Possible liver & kidney cyst - whats the follow-up?

Doc –

I previously asked you whether you agreed with an MRCP and liver biopsy to rule out  PSC.  (I’m 30 year old male crohn’s patient with six months of mildly elevated AST and ALT.  Also had an epidose a few years ago of very high fever for a week with raised AST/ALT/AP.) You agreed with the approach.  The MRCP was conducted and came back normal except “punctate T2 hyperintense focus in the anterior aspect of the liver as well as in the upper pole of the right kidney, too small to characterize further at cross-sectional imaging, and likely to represent simply cysts." I do have some right flank pain intermittent that I'm positive is my liver, and fatigue, but that may just be my crohns.

Do you think this is cause for further followup? I think it is noteworthy that I had MR imagiing done less than six months ago that did not show any cyst possibilities.  I do have a liver biopsy scheduled.   If you think there should be follow-up, what would that be? How can they confirm what kind of cysts these are?  

Thanks.

[Kevin Pho, MD]

Liver and kidney cysts are, in most cases, benign.

I believe that you are doing all you can in terms of follow-up.  In fact, I cannot recommend any more comprehensive tests.

A liver biopsy indeed would be the next diagnostic step, and if negative, would make liver disease less likely.

The same goes for the kidney cyst.  A sizable number of the general population have kidney cysts, and do so without any added risk.

Periodic followup, with serial imaging studies for instance, is recommended to ensure the size, shape and character of the cysts don't change.

This 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 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