key saath, chloroma key nidan koo adhik vishvasaniya banaaya jaa sakata haye. travic aur anya. immunohistochemistry key madhyam seey chloroma kaa sateek nidan karane aur ise lymphoma seey alag karane key liye myeloperoxidase, cd68, cd43 aur cd20 key khilaf monoclonal antibody key ack vyaavsaayik roop seey upalabdh panel key upayog kaa varnan kiya. aajkal, cd33 aur cd117 key khilaf monoclonal antibody kaa upayog karke immunohystochemical steining nidan kaa mukhya aadhar hoga. pravaah koshika-maapan key teji seey parishkrit upayog ney inn ghaavon key adhik sateek nidan koo bhee suvidhajanak banaaya haye.
purvanumanatmak mahatva.
teevra myeloid leukemia key rogiyon mein chloroma key purvanumanatmak mahatva parr sakshya virodhabhasi haye. samanya taur parr, unhein upchaar key liye kharaab pratikriya aur badatar uttarjeevita key saath ack kharaab purvanuman key liye sanket diyaa jaataa haye; haalaanki, anya logon ney anya kharaab purvanuman karakon key saath ack javic marker key roop mein chloroma key sahayogi kii soochana dee haye, aur isaliye swatantra purvanuman mahatva naheen haye. praathamik prithak coloroma key mamle mein, purvanuman behtar haye 
upchaar.
jaisa kii oopar varnit haye, chloroma koo hamesha alag-thalag sthaaniya ghatnaaon key bajaay pranaaleegat roga kii abhivyaktiyaan maanaa jaanaa chaahiye, aur iss tarah seey ilaaj kiya jaanaa chaahiye. nae nidan kiye gaye leukemia aur ack sambandhit chloroma vaale rogi mein, leukemia key khilaf pranaaleegat chemotherapy kaa upayog aam taur parr pahali pankti key upchaar key roop mein kiya jaataa haye, jaba taka kii chloroma key sthaaniya upchaar key liye koee sanket naa hoe (jaise.jee. reedh kii huddy kaa samjhauta) ubharata haye. chloroma aamtaur parr maanak antileuchemic chemotherapy key prati kaafee samvedansheel hotey hain. upayukt upalabdh daataa key saath swasth rogiyon mein allogenic hematopoetic stame cell pratyaropan parr vichaar kiya jaanaa chaahiye, kyonki deerghakaalik chhoot kii soochana dee gaee haye.
yadi induction chemotherapy key puuraa honey key baad chloroma banaa rahata haye, tou sthaaniya upchaar, jaise kii sergery yaa vikiran chikitsa parr vichaar kiya jaa sakata haye, halanki donon mein seey kissy kaa bhee astitva parr prabhaav naheen padata haye.
praathamik chloroma vaale rogiyon koo aam taur parr pranaaleegat chemotherapy praapt hoti haye, kyonki chloroma kaa pataa chalane key baad teevra leukemia kaa vikas alpaavadhi mein lagbhag saarvbhaumik hotaa haye.
teevra leukemia key liye ilaaj kiye gaye rogiyon koo, joe ack alag chloroma key saath phir seey aatey hain, aamtaur parr phir seey honey vaale leukemia key liye pranaaleegat chikitsa key saath ilaaj kiya jaataa haye. haalaanki, kissy bhee punah praapt leukemia kii tarah, durbhagya seey parinam kharaab hain.
pree-leukemic" sthitiyon vaale rogi, jaise kii myelodysplastic syndrome yaa myeloproliferative syndrome, joe chloroma vikasit karate hain, unhein aksar aise maanaa jaataa haye jaise way teevra leukemia mein badal gaye houn.
itihas.
abb chloroma key roop mein jaani jaane vaali sthiti kaa varnan pahali baar british chikitsak aeye. 1811 mein jalata haye, halanki "chloroma" shabd 1853 taka dikhaai naheen diyaa thaa. yeh naam yunani shabd "chloros" (haraa) seey liya gayaa haye, kyonki inn tumours mein aksar myeloperoxidase kii upasthiti key kaaran haraa rung hotaa haye. chloroma aur teevra leukemia key beach sambandh koo pahali baar 1902 mein dock aur warthin dwara pahachaana gayaa thaa. haalaanki, kyonki inmein seey 30 pratishat taka tumour harey key bajaay safed, bhoore yaa bhoore rung key hoe sakate hain, adhik sahee shabd "granulocytic sarcoma" 1967 mein rapport dwara prastaavit kiya gayaa thaa aur taba seey yeh "chloroma" shabd kaa lagbhag paryaay bunn gayaa haye.
vartamaan mein, teevra myeloid leukemia kii kissy bhee baahya abhivyakti koo granulocytic sarcoma yaa chloroma kahaa jaa sakata haye. vishisht shabd joe granulocytic sarcoma key saath overlap hotey hain unamen shamil hainh
haal key varshon mein, "myeloid sarcoma" shabd koo pasand kiya gayaa haye.

