I recently had blood work done for a complete physical with cholesterol at 248 and bilirubin at 1.7, since the bilirubin was high my dr ordered a Ultrasound then that report came back with liver having 1.8 x 1.6 x 1.6 cm echogenic lesion is noted within the left hepatic lobe. A second echogenic lesion measuring 1.3 x1.3 x 1.2 cm likely within the left hepatic lobe medial segment. A third lesion measuring 2.6 x 3.4 x 2.7 cm within the right hepatic lobe. A fourth echogenic structure measuring 1.3 x 1.2 x 1.0 cm appears to be near the hepatic hilar region. Area of heterogeneous echogencity is noted measuring 5.2 cm in greatest dimension within the right hepatic lobe anterior segment along the lateral periphery. Probable gallbladder polyp measuring 4 mm is seen along the anterior margin. No gallbladder wall thickening. Additional 2 mm possible gallbladder polyp is noted in the fundus. the appearance is consistent, but not diagnostic for hemangiomas. Then a CT scan was ordered with these results: Liver mildly enlarged. Two left hepatic lobe lesions measure 17.2 mmand 12.8 mm in greatest dimension. There are hypodense unenhanced. A hypodense mass in the right hepatic lobe anterior segment measures 2.5 cm in diameter. These lesions are hypodense, unenhanced. Thet demonstrate intial peripheral puddling enhancment by 7 minutes. The two smaller lesions are isodense with liver and so on. Kidneys: Symmetric function, no calculi, suspected subcentimeter left renal cyst. Nodes Survey: Multiple mesenteric nodes measure up to 11.5 mm in greatest short axis diameter.
1. Long segment mucosal thickening of the transverse colon. Correlation for inflammatory or neoplastic changes of the transverse colon is recommended.
2. Mesenteric adenopathy.
3. Left hepatic lobe and anterior segment right hepatic lobe lesions most compatible with hemangiomas. The two smallest lesions may also represent cysts.
4. Right hepatic lobe posterior segment mass with early arterial enhancement and rapid washout. These features are compatible with a neoplastic mass and/or atypical hemangioma. The possibility of metastatic or primary hepatic neoplastic lesion is within the differential diagnosis of this right hepatic lobe lesion.
Then from this I was told I may possibly have colon cancer and I would have to have a colonoscopy, which I did yesterday and I do not have colon cancer but I would need to have another CT scan in 3 months to look at the liver lesions. Why wait 3 months if the lesions are cancer would it not be better to start treatment ASAP? What else would they be looking for? Thanks.
My CT and MRI both with contrast shows 1.3 cm lesion in the superior left hapatic lobe which demonstrates diffuse arterial enhancement with washout with persistent pseudocapsule enhancement, possibly representing compressed prenchyma. Additional there is a 0.9 cm lesion in the superior right lobe with similar imaging characteristics. A subcentimeter simple cyst is seen in the inferior right hepatic lobe.
Also the pancreas demonstrates homogeneous T1 signal. There are no hypervascular or hypervascular masses. the panceatic duct is normal in caliber. What does this mean.
Your doctors will want to watch the 1.3 cm/left-lobe and 0.9 cm/right-lobe lesions carefully over the next 3 to 6 months. They are very likely benign but the arterial enhancement with washout along with capsular enhancement make them somewhat suspicious. Also, lesions this small are very hard to nail down due to the resolution limits of both CT and MRI technology. The next imaging procedures will have have to wait at least 3 months to allow for enough time for lesional characteristic changes to develop between imaging sequences, these changes will provide extra diagnostic data.
And a homogeneous,T1 signal is likely to be fatty deposits. It's great your doctors are on top of things. But you may want to get a second opinion just for confidence. Hopefully it's nothing, the vast majority of these lesion, in non-cirrhotic livers, are benign. Hoping this is the case here as well.
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