Mildly Enlarged Liver

I am 55 years old with a history of severe hepatitis A over 20 years ago. A liver biopsy was required after 6 months, but all liver tests resolved in time. I have repeatedly tested negative for hepatitis B and C.   In 2005 I had a total hysterectomy due to a suspicious ovarian cyst. It was benign.  In March all my liver tests were normal. A CA 19-9 test was also routinely taken. The result  was 50, the normal being 37.  A month later in another lab the result was 33.4, the normal being 33. Because I was worried, I saw a Dr. who sent me to have an abdominal MRI and a MRCP. The ab MRI was normal, but the MRCP stated "normal biliary tree and pancreatic duct. There is no obvious mass identified in the pancreas and the liver itself is mildly enlarged, especially at the right lobe."  I was actually feeling something in my ribs, especially on the right side before reading the MRI results for some time.  I had a colonoscopy done around 5 months ago. I had polyps, 2 of which were adenomous, and they were removed. 4 months ago I had a gastroscopy due to past gastritis. Also had hyperplasic polyps which were removed.  I don't drink and eat very healthily. The only fat I consume is olive oil, and in moderation.  My Dr. says to forget about this, that what I'm feeling is in my head, and to go and repeat the MRI and blood test (CA 19-9) in 4 months.  I'm concerned with waiting so long.  Should I have another test performed before this time?  Assuming with my history of a good diet that it's not fatty liver causing the enlargement, what else could it be?  Is this the beginning of cirrhosis or liver cancer?  Is a mildly enlarged liver not caused by fatty liver reversible?  

[Kevin Pho, MD]

There clearly has been a comprehensive set of tests done, which would rule out many of the major diseases that can lead to the symptoms.

CA 19-9 is a marker of pancreatic cancer.  The MRIs you had done appropriately evaluate this possibility.  If the results continue to be inconclusive, an endoscopic ultrasound can be considered.  

Cirrhosis would be less likely given the non-revealing liver biopsy results.  

As to whether an enlarged liver is reversible or not, it would depend on the cause.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[Karina]

As stated, the liver biopsy was done over 20 years ago.  No biopsy has been performed recently.