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Gastroenterology (Expert Forum)
Biopsy Results § Blood Test
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Biopsy Results § Blood Test
by thaibinh, Apr 07, 2004 12:00AM
I just had a biopsy on 30 March 2004 and the results are back (please see the report below). Please help me to make sense out of this report and what is my liver cuurent status based on the biopsy report. I'm trying to do some findings/reserach prior to seeing my doctor.
In addition to the report below, here are some of my blood test result
- AST 19; ALT 14
- HEP B Viral DNA: 1470 IU/ml
- HP B Viral DNA: 2820 copies/ml
- HVC RNA, quantitative (Real time PCR): <50 IU/ML
- HVC RNA, quantitative (Real time PCR): <1.70 LOG IU/ML
Thanks
=================================
Pathology Report -- Liver Biopsy
MICROCOSPIC FINDINGS:
The sections reveal multiple needle like fragments of liver parenchyma showing some preservation of the architecture, there is some mild fatty infiltration which is patchy. The parenchyma shows an occasional focus of individual liver cell drop out but no balloon generation or councilman bodies are seen. There is no bile stasis. A rare nucleus shows glycogenation. The portal areas show some expansion, chronic inflammation and some break in the limiting plate with a few inflammatory cells spilling
into the adjacent lobule. An occasional bile duct radicle is identified. No marked increase in fibrosis or bridging is identified.
Special stains with trichrome show some portal fibrosis but no distinct bridging or cirrhosis noted.
DIAGNOSTICS:
NEEDLE BIOPSY OF LIVER SHOWING PORTAL TRIADITIS, MINIMAL FATTY INFILTRATION AND CHRONIC HEPATITIS, COMPATIBLE WITH HEPATITIS-C INFECTION
NO BRIDGING FIBROSIS OR CIRRHOSIS NOTED.
THE SEVERITY INDEX IS SCORE AT 8 OUT OF A SCORE OF 28
=================================
In addition to the report below, here are some of my blood test result
- AST 19; ALT 14
- HEP B Viral DNA: 1470 IU/ml
- HP B Viral DNA: 2820 copies/ml
- HVC RNA, quantitative (Real time PCR): <50 IU/ML
- HVC RNA, quantitative (Real time PCR): <1.70 LOG IU/ML
Thanks
=================================
Pathology Report -- Liver Biopsy
MICROCOSPIC FINDINGS:
The sections reveal multiple needle like fragments of liver parenchyma showing some preservation of the architecture, there is some mild fatty infiltration which is patchy. The parenchyma shows an occasional focus of individual liver cell drop out but no balloon generation or councilman bodies are seen. There is no bile stasis. A rare nucleus shows glycogenation. The portal areas show some expansion, chronic inflammation and some break in the limiting plate with a few inflammatory cells spilling
into the adjacent lobule. An occasional bile duct radicle is identified. No marked increase in fibrosis or bridging is identified.
Special stains with trichrome show some portal fibrosis but no distinct bridging or cirrhosis noted.
DIAGNOSTICS:
NEEDLE BIOPSY OF LIVER SHOWING PORTAL TRIADITIS, MINIMAL FATTY INFILTRATION AND CHRONIC HEPATITIS, COMPATIBLE WITH HEPATITIS-C INFECTION
NO BRIDGING FIBROSIS OR CIRRHOSIS NOTED.
THE SEVERITY INDEX IS SCORE AT 8 OUT OF A SCORE OF 28
=================================
Doctor's Answer
by Kevin Pho, MD, Apr 08, 2004 12:00AM
, Apr 08, 2004 12:00AM
The discussion of the biopsy was addressed in a question below.
Regarding the hepatitis C, given then fact that the ALT was normal, and there was not significant damage on the biopsy, it is likely that therapy for hepatitis C may not be needed.
For the hepatitis B, interferon therapy should be considered in patients with chronic HBV infection (HBsAg positive for more than six months), who have evidence of active virus replication (HBeAg and HBV DNA positive), and active liver disease (elevated serum ALT concentration and chronic hepatitis on liver biopsy). Again, in your case, the ALT levels are normal, reducing the necessity of therapy.
These considerations should be discussed with your gastroenterologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Lok. Interferon therapy for chronic hepatitis B virus infection. UptoDate, 2004.
Regarding the hepatitis C, given then fact that the ALT was normal, and there was not significant damage on the biopsy, it is likely that therapy for hepatitis C may not be needed.
For the hepatitis B, interferon therapy should be considered in patients with chronic HBV infection (HBsAg positive for more than six months), who have evidence of active virus replication (HBeAg and HBV DNA positive), and active liver disease (elevated serum ALT concentration and chronic hepatitis on liver biopsy). Again, in your case, the ALT levels are normal, reducing the necessity of therapy.
These considerations should be discussed with your gastroenterologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Lok. Interferon therapy for chronic hepatitis B virus infection. UptoDate, 2004.
Member Comments
by sandybliv, Apr 13, 2004 12:00AM
Hi, I was wondering how you are doing after your liver biopsy? I went for one last week, I am still waiting for the results. Good luck.
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