Liver Lesion

  I am a 35-year old male smoker, 5'10', 150 lbs.  My saga begins with a low grade fever.
  After two weeks, I experienced RUQ pain.  I saw my doctor the day the RUQ pain started.
  He did not do anything, wanting to see how things progressed.  I went back to him 5 days
  later as my symptoms were the same.  He sent me for an abdominal US and started me on
  antibiotics (Cipro 750mg 2X/12 days.)  After starting the Cipro, I was asymptomatic.  
  The US showed thickened gallbladder wall (5 mm) and some sludge.  I had a CT scan a week
  later.  It showed a well defined low attenuation 4.5 cm lesion on the right posterior
  lobe of my liver.  The radiologist's diferential diagnosis was a liver abcess (abscess) versus
  hepatoma.
  At this point, I was referred to a GI.  Blood tests came back normal (LFT, amebiasis,...)
  I had a tagged RBC scan, which came back normal.  Then I had a liver biopsy which ruled
  out an abcess (abscess), hemangioma or other tumor.  The biopsy did show high iron, inflammation,
  and some fibrosis, but was otherwise inconclusive.  Blood tests for hemochromatosis and
  hepatitis B and C were done; iron was "a little low" and hepatitis was negative.  I am
  back to running a low grade fever.  I also had a HIDA scan which showed my gallbladder
  function to be normal and did not indicate inflammation.  I do not have currently have
  abdominal pain, but have been avoiding strenous activity as it previously caused my back
  to ache in the area of my liver.
  I had erythema nodosum, but have not had any new lesions in several years.
  My GI now wants me to consult with a surgeon about removing my gallbladder and getting a
  visual on my liver lesion.  7 weeks have elapsed since I first began running a fever.  I
  have lost a few pounds since this started (depressed appetite) and seem to get more easily
  fatigued.  Have not had any jaundice.  Stools have been normal, although my urine seemed
  a bit dark prior to the antibiotic.
  Is a thickened gallbladder wall reason enough to remove it?  Any ideas as to what my liver
  lesion might be?
    

[HFHSM.D.-D.M.]

Dear Danny:
Wow.  Well don