Cirrhosis of the Liver Community
ABD US doesnt quite jive with Loosy Worksheet
About This Community:

Cirrhosis is the end result of chronic liver damage caused by chronic liver diseases. The purpose of the community is to share support and information with Cirrhosis of the Liver patients and their loved ones. Topics in the community include: causes, clinical trials, complications, family issues, living with Cirrhosis of the Liver, prognosis, research, surgery, treatments

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

ABD US doesnt quite jive with Loosy Worksheet

Had my US done in 8-2012.  The US Final report stated that the liver was MILDLY hetergeneous echogencity.  A liver cyst with small indentations.  No acites (ascites). Spleen normal sized.  Kidneys normal that can be visualized. GB normal..pancreas normal that can be seen.  No masses, etc. .

BUT .. I had to get a CD made for the hep I will be seeing end of the month..was looking it since I wanted to see the size of the cyst.  Came across the Loosy report which is the worksheet the dr reading the US jots down the info from his reading of the US.  

His report states: DIFFUSELY hetergeneous liver (fatty liver is circled)... COMPLRX CYST 2.3 x 2.1 x 2.1  

Aorta P - 2.3 cm

SPLEEN ENLARGED - 13.8 x 4.8 x 4.9   US didnt state this and said it was normal..  

ALSO....US stated no acites (ascites) but the bottom of the report doesnt have it marked and has FLUID COLLECTION (either wrote VS or IS) artifact midline.  12.0 x 8.9 x 4.5 cm.

AND...the Loosy report mentions dilated ducts at pancreas head.  That was never typed on the Final ABD US report.

So..the two reports dont match..some discrepancies. Anyone know much about what the dr who read the report is seeing?  Somehow the same thing didnt get translated on the Final US Report.  

I called the gastro and told him I was going to come in with the cd.  He asked if they ever did a liver bx and I told him no...so looks like I will be having a liver bx and poss a bone marrow biopsy.  Knew I would have to have it eventually.  Is the biopsy the best way to go?  Is a bone marrow biopsy also something that will have to be done?  My platelets run about 100,000 or 90,000.  

I dont go to the old gastro and now have a new gastro who is mentioning a liver bx...and doesnt know why they didnt order one.    

Thanks all...if you can help with this....I'd appreciate.  

Paula
Blank
1475202_tn?1388955435
Paula it's great you have the CD of your US. I know you worry a lot and it is good to be cautious! The most I can gather from the report is that two different types of cells are present, healthy liver cells and most likely fatty liver cells. Meaning that you would have a fatty liver. Many people live with fatty liver disease and don't know it. This gives you the opportunity to change your diet so that it will not result in fibrosis.

The other concern I had was the cyst that was found. Here is some information I found concerning liver cysts and I hope it helps rest your mind a bit. Notice this was written by:

Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society

http://www.cnn.com/2010/HEALTH/expert.q.a/04/21/liver.cysts.brawley/index.html

There are many non-cancer-related causes of cystic masses in the liver. Indeed, simple liver cysts are almost always asymptomatic and found incidentally during routine testing for something else. These masses are not cancerous and not even dangerous.

Simple cysts of the liver contain fluid. This can be seen on liver imaging with ultrasound or CT scanning. They are found in about 1 percent of adults and are more common in women than men. They are usually a few millimeters in size. Very rarely, they can be large and need to be treated because of size and the discomfort they cause.

Physical examination, blood studies and ultrasound findings are usually sufficient to distinguish simple cysts from other less-common lesions that can appear cystic. Occasionally, a CT scan is needed to make the distinction, and rarely a needle biopsy or surgical resection is done to make the diagnosis.

Note: The above discusses cystic lesions of the liver. There are a number of solid lesions that can be found in the liver. The liver is a common site for the spread of colon, breast and lung cancer. These lesions are usually solid and rarely cystic. Patients will have probably been diagnosed with their cancer before the lesions are seen in the liver. Nodular liver non-cancerous diseases with solid masses are also common. They can be due to alcoholic liver disease, """"rheumatologic diseases""""" and other causes.
---------------------------------------------------------------------------------------------------
Notice it mentions rheumatologic diseases, aren't you a bit familiar with these?

I wish you all the best, your a great lady Paula

Randy
9 Comments Post a Comment
Blank
89592_tn?1391278022
Noted "dilated duct (s) at pancreas head  EDEMA  
Blank
1475202_tn?1388955435
Paula it's great you have the CD of your US. I know you worry a lot and it is good to be cautious! The most I can gather from the report is that two different types of cells are present, healthy liver cells and most likely fatty liver cells. Meaning that you would have a fatty liver. Many people live with fatty liver disease and don't know it. This gives you the opportunity to change your diet so that it will not result in fibrosis.

The other concern I had was the cyst that was found. Here is some information I found concerning liver cysts and I hope it helps rest your mind a bit. Notice this was written by:

Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society

http://www.cnn.com/2010/HEALTH/expert.q.a/04/21/liver.cysts.brawley/index.html

There are many non-cancer-related causes of cystic masses in the liver. Indeed, simple liver cysts are almost always asymptomatic and found incidentally during routine testing for something else. These masses are not cancerous and not even dangerous.

Simple cysts of the liver contain fluid. This can be seen on liver imaging with ultrasound or CT scanning. They are found in about 1 percent of adults and are more common in women than men. They are usually a few millimeters in size. Very rarely, they can be large and need to be treated because of size and the discomfort they cause.

Physical examination, blood studies and ultrasound findings are usually sufficient to distinguish simple cysts from other less-common lesions that can appear cystic. Occasionally, a CT scan is needed to make the distinction, and rarely a needle biopsy or surgical resection is done to make the diagnosis.

Note: The above discusses cystic lesions of the liver. There are a number of solid lesions that can be found in the liver. The liver is a common site for the spread of colon, breast and lung cancer. These lesions are usually solid and rarely cystic. Patients will have probably been diagnosed with their cancer before the lesions are seen in the liver. Nodular liver non-cancerous diseases with solid masses are also common. They can be due to alcoholic liver disease, """"rheumatologic diseases""""" and other causes.
---------------------------------------------------------------------------------------------------
Notice it mentions rheumatologic diseases, aren't you a bit familiar with these?

I wish you all the best, your a great lady Paula

Randy
Blank
89592_tn?1391278022
Hi Randy..can you tell I worry?  Is there a prize for the most worrisome frequent msgs?  LOL  I do have cirrhosis since the gstro found gr 2 non bldg varices.  So..its a given.

I took the CD to my pcp.  They asked me to bring it in and when I did, he told me he doesnt know how to read an US.  lol  He took it into the other room and not sure if he called someone but came back and said  Mild is the same as diffuse, that the pancreas was normal the part that could be visualized, the pancreas edema is from the cyst.  My spleen states normal on the final report but on worksheet states it  is13.8 ins.  He says thats normal. GB and common duct were normal.  

I am going to get another US next week.  Its been about 6 months since the above,  So..thats a good thing.  I just hope that everything is stable.  

My bloodwork is good.  

Oh..also....the pcp asked if I was on HRT (hormone replscement therapy) said yes.  He told me that its known that HRT long term can cause hemangiomas and cancer in the liver.  SO..needlees to say, I'm discontinuing them.  I hope this complex cyst is not growing and staying the same size.  Not  sure how fast they can grow.  MIne is 2.3 cm.  Will they do a ct scan if it is shown to be growing?

Oh yes...rheum, arth..the disease that keeps on taking.  I am now waiting to see if I have lupus..which I am pretty positive I have.  

Thank you so much Randy  I live by myself now and this has really sent me into a small tailspin.  I'm fed up with an old gastro who didnt call about the results or my US and didnt put me on a betablocker because, "we dont do that unless they bleed".  So I went to my pcp and he prescribed one for
While you're at ....anxiety med please.

Because I think mine is either autoimmine or alcohol related..I worry about anything to do with the pancreas.  

Thank you for your reply Randy..,..!!!  

Paula



Blank
89592_tn?1391278022
Cyst was Complex..the reason I was concerned...  going on monday..moved it up. ..I hate to wait.  6 months was long enough.  Hope things stay stable.
Blank
Avatar_m_tn
I had a moderate to severe fatty liver about 4 years ago when I was a daily drinker. I stopped all alcohol and retested with an US last year which showed everything was normal except "mild heterogenous echo-texture possibly representing mild patches of fat".
I spoke to the radiologist at NYU and she said heterogenous echo-texture is one of the most common finding out there. she sees it almost daily.

Are you 100% sure about the cirrhosis based solely on the varicese? There are other causes of varices.
Blank
89592_tn?1391278022
That is all I hear from the 2 gastros that I have had is that it is cirrhosis 90% chance because of the varices..gr 2 non bleed.   They always tell me I have fatty liver then I have to remind my gastro that he found two varices  during my EGD and  then says..oh, then you have cirrhosis.  The worksheet states DIFFUSE hetergeneous echogencity while the final report states mild hetergeneous echogencity.   My spleen is mildly enlarged at 13.8 but my pcp says thats normal.  ??   I think a liver biopsy is coming up.  My new gastro has mentioned it BUT my PCP says its not necessary..doesnt think I need to go thru it.
I stopped drinking about 9 yrs ago.
I am being tested for lupus .. I know I have it but labs dont show it.  We're retesting now.  Sometimes labs dont show lupus rught away.
I've had so much stuff going on with me with the rheum arth since 83 and the sjogrens, raynauds, limited scleroderma.
I go for a 6 month US tomorrow to chrck on a complex cyst  2.3 x 2.1 x 2.1 ...it had small areas of indentation so thats concerning to me.  My CMP is pretty good...  Meld runs 6 or 7.
Thank you for your reply!!!    Glad you're doing well.
Paula
Blank
Avatar_m_tn
My fear is also that I may have Cirrhosis. I just had an upper endoscopy though and no varices, but still worry.
How is your blood tests? My AST ALT etc are always well within normal. My bilirubin at times has been borderline high at 1.2 or 1.3 but the doctors are not concerned.
Platelets 245
But its the fear that there is something going on but it just hasn't appeared yet.
It appears that in your case, the cirrhosis is very early. May I ask your age?
If your over 50, theres probably a good chance you will die of something else without needing a transplant.
Blank
89592_tn?1391278022
Thats great that you had no varices.  
My Meld is 6 or 7.  Ast is usually slightly elevated.  ALT is normal most of the time.  Bilirubin is about 1.1 I believe..last labs normal.  Platelets vary from 100-110 last lab 124.  So they've been rnning low but my rheumy blames it on the biologics I take.
I'm 63...well, 64 tomorrow.  
I kno with all the other stuff going on with me...the r.a lupus, etc.  I am also a stage 1 gyn cancer survivor so this cyst is worrisome to me.
Have my appt at 10 this morning..will keep you informed. Seems like all I do anymore is go to drs appt and to tests.  
Hope you dont have cirrhoisis...  How old are you?  
Paula
Blank
89592_tn?1391278022
CMP has been normal this past test.  Normal but I have varices.  Geesh..if it wasnt for thos darn varices..and the complex cyst.  Waiting for the lupus ana antibody panel to come back.    
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Cirrhosis of the Liver Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Hepatitis Answerers
Avatar_f_tn
Blank
nan535
Brooklyn, NY
446474_tn?1404424777
Blank
HectorSF
CA
317787_tn?1373214989
Blank
Dee1956
DC
223152_tn?1346981971
Blank
frijole
Midland, TX
1840891_tn?1383280315
Blank
ceanothus
Los Gatos, CA
683231_tn?1408489117
Blank
flyinlynn
Auburn, WA