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},
"code": "C83.7",
"name": "Опухоль Беркитта",
"icd_name": "Опухоль Беркитта",
"gender": 0,
"age_min": 1,
"age_max": 100,
"cause": [
"0"
],
"periodicity": 1,
"slug": "c83.7_opuhol_berkitta",
"lead": "опухоль высокой степени злокачественности, относящаяся к группе неходжкинских лимфом",
"description": "<p><span id=\"docs-internal-guid-0c61850b-7fff-227a-d62a-b31eeff3d83d\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Первичный очаг может локализоваться не только в лимфоузлах, но и в различных органах и тканях: в костях лицевого скелета, желудке, кишечнике, молочных железах и т. д. Характерен агрессивный местный рост и быстрое метастазирование. </span></span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Многие врачи считают, что толчком к неправильному развитию тканей становится наличие внутри организма особого вируса под названием Эпштейн-Барр. Также указывают на то, что опухоль развивается из-за значительного снижения защитных функций системы.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причины, приводящие к развитию лимфомы Беркитта:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Снижение защитных функций организма. Явление связано с воспалительным процессом хронического характера.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Воздействие ионизирующего излучения.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Регулярный контакт с веществами – токсинами. При попадании внутрь организма токсические соединения проникают кровь и накапливаются в органах. Первой страдает печень, поскольку занимается очисткой кровяной жидкости. Часть токсинов откладывается в тканях органа, нарушая нормальное функционирование системы.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Нeблагоприятная экология в районе.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Проживание в районе сильного загрязнения.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наличие внутренних процессов неопластического вида.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врачи отмечают, что контакт с пестицидами, гербицидами и другими канцерогенами также становится причиной развития онкологии.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"pathogenesis": "",
"diagnostics": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагноз выставляется на основании жалоб, анамнеза, результатов внешнего осмотра и данных объективных исследований. Пациентам с подозрением на лимфому Беркитта выполняют биопсию лимфатического узла с последующим гистологическим исследованием. Назначают ИФА, РТ-ПЦР и ПЦР. Проводят рентгенографию черепа, КТ, МРТ, УЗИ внутренних органов и другие исследования для оценки поражения ЛОР-органов, органов брюшной полости, других органов и систем. По показаниям осуществляют стернальную пункцию.</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Основным методом лечения лимфомы Беркитта является полиохимиотерапия. Поскольку данным заболеванием чаще страдают дети, химиотерапию обычно проводят короткими курсами, чтобы уменьшить риск возникновения отсроченных токсических эффектов (нарушений роста, бесплодия, развития других злокачественных новообразований). Во всех случаях, кроме лимфомы Беркитта I стадии и состояния после радикального удаления опухоли, расположенной в брюшной полости, осуществляют профилактику поражений ЦНС с использованием метотрексата, преднизолона и цитарабина.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Химиотерапию дополняют приемом иммуномодуляторов и противовирусных средств. Назначают большие дозы интерферонов, фоскарнет и ганцикловир. Возможность применения других противовирусных препаратов для лечения лимфомы Беркитта пока находится в стадии изучения. В некоторых источниках сообщают об использовании комбинации химиотерапии и лучевой терапии, однако, исследования показывают, что облучение не повышает эффективность терапии с использованием лекарственных препаратов.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Радикальное хирургическое удаление опухоли, расположенной в брюшной полости или забрюшинном пространстве, рассматривается как вспомогательный метод лечения лимфомы Беркитта, улучшающий качество жизни пациентов, но не оказывающий влияния на прогноз. Операции при опухолях челюстей (даже сопровождающихся выраженной деформацией) не показаны из-за обильной васкуляризации лимфомы Беркитта и высокого риска развития массивного кровотечения. Иногда хороший эффект дает своевременная пересадка костного мозга.</span></p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Профилактика лимфомы Беркитта на разработана.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Проявления лимфомы Беркитта зависят от того, где она находится. Опухоль может локализоваться как в лимфатических узлах, так и в различных органах, в которых имеется лимфоидная ткань (экстранодальные поражения). Для лимфомы Беркитта более характерна экстранодальная локализация. Наиболее распространенные проявления формы заболевания, связанной с иммунодефицитом:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При поражении подкожных лимфатических узлов появляется опухоль, которую можно увидеть и прощупать. Обычно она безболезненная и быстро растет.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При лимфомах в брюшной полости беспокоит дискомфорт, боль в животе, тошнота, увеличение живота, боли в спине, диарея. Могут возникнуть симптомы кишечной непроходимости, желудочно-кишечного кровотечения.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При лимфомах красного костного мозга опухолевые клетки вытесняют нормальную кроветворную ткань. В итоге снижается количество всех клеток крови. Чаще всего таких пациентов беспокоит одышка, постоянное чувство усталости, повышенная кровоточивость, которая проявляется в виде синяков.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Общие симптомы включают потерю веса (до 10 кг и более за месяц), беспричинные повышения температуры тела, потливость по ночам, зуд во всем теле. Эти проявления называются B-симптомами.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Спорадические лимфомы Беркитта чаще всего находятся в брюшной полости, реже в области головы, шеи. В редких случаях отмечается поражение челюсти, красного костного мозга, средостения, центральной нервной системы, яичек, кожи, щитовидной железы и молочной железы.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Эндемическая форма обычно проявляется в виде поражения челюсти, мочеполовой системы или отека вокруг глаз.</span></p>",
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"name": "Диффузная неходжкинская лимфома неуточненная",
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"standard_type": 3,
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"parent": 7982,
"block_rubric": 34,
"standards": []
}
]
}