Biopsy/Blood results

[Charles__0]

Posted by Charles on June 02, 1999 at 21:37:20
My gastro does not like to explain my test results to me in common language.  Could you please explain the following to me?
Blood Results:
     ALT   534
     AST   264
     RNA, RCR  810,000 COPIES/mL
Biopsy Gross Description:  The specimen consists of a core biopsy of tan-brown tissue measuring 1.5 cm in length and 0.1 cm in diameter.
AGR:csf
Microscopic examination reveals a liver biopsy showing generally normal relationships between portal areas and central veins.  The portal areas are diffusely infiltrated with chronic inflammatory cells.  The limiting hepatic plates have been destroyed.  The adjacent hepatic parenchyma is involved by inflammation.  Clear cut hepatocytic necrosis is not seen.  The hepatic parenchyma is diffusely infiltrated by microvesicular fat.  A small amount of macrovesicular fat is also present.  Clusters of chronic inflammatory cells are noted surrounding necrotic hepatocytes.  The hepatocytic trabeculae are somewhat distorted.  The few bile ducts that are present are unremarkable.  No cholestasis is seen.  Early periportal fibrosis is present.
These changes are compatible with those reported in Hepatitis C.
MICROSCOPIC DIAGNOSIS:  Chroic periportal and lobular hepatitis, moderate, compatible with Hepatitis C, core biopsy, liver.
It appears that the only risk group I could have encountered this is when I got a gammagobulin shot to prevent hepatitis in 1985 when I was leaving the country to work overseas.
Thank you,
Charles

Posted by HFHSM.D.-D.M. on June 09, 1999 at 17:06:22

Dear Charles:
I will try to make some comments though I will note that I am not commenting on your biopsy.  Instead I am commenting on a biopsy report.  This is important because I do not understand all the aspects of your biopsy report.  For instance microvesicular fat is usually less predominant than macrovesicular fat.
I always tell MedHelp participants that probably one of the most important things on the biopsy is the amount of fibrosis or scarring.  Fibrosis is scar tissue that forms as a result of persistent inflammation.  If you cut your skin, you form scar tissue which is good.  However, if you inflame the liver, you can develop scar tissue or fibrosis which can be bad.  If the fibrosis advances, it can start to destroy the liver.  Typically fibrosis starts around the portal tract and the mildest form of fibrosis is “periportal”.  As a result “early periportal fibrosis” would be an encouraging result from a liver biopsy.   Your liver enzymes and the amount of inflammation on your biopsy report seem out of proportion to the amount of fibrosis.  You just want to make sure you are not using alcohol or other medications that can affect the liver.  
I did want to point out that as a general rule, we do not feel standard gammaglobulin shots are or were a major risk factor for hepatitis C because of the way the preparations were made.  I certainly can’t rule out this possibility, however.  
I hope this information is helpful to you. Good luck with your situation.  I would invite you to contact us at MedHelp again with additional concerns or questions.   At Henry Ford, we have an active group of liver specialists.   The direct number to our Liver Clinic is [phone].
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.