Liver Biopsy

[Lika]

I had my second CT on my Liver. Follow up of atypical lesion in the posterior right lobe of liver. Had a Nuc Med scan, Ultrasound, MRI and CT 3mo. ago. Had 2nd CT wk. ago. Findings:Lesion 22x28mm (same as 3 mo ago). there is heterogeneous increased density within this mass does not appear typical for hemangioma. Delayed images demonstrate persistent heterogeneous enhancement. Is some peripheral diminished attenuation. No new hepatic lesions. Characteristice of mass lesion in right lobe are atypical for a benign cavernous hemagioma. Differential includes atypical focal nodular hyerplasia, possibly adenoma, but other lesions are not entirely excluded by imaging criteria alone. everything else ok. they want to either continued F/U with another CT or Biopsy. The location is a little harder to get to. My GI doctor has not gotten back to me yet. Any sugestions?
This started because I got really sick high liver tests ALT 600+. They think it was because of a antibiotic.
Thank you for you help. Lika59

[Kevin Pho, MD]

Difficult to say without evaluation.

At this time, I would consider a biopsy given the ALT has been persistently elevated.  The recommendation of a biopsy can be changed if the lesion is difficult to get to.

I would discuss these options with your gastroenterologist, or in conjunction with another opinion.

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_

[Lika]

Thank you for your response.

I want to add, my lab test have been normal for the past month. The doctor's do not think the high lab results and the lesion on my liver is connected.

Lika59

[Kalio1]

Are you seeing a Heptologist? I'd strongly recommend you see one if you aen't seeing one mpw and have him evaluate your case, including the lesion and the episode of high enzymes. I think you really need to be absolutely sure of what the lesion is and what you need to do to monitor it from now on.

[Lika]

Thank you. I belong to an HMO. I will look and see if they have a Hepatologist. I do not have Hepatitis or Cirrhosis though.
But, I will see if our HMO has a Hepatologist.

Thanks again,
G.Roberts