
stun srav karkarog

stun sravi karkarog (emm. ess. see.), jyala stanacha sravi karkarog dekhil mhanatat, haah stanachya karkarogacha eka durmil prakar aahe. emm. ess. see. sahasa striyanna prabhavit karate parantu lakshaniy takkevarit purush aanee mulanmadhyehi hote. kharey tarr, mcdavit aanee stuart yanni pratham 1966 madhye emm. ess. see. chey varnan kele aanee tyala kishore stanacha karkarog asey mhatale kaaran tyaveli kishoravayin mahilanmadhye prakarananchi sankhya vadhali hotee. emm. ess. see. haah mulanmadhil stanachya karkarogacha sarvat samanya prakar aahe, joou balpanatil stanachya karkaroganpaiki 80 takke karkaroganche pratinidhitva karato, jaree serve stanachya karkaroganpaiki too 0.15% peksha qamee aahe. (balrog loksankhyemadhye, stanachya serve durdamya roganpaiki sumare 65 takke karkarog aahet.)
1980 madhye, tavosoli aanee norris yanni kishore stanachya karkarogache naav badaloon 'stanacha sravi karkarog' asey kele, jeey tyachya eosynophilic (i.eae. laal kinwa gulabi) bahya koshikeey srav jevha tyachya uutinvar etch andd eae dagane rangale gele hote. stanachya karkarogachya sthanacha sandarbh naan gheta emm. ess. see. laa kadhikadhi sravi karkarog mhatale jaate. tathapi, sravi karkarog haah shabd laale granthi (aata stun analogue sravi karkarog mhanatat), thyroid granthi (aata thyroidcha laal granthi-prakarcha karkarog mhanatat) kinwa tvacha (aata tvachecha sravi karkarog kinwa prathamik tvachecha stun analogue gupt karkarog mhanatat) madhye sthanbaddh asalelya emm. ess. see. chya sookshm swarupasah arbudanche naav denyasathi dekhil vaparla gela aahe. stun sravi karkarog haah purvichya sravi karkaroganpasun vegala karnyasathi yethe vaparla jaato. 
emm. ess. see. samanyatah ductal stanachya gathee mhanoon vikasit hotat jyanni tyanchya mool nalikanchya sabhovatalachya uutinvar aakraman kele aahe, jawalchya centinal lymph nodes kinwa accelery lymph nodesmadhye pasarale asateel parantu kvachitach metastasise kelele asateel (i.eae. pasarane) durchya uutinmadhye. teey sahasa lahan, haloohaloo vadhanare, vedanarahit, changlya prakare pradakshina ghatalele, halanare stananche dravyaman asatat. emm. ess. see. gathimadhye samanyatah vishisht sookshm vaishishtye aanee gathee peshi asatat, jyat eka vaishishtyapurn anuvanshik vikrutee asate, jee tyanchya vikas aanee/kinwa pragatila aadhar denari disate.
sthanik emm. ess. see. ess. gathisathi shastrakriya kadhoon takane haah upcharacha mukhya aadhar manla gela aahe. emm. ess. see. tumourchya durmil prakarananmadhye, jyanche metastacisation durvarchya uutinmadhye jhaale aahe, tyanchyavar chemotherapy aanee radiation therpidware upchar kele gele aahet, parantu yaa upcharanna farsa kinwa konatahi pratisad disun aalela nahee. emm. ess. see. tumour peshinmadhil anuvanshik vikruteela lakshya karnari aushadhopacharpaddhati nantarchya tumoursathi adhik prabhavi upchar asoo shakate, asey udayonmukh abhyas suchavatat.
sadarikaran.
emm. ess. see. chey nidan jhalelya 190 vyaktinchya punaravalokan abhyasat, rugnache vay 2 teey 96 varshe (sarasari vayah 56 varshe) hote; 5 takke prakarane 21 varshanpeksha qamee vayachi hotee; purush teey stree gunottar 1 teey 30 hote; gathee anukrame 103,85 aanee 2 prakarananmadhye davya, ujavya aanee donhi stananmadhye hotya; aanee gathee samanyatah stanachya davya, bahya chaturthanshavar asatat. (tarun rugnanmadhye, hii gaath adhik vela eriolachya khalee udbhavtat, mhanje.eae. stanachya stanagrajaval rangdravya asalela bhag.) 99 rugnanchya upagatat, jyavar pureshi mahitee hotee, gathicha sarasari aakar 2.3 centimeter (centimeter) hota.) yaa rugnanpaiki 29.3% lasika granthi metastasischa purava detat. yaa abhyasat asey rugna navhate jyanna tyanchya prahari lasika granthichya palikade uutinmadhye metastasis jhaala hota. emm. ess. see. asalelya 44 vyaktinchya punaravalokan abhyasat, 41 rugna mahila aanee 3 purush hote; 4 rugna kishoravayin asoon 4 rugna aanee rugnache vay 4 teey 76 varshe (sarasari vayah 48 varshe) darmyan hote; rugnachya arbudache aakarman 1.5 teey 10 centimeterparyant hote. (sarasari aakarah 3.5 semee.) (emm. ess. see. chya vaiyaktik prakarananmadhye gathicha aakar 16 centimeter itka motha hota.) aanee 15 rugnanna lasika granthi metastasische lakshan hote. yapaiki konatyahi rugnala centinal lymph nodeschya palikade metastasis navhata, tarr sarasari 93.4 mahinyanchya pathpuravyachya abhyasat hadanna metastasis asalele 4 rugna, yakrutala metastasis asalele 1 rugna aanee anirdisht durastha metastasis asalele 1 rugna aadhalale. yapaiki paach rugna tyanchya aajarane maran pavale.
eka punaravalokan abhyasat 12 mahila aanee 2 purush rugna 8 teey 81 varshe (sarasari vayah 48 varshe), 8 rugna spasht vastumanasaha sadar kele gele, 4 rugnanni memographychya tapasanivar aadhalalelya vastumanasaha sadar kele aanee 2 rugnanna yabaddal mahitee navhati; 8 gaath davya bajula aanee 6 ujavya stanat hotee; aanee bayopsidware chachani kelelya 10 petantpaiki 2 petantmadhye centinal lymph node metastasis hote. yapaiki eka rugnala durchya uutinche metastasis hote, 12 rugnanna tyanchya prarambhik nidan aanee upcharanchya 5-240 mahinyanchya aat durchya metastasis punha sadar kele gele aanee ekala yabaddal mahitee navhati. yapaiki aath rugna tyanchya rogamule tyanchya prarambhik nidananantar 7 teey 240 mahine (sarasari jaganyacha samayah 74.6 mahine) maran pavale, 4 tyanchya rogasah tyanchya prarambhik nidananantar 7 teey 84 mahinyanni jiwant hote aanee 2 laa yabaddal konatihi mahitee navhati. metastes, jeey anekada anek thikani asat, teey fuffus (9 prakarane), yakrut (4 prakarane), hadey (4 prakarane), tvacha (2 prakarane), mootrapind (1 prakaran), mediastinum (1 prakaran), swadupind (1 prakaran) aanee/kinwa fuffusachya fuffusamadhye (1 prakaran) hote. stananchya papillomatosisathi upchar jhalelya kinwa jhalelya vyaktinmadhye emm. ess. see. chee durmil prakarane aadhalali aahet; heey saumya stanache rog bahutekda itar stanachya carcinomashi sambandhit asatat, jyapaiki sarvat samanya emm. ess. see. aahe. 
2019 paryant, keval 6 prakarane purnapane 'inn seatoo' (mhanje.eae. stananchya nalikanchya bahereel uutinvar aakraman naan kelelya purnapane sthanik tumour) tumour (ingraji sahityat nondavalyapramane). yaa serve prakarananmadhye arbud uutinmadhye papillary microscopic hystopathologies kiman eka kshetra hote (pathology vibhag pahaa).
pathology.
etch andd eae-stein emm. ess. see. tumourchya sookshm hystopathologymadhe samanyatah anek sukshmapeshi aanee upakala peshinchya patrakansah changlya prakare pradakshina ghatalele ghan tumour disun yetat, jyat tyanchya cytoplasm, signet ring peshinmadhye (mhanje.eae. globule mhanoon olakhalya jaananya eka mothya cytoplasmic vacule asalelya peshi aanee cytoplasmic globulesarkhe disanare bahyakoshikiy thembasarkhe strav. peshinchya patraka sanyoji uutinchya pattyanni vegalya kelya jaatat. adhunmadhun, emm. ess. see. gathitil peshi eka pepilarimadhye (mhanje.eae. botasarkhe) kinwa nalikatmak namuna. etch andd eae dagane rangalele asatana bahyakoshikiy sukshmapeshi aanee antahkoshikiy nirvat aanee golakar laal rangat rangatat, sulfated glycosaminoglycanes aanee musinyukt samagri asatat aanee niyatkalik aaml-shif, padd diastage kinwa elysian nile daag vaparoon olakhale jaatat. emm. ess. see. sathee 'srav' hii sandnya hii manya karate qee uutinna tyanche sukshmasakriy swaroop denyasathi arbud peshi vacules aanee globules bahya koshikiyaritya sravit hotat. emm. ess. see. chya kiman 2 prakarananmadhye tyanchya gathichya kahee bhaganmadhye sarcoma sarkhya ghatak peshi aanee vegane metastasising rog hota.
immunohystochemistry.
emm. ess. see. gathichya amohistochemical vishleshanat asha peshi aadhaltat jyah 50 takkyanhun qamee rugnanmadhye (eka mulasah) istrogen aanee/kinwa progesterone receptors vyakt karatat; durmil prakarananmadhye tiche 2/neuro receptors vyakt karatat; aanee bahutek prakarananmadhye ess 100 prathine, mamaglobin prathine aanee cytocaratin 5 kinwa 6 (cytocaratin 5/6 pratipinde vaparoon aadhalalyapramane) vyakt hotat. 44 rugnanchya abhyasat, emm. ess. see. tumour peshinni anukrame 21,23,16,12 aanee 42 rugnanmadhye istrogen receptor, progesterone receptor, harr2/neuro receptor, pii53 tumour prathine aanee ess100 prathine vyakt kelee.
anuvanshik vikrutee.
emm. ess. see. gathimadhye utparivartan hote, i.eae. eka santulit anuvanshik sthanantar, jyamadhye 'aine. tii. aar. keey. 3' janukacha jyaa bhagat band donmadhye sthit aahe, too bhag kyu (aay) varr paach up-band 2 (gunasutra banding pahaa) aahe.eae. gunasutra 15 chaa lamb) bahoo haah samooh ekamadhye asalelya "eae. tii. vhee. 6" janukanchya eka bhagashi, gunasutra 12 varr teen up-samooh 2 madhye sthit asalelya "eae. tii. vhee. 6-aine. tii. aar. keey. 3" yaa sanlayan januk utpadanat, eae. tii. vhee. 6-aine. tii. aar. keey. 3 navachya chimerick utparivartit prathinala sanketan kele jaate. heey sanlayan prathin aanee tyache sanketan "eae. tii. vhee. 6-aine. tii. aar. keey. 3" heey sanlayan januk bahutekanchya arbud peshinmadhye aadhaltat (udaa.jee. 88.emm. ess. see. chee 6 takke teey 100%) prakarane. eae. tii. vhee. 6-aine. tii. aar. keey. 3 prathinanchya aine. tii. aar. keey. 3 bhagat tyrosine keynage kriyakalap niyantrit asato. hii kriya done sanket marganna uttejit karate, piay3keey/aii. keey. tii./emm. tii. aar. aanee mapke/aii. aar. keey. marg, jeey peshinchya prasarala, peshinchya astitwala protsahan detat aanee asey manale jaate qee, tyadvare emm. ess. see. chya vikasat aanee/kinwa pragatimadhye yogdan detat. emm. ess. see. gathimadhye disana riktika aanee golakaranchya vikasala uttejan denyasathi dekhil heey marg jababdar asoo shakatat. eae. tii. vhee. 6-aine. tii. aar. keey. 3". sanlayan januk aanee tyache eae. tii. vhee. 6-aine. tii. aar. keey. 3. chimerick prathin utpadan heey stanpayi granthichya stanpayi analogue sravi karkarog, thyroidchya laale granthi-prakarchya karkarog aanee tvachechya sravi karkarogachya arbud peshinmadhye dekhil aadhaltat. bahutek emm. ess. see. gathimadhye nondavalele heey sthanantar heey ekmev anuvanshik utparivartan aahe; emm. ess. see. gathee peshinmadhil eka vaishishtyapurn vaishishtyapurn anuvanshik vikrutee aahe; emm. ess. see. chya nidanachi pushti karnyasathi vaparali jaate; aanee yamule ghatak emm. ess. see. gathivar larotrectinib yaa aushadhane upchar kele jaatat, jeey eae. tii. vhee. 6-aine. tii. aar. keey. 3 sanlayan prathinanchya aine. tii. aar. keey. 3 bhagachya tyrosine keynage kriyakalapala pratibandhit karate.
nidan.
emm. ess. see. gathiche nidan stanachya ductal uutinmadhye tyanchya ghatanevar, tyanchi vishisht sookshm hystopathological vaishishtye aanee visheshtah paypillary hystopathology darshavina gathimadhye, peshinchya gathimadhye asaleli upasthiti jee "eae. tii. vhee. 6-aine. tii. aar. keey. 3" sanlayan januk aanee/kinwa tyache eae. tii. vhee. 6-aine. tii. aar. keey. 3 chimerick prathine vyakt karate yavar avalambun asate. tarr 'eae. tii. vhee. 6-aine. tii. aar. keey. 3' januk sanlayan itar anek prakarchya arbudanmadhye (udaa.jee. dahak myophybroblastic tumour, janmajat mesoblastic nephromacha cellular prakar aanee kiranotsarg-prerit papillary thyroid carcinoma), yaa tumourchi clinical sadarikaran aanee hystopathologyche nishkarsh tyanna emm. ess. see. tumourpasoon vegale karatat.
upchar.
emm. ess. see. gathivar upchar karnyasathi vaparlya gelelya anek vegvegalya dhorananche moolyankan karnare konatehi niyantrit abhyas jhalele naheet. abhyasanni asey suchavale aahe keeh 1) emm. ess. see. gaath 2 kinwa 3 centimeterpeksha qamee aakarachi, parighbaddha gathee, akshatantu lasika granthi metastasischa konatahi purava nasaleli gaath, nidanaveli 20 kinwa 30 varshanpeksha qamee vayachya vyaktinmadhye gaath aanee/kinwa purnapane 'sthit' asalelya gathimadhye adhik anukool purvasoochana asatat; 2) prasar honyache uchch praman asalelya gathee, 2 teey 3 centimeterpeksha jaast vyapak parimanatil gathee, sarcoma sarkhya peshinche bhag asalele gathee, 20 kinwa 30 varshanpeksha jaast vayachya vyaktinmadhye gathee aanee/kinwa durchya uutinmadhye pasarlelya gathimadhye qamee anukool purvasoochana asatat.
sarvasadharanpane, emm. ess. see. gathisathi shastrakriya haah sarvottam upchar manla gela aahe parantu yaa shastrakriyechya vyaptivar ekmat nahee. emm. ess. see. tumour asalelya, jyanche rognidan adhik anukool aahe, asha rugnansathi, sanvedanshil shastrakriya kinwa centinal lymph nodeschya biopsies sadhya stanchhedanachi shifaras kelee gelee aahe. serve aakramak ootee kadhoon takalya gelya aahet yachee khatri karnyasathi gathala lagoon asalelya stun ootee kadhoon takanyachi shifaras dekhil kelee gelee aahe kaaran shastrakriyenantar gaath ootee mage sodalyane sthanik punaravrutti honyacha dhoka jaast asato. pratikool purvasuchanatmak vaishishtyansah gathinvar radicals mastectomeedware upchar kele gele aahet. emm. ess. see. gathee haloohaloo vadhatat, tulanene changle purvasoochana detat aanee jarr durchya uutinmadhye metastasising samanyatah fakt 10 teey 20 varshannantar kele tarr, sahayyak chemotherapy aanee/kinwa radiotherapychya fayadhyasathi konatahi thos purava nahee. emm. ess. see. asalelya 190 rugnanchya purvalakshi abhyasat, jyanni durchya uutinmadhye metastasize kele navhate, asey aadhalale qee stanachi sanrakshn shastrakriya aanee radiotherapyne sadhya stanchhedanapeksha jaganyacha barach changla kaal deela. sarvasadharanpane, emm. ess. see. asalelya mulansathi puresa upchar mhanoon, puranmatvadi shastrakriya, sudharit radical mastectomy aanee radical mastectomy yaa praudhanmadhye sarvat varanvar honanya prakriya aahet, tarr sadhya mastectomy, centinal lymph node biopsies sthanik vichhedan aanee sampoorn aksheey vichhedan yanchi shifaras kelee gelee aahe. kiranotsarg upcharpaddhati nantarchya upcharpaddhatinpaiki eka kinwa adhik sudharate yachee pushti karnyasathi pudhil abhyas aavashyak aahe. serve prakarananmadhye, dirghakalin pathpurava tapasani, udaa.jee. nidananantar kiman 20 varshanparyant, jordar shifaras kelee jaate.
emm. ess. see. gathichya durmil prakarananmadhye, jeey tyanchya prarambhik sadarikaranantar kinwa purv upcharanantar durchya uutinmadhye pasaratat, tyanchyavar vividh chemotherapy pathkandware upchar kele gele aahet. yaa regimentna midalela pratisad qamee teey shoonya aahe. alikade, durchya uutinmadhye metastasise jhalelya "eae. tii. vhee. 6-aine. tii. aar. keey. 3" fusion januk-aashray emm. ess. see. tumour asalelya teen vyaktinvar (done alpavayin mahila aanee eka 26 varshancha purush) laerotrectinib yaa aushadhane upchar karnyat aale, jeey yaa rogachya antargat asalelya anuvanshik vikrutivar hallah karate. heey aushadh tondawate upalabdh asalele nivadak aine. tii. aar. keey. aay. avarodhak aahe jeey aine. tii. aar. keey. 3 prathinanchya tyrosine kinness kriyakalapanna avarodhit karate. nondavalelya teen emm. ess. see. prakarananmadhye tyane changla, vegane vikasit honara pratisad deela aahe. tathapi, yaa teen pratikriya anshatah hotya, i.eae. kahee arbud ootee upcharanantar shillak rahilya. larotrectinibchi parinamkarakta, tyachya parinamancha kalavadhi aanee entrectinibsarkhya itar emm. tii. aar. keey. 3 prathine avarodhakanchi parinamkarakta paribhashit karnyasathi emm. ess. see. asalelya vyaktinchya mothya sankhyevar pudhil abhyas aavashyak aahe.
purvasoochana.
ekandarit, emm. ess. see. chaa eka anukool purvasoochana aahe. durchya uutinmadhye naan pasarlelya emm. ess. see. sathee upchar kelelya 190 vyaktinchya abhyasat, 95.79,93.16 aanee 93.16% chya prarambhik upcharanantar anukrame 5,10 aanee 20 varshanni jaganyache praman (itar karananmule maran pavana vyakti vagalata) nondavale gele. emm. ess. see. chya durmil prakarananmadhye, jyanche durchya uutinmadhye rupantar jhaale aahe, tyancha jaganyacha kalavadhi dekhil dirghkal asoo shakato, parantu kahee qamee jaganyachya velesah (udaa.jee. nidananantar 1 varsh). larotrectinib upcharpaddhatimule, nidan qamee jhalelya emm. ess. see. gathee asalelya vyaktinmadhye jaganyacha kaal sudharu shakato.