Liver nodule

I had abdominal ultrasound in May 2008 result was two gallbaldder polyps - Largest 5.6mm.  The remaing viscera were unremarkable.

Follow-up ultrasound on Nov 26, 2008  and report read:

"Hypoechoic lesion in the left lobe, probably segment 4b. measuring 12x10x8mm.  The liver measures 17cm in size.

Threre are a few gallbladder polyps seen the largest 4mm in size.

The spleen measures 12.6cm.  

Opinion:  questionalbe hyperechoic area in left lobe of liver.  This is a solid nodule.  Being solitary it could represent a hemangioma but the apperance is atypical.  Follow up ultrasound in three months to confirm stability."

note that five days prior to Nov 26  (nov 19, 2008) I had another ultrasound of the abdomen and no concern was noted with the visulaised portions of liver, kidney and spleen.

Questions:

1.  What does liver size of 17cm mean - small/big/normal

2. what does spleen size of 12.6cm mean - small/big/normal

3 Are liver nodules common incidental findings?

4.  Is a three month wait and follow-up ultrasound normal procedure?

5.  If not what other diagnostics would be recommended?

6.  Why would this nodule not have been visaulied on Nov 19th ultrasound?

7.  What could this nodule most likely be??????

8. Are the gallbladder polyps of concern????  i.e what are they????

thanks

[Kevin Pho, MD]

To answer your questions:

1) 17cm would be bigger than normal.  The upper range would be in the high 16cm range.

2) Normal spleen size ranges from 12 to 14 cm.

3) Liver nodules can be incidental findings.  If inconclusive, further imaging, like an MRI, should be done.

4) It depends on how suspicious the radiologist is of the lesion.  If the nodule is benign, routine follow-up is appropriate.

5) An MRI would be the next diagnostic step.

6) I cannot answer that.  It is possible that the first ultrasound may have missed the nodule.  

7) Cannot say without seeing the study myself.

8) Gallbladder polyps that size should be monitored with a repeat ultrasound in 3 and 6 months.  If they grow, removal of the gallbladder should be considered.

These questions should be discussed with your personal physician.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd