Hep c/Cirrhosis/Enlarged Spleen and Enlarged Lynph Nodes

Male 58 hepc 1998.Ast and Alt normal. 2005 (abdominal pain)Dr orders a Ct. Liver mild heterogeneity with subtle nodularity to the hepatic parenchyme. There is nodularity to the capsular. 2.Adenopathy--very small periaortic lymph nodes . However there is a moderately enlarged lymph node posterior to the proximal portal vein at 2.7cm. Above the pancreac neck there is an enlarged lymph node of 3.4 cm in length.There is also a retrocaval lymph at the renal veinswhich is 2.7cm long.
There is retroval and periportal adenoparth of uncertain etiology. NOV 2006 Ast 257 alt 255.Jan alt 237 ast 184 MAY ast257alt255. ultrasound May  2007 results liver is not enlarged,the right lobe has a sagittal span of 14.9 the liver parenchyma has a salt and pepper appearance consistent with diffuse fatty infiltration there is no focal abnormality nor ascites. The spleen is enlarged it has a sagittal span of 15.1 cm and a splenic index of 63(normal range 8to 34)mpression -moderate fatty change of liver splenomegaly,right renal simple cyst Patient has pain in abdominal on left side from time to time.  He is very tired and has had night sweats.
QUESTIONS   Based on this info do you think he may have cirrhosis(why the discrepancy between the 2 reports)  and should we be concerend about the enlarged spleen and what could the enlarged lymph nodes indicate. and is it safe to wait 6 month to see another dr  Really need another opinion on this thanks

[Kevin Pho, MD]

Cirrhosis is a pathologic diagnosis.  If this possibility is in question, a liver biopsy would be needed for a more definitive diagnosis.

Enlarged lymph nodes can be due to cancer.  If they persist, or enlarge, a surgical referral can be considered for possible biopsy.  

Regarding the spleen, various hematological disorders can lead to this.  Further evaluation with a CBC, peripheral smear or even a splenectomy can be considered.

These options can be discussed with your personal physician.

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.

Kevin, M.D.
kevinmd_

[LukeL]

While I am not a doctor enlarged nodes and nightsweats could indicate a lymphoma, it might be something to mention to your doctor.

[dixiechick]

Can someone tell me what a patholgic diagnosis is? Also there was no mention in the response about the spleen being enlaged due to hep c.  After reading the response it s possible he has a couple of ussues to deal with and not just the hep c right> Wonder why the dr that read the ct siad no worries about enlarged lymph nodes.  

[lizziecee]

Pathological diagnosis - this is done by taking a sample of tissue from the organ/area that is suspect. It is called a biopsy.
Dixie - the doctor doesn't answer supplemental questions, but you may get some answers from other gastro patients like me.
You could also try posting on the patients' forum. Go to the top of the home page and click on "Gastroenterology communities."
Take care and hope your friend gets a proper diagnosis soon and can start treatment.
Liz.

[dixiechick]

Thanks Luke for your repsonse will check that out.  Liz thanks for the clarification I thought he was trying to say that it was cirrhosis by the report of the ultrsound.  I will look at the other site that you mentioned.  

[abdula]

u ned to be healty get everything about healty on http://behealthyforum.com/

[Jo_L]

A related discussion, enlarged spleen and low white count was started.