Kadrovska organizacija/struktura i funkcionisanje centara za transplantaciju matičnih ćelija – kako optimizovati program transplantacije?

  • Milena Todorović Balint Klinika za hematologiju Kliničkog centra Srbije, Beograd
  • Bela Balint Institut za kardiovaskularne bolesti „Dedinje”, BeogradSrpska akademija nauka i umetnosti, Beograd, Srbija
  • Irena Đunić Klinika za hematologiju Kliničkog centra Srbije, Beograd, Medicinski fakultet Univerziteta u Beogradu, Srbija
  • Mihailo Smiljanić Klinika za hematologiju Kliničkog centra Srbije, Beograd
  • Biljana Mihaljević Klinika za hematologiju Kliničkog centra Srbije, Beograd, Medicinski fakultet Univerziteta u Beogradu
Ključne reči: limfadenopatija, diferencijalna dijagnoza

Sažetak


Kod većine pacijenata sa perifernom limfadenopatijom je lako identifikovati njen uzrok, koji je obično benigne prirode ili lokalizovan. Prevalencija maligniteta kod pacijenata sa limfadenopatijom u primarnoj zdravstvenoj zaštiti je pro­ce­njena na oko 1,1%. Identifikacija limfadenopatije uzrokovane malignitetom ili drugim teškim stanjima predstavlja kritičan izazov za lekare u primarnoj zdravstvenoj zaštiti. Glavni faktori rizika za malignitet su starost, čvrsti i fiksirani nodusi, supraklavikularna lokalizacija i trajanje limfadenopatije više od 2 nedelje. Posedovanje znanja o ovim ključnim faktorima rizika je kritično u tretiranju neobjašnjive limfadenopatije. Uz to, uzimanje kompletne anamneze, procena povezanih simptoma i detaljan fizički pregled mogu da pomognu u utvr­đivanju da li je limfadenopatija benigna ili maligna. Ne­objašnjiva limfadenopatija bez znakova ili simptoma teškog oboljenja ili maligniteta može biti praćena do mesec dana, nakon čega se indikuje specifično testiranje ili biopsija. Iako su moderne hematopatološke tehnike unapredile dijagnostičku preciznost aspiracije (biopsije) tankom iglom, eksciziona bi­opsi­ja i dalje ostaje dijagnostička procedura prvog izbora.

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