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Results for my husband's liver blood/ultra sound/biopsy? Could someone help in putting in laymans lingo ??
We are not sure what all this means and just recieved it all yesterday from my Dr.s office as I took your, the forums advice and called and demanded his results. Now we have them but don't understand the stage he is at. Is there anyone out there whom is qualified or understands this verbage etc? If so we would appreciate the translation.
Abdominal Ultra sound- Aug 2007
The liver shows mild fatty infiltration and is heterogeneous. The gallbladder has a normal thickness wall and is free of calculi and the bile ducts are not dilated. The pancreas is poorly visualized but appears grossly normal.
There is marked splenomegaly which has a craniocaudal length of over 18cm. No focal lesion was shown. Kidnesy are within normal limits as is the abdominal aorta.
IMPRESSION:
HETEROGENEOUS FATTY LIVER WITH SPLENOMEGALY. NO PREVIOUS STUDIES ARE AVAILABLE FOR COMPARISON AT THIS TIME.
Ultrasound examination does demonstrate the presence of diffuse coarsening of the textural architecture of the liver, in keeping with diffuse fatty infiltration of the liver or hepatocellular disease. No focal hepatic parenchymal abnormalilties were demonstrated.
An appropriate cutaneous site in the mid axillary was marked with marker.
Liver Biopsy Aug 23-07
Hep C Query degree of inflammation. Query degree of fibrosis
The section shows fragmented needle biopsies of the liver, showing replacement of normal architecture with somehwat early cirrhosis. The fragments have rounded edges. Hepatocytes show patchy mild to moderate inflammation, consisting of lymphocytes as well as neurtophilis. Firbrous expansionof some portal spaces is noticed with short fibrous septae. The sinusoids are Kupffer cells appear unremarkable. The Special Stain for Iron shows no significant increase of the iron stores. The Silver stain shows accentuation of reticulin with areas of fibrosis. The degree of inflammation is moderate and the fibrosis is mild to moderate.
Diagnosis: Moderate hepatits with mild to moderate fibrosis
Below are 4 different times his blood was taken.
Blood lab results HLV/II Aug 22-07 Oct.10-2008 Nov.5-2008 Jan.31-2009
ALT 343 383 (HI) 239 (HI) 415 (HI)
AST 260 289 (HI) 189 (HI) 316 (HI)
GAMMA-GLUTAMYLTRANSF. 76 72 133
WHITE BLOOD CELL CT 3.6 3.7
RDW 15.9 16
LYMPH .8 .9
PLATELET COUNT 70 70
SEDIMATION RATE (ESR) 27 N/A
ALBUMIN N/A 41
PLATELTS AFP ONCOLOGY N/A 6.5
Oct.10-08 FINAL REPORT--> FLAP 1 COLLECTION DATE- CCC OCCULT BLOOD- NEGATIVE
Pathologists comments-Thrombocytopenia may be related to an immune process (itp), drug therapy, hypersplenism or platelet comsumption
Nov-12-08 Lab Manual Result
Hepatitis C Antibody- Evidence of Antibody Viral RNA is >600 IU/ml; see test value
Abdominal Ultra sound- Aug 2007
The liver shows mild fatty infiltration and is heterogeneous. The gallbladder has a normal thickness wall and is free of calculi and the bile ducts are not dilated. The pancreas is poorly visualized but appears grossly normal.
There is marked splenomegaly which has a craniocaudal length of over 18cm. No focal lesion was shown. Kidnesy are within normal limits as is the abdominal aorta.
IMPRESSION:
HETEROGENEOUS FATTY LIVER WITH SPLENOMEGALY. NO PREVIOUS STUDIES ARE AVAILABLE FOR COMPARISON AT THIS TIME.
Ultrasound examination does demonstrate the presence of diffuse coarsening of the textural architecture of the liver, in keeping with diffuse fatty infiltration of the liver or hepatocellular disease. No focal hepatic parenchymal abnormalilties were demonstrated.
An appropriate cutaneous site in the mid axillary was marked with marker.
Liver Biopsy Aug 23-07
Hep C Query degree of inflammation. Query degree of fibrosis
The section shows fragmented needle biopsies of the liver, showing replacement of normal architecture with somehwat early cirrhosis. The fragments have rounded edges. Hepatocytes show patchy mild to moderate inflammation, consisting of lymphocytes as well as neurtophilis. Firbrous expansionof some portal spaces is noticed with short fibrous septae. The sinusoids are Kupffer cells appear unremarkable. The Special Stain for Iron shows no significant increase of the iron stores. The Silver stain shows accentuation of reticulin with areas of fibrosis. The degree of inflammation is moderate and the fibrosis is mild to moderate.
Diagnosis: Moderate hepatits with mild to moderate fibrosis
Below are 4 different times his blood was taken.
Blood lab results HLV/II Aug 22-07 Oct.10-2008 Nov.5-2008 Jan.31-2009
ALT 343 383 (HI) 239 (HI) 415 (HI)
AST 260 289 (HI) 189 (HI) 316 (HI)
GAMMA-GLUTAMYLTRANSF. 76 72 133
WHITE BLOOD CELL CT 3.6 3.7
RDW 15.9 16
LYMPH .8 .9
PLATELET COUNT 70 70
SEDIMATION RATE (ESR) 27 N/A
ALBUMIN N/A 41
PLATELTS AFP ONCOLOGY N/A 6.5
Oct.10-08 FINAL REPORT--> FLAP 1 COLLECTION DATE- CCC OCCULT BLOOD- NEGATIVE
Pathologists comments-Thrombocytopenia may be related to an immune process (itp), drug therapy, hypersplenism or platelet comsumption
Nov-12-08 Lab Manual Result
Hepatitis C Antibody- Evidence of Antibody Viral RNA is >600 IU/ml; see test value
I am confused.... In one part it says early cirrhosis, but in the conclusion it says
Diagnosis: Moderate hepatits with mild to moderate fibrosis
which I would translate to Grade 2, Stage 1-2
Diagnosis: Moderate hepatits with mild to moderate fibrosis
which I would translate to Grade 2, Stage 1-2
It looks like you might want to talk to your doc about treating...Is your husband over weight ? sometimes that could cause your spleen to be enlarged also could have something to do with the fatty liver, but your platelets are low too so i would surely get with your doc soon....
Blessings
Goldyn
Blessings
Goldyn
The section shows fragmented needle biopsies of the liver, showing replacement of normal architecture with somehwat early cirrhosis.
------------
Is "cirrhosis" in the above biopsy report excerpt a mistake, or perhaps error in transposition, and perhaps the correct word is "fibrosis"?
I ask because later in the report, the diagnosis reads "Diagnosis: Moderate hepatits with mild to moderate fibrosis" which is more consistent with some of the other description. First, I'd want clarification from my doctor on this point. Also, the actual staging seems missing which usually gives the stage and grade on a numerical scale.
Are you under the care of a hepatologist (liver specialist) or a gastroenterologist? Personally, I wouldn't make a move one way or another without going over everything with a hepatologist who can be found in your larger, teaching hospitals.
You should also know that fatty liver is associated not only with more rapid fibrotic progression but also with a lower success rate in treatment. This should also be addressed with a hepatologist. You don't have to be overweight to have fatty liver but this can be the cause and if so can be addressed by appropriate diet. Also saw no "genotype" listed which perhaps was tested for at another time?
Another issue is the low platelet count which could be consistent with cirrhosis and/or other possiblities listed by the pathologist under comments re thrombocytopenia -- but again, the report as written needs clarification. The low platelet issue is something else a hepatologist should address.
-- Jim
-- Jim
------------
Is "cirrhosis" in the above biopsy report excerpt a mistake, or perhaps error in transposition, and perhaps the correct word is "fibrosis"?
I ask because later in the report, the diagnosis reads "Diagnosis: Moderate hepatits with mild to moderate fibrosis" which is more consistent with some of the other description. First, I'd want clarification from my doctor on this point. Also, the actual staging seems missing which usually gives the stage and grade on a numerical scale.
Are you under the care of a hepatologist (liver specialist) or a gastroenterologist? Personally, I wouldn't make a move one way or another without going over everything with a hepatologist who can be found in your larger, teaching hospitals.
You should also know that fatty liver is associated not only with more rapid fibrotic progression but also with a lower success rate in treatment. This should also be addressed with a hepatologist. You don't have to be overweight to have fatty liver but this can be the cause and if so can be addressed by appropriate diet. Also saw no "genotype" listed which perhaps was tested for at another time?
Another issue is the low platelet count which could be consistent with cirrhosis and/or other possiblities listed by the pathologist under comments re thrombocytopenia -- but again, the report as written needs clarification. The low platelet issue is something else a hepatologist should address.
-- Jim
-- Jim
Ultrasound results.....
Fatty liver. "Heterogeneous" means not uniformin structure or composition ....because of the presence of fatty infiltrates. In other words, the fat accumulation makes it look different.
His spleen is enlarged....over 18 cm in length. (A normal spleen is approximately 11 cm in length). When the spleen is enlarged, it traps the platelets. That's why his are low.
Gallbladder normal (no stones). Pancreas and kidneys normal.
Biopsy results.....
Early cirrhosis with moderate inflammation. No iron overload, which is good.
Blood tests.....
The liver enzymes are high.....higher compared to August.
White cells (which protect against infection), are normal.
Platelets are low...which correlates with having cirrhosis.
Sedimentation Rate is used to detect and monitor inflammation in the body. Normal results are 0 to 20. His is 27 so it shows there slight inflammation...and it could be anywhere. It could be from the inflammation in the liver.
Albumin....you may have forgotten a period after the 4. Because the normal range is 3.4 - 5.4 so if you forgot the period and the result is really 4.1 then that would be normal. Albumin is a protein made by the liver. Therefore, liver disease can cause it to be low.
"Oct.10-08 FINAL REPORT--> FLAP 1 COLLECTION DATE- CCC OCCULT BLOOD- NEGATIVE "
-------------
I believe that's a Hemoccult.... a stool sample checked to see if there's any blood. It was negative.
"Hepatitis C Antibody- Evidence of Antibody Viral RNA is >600 IU/ml; see test value"
-----------
His Hepatitis C test is positive.
The results should include HEMOGLOBIN. That would tell you whether he's anemic. Cirrhosis is associated with low platelets and anemia.
He also doesn't have results of a GENOTYPE or VIRAL LOAD (measures amount of virus).
Has he had a fasting blood sugar done? That would also be important.
So they did the ultrasound and biopsy in 07...and they didn't do a Hep C test until a year later?
I wish I could have given you better news. Let me know if you have any other questions.
Co
Fatty liver. "Heterogeneous" means not uniformin structure or composition ....because of the presence of fatty infiltrates. In other words, the fat accumulation makes it look different.
His spleen is enlarged....over 18 cm in length. (A normal spleen is approximately 11 cm in length). When the spleen is enlarged, it traps the platelets. That's why his are low.
Gallbladder normal (no stones). Pancreas and kidneys normal.
Biopsy results.....
Early cirrhosis with moderate inflammation. No iron overload, which is good.
Blood tests.....
The liver enzymes are high.....higher compared to August.
White cells (which protect against infection), are normal.
Platelets are low...which correlates with having cirrhosis.
Sedimentation Rate is used to detect and monitor inflammation in the body. Normal results are 0 to 20. His is 27 so it shows there slight inflammation...and it could be anywhere. It could be from the inflammation in the liver.
Albumin....you may have forgotten a period after the 4. Because the normal range is 3.4 - 5.4 so if you forgot the period and the result is really 4.1 then that would be normal. Albumin is a protein made by the liver. Therefore, liver disease can cause it to be low.
"Oct.10-08 FINAL REPORT--> FLAP 1 COLLECTION DATE- CCC OCCULT BLOOD- NEGATIVE "
-------------
I believe that's a Hemoccult.... a stool sample checked to see if there's any blood. It was negative.
"Hepatitis C Antibody- Evidence of Antibody Viral RNA is >600 IU/ml; see test value"
-----------
His Hepatitis C test is positive.
The results should include HEMOGLOBIN. That would tell you whether he's anemic. Cirrhosis is associated with low platelets and anemia.
He also doesn't have results of a GENOTYPE or VIRAL LOAD (measures amount of virus).
Has he had a fasting blood sugar done? That would also be important.
So they did the ultrasound and biopsy in 07...and they didn't do a Hep C test until a year later?
I wish I could have given you better news. Let me know if you have any other questions.
Co
well sorry to say that according to this report your husband has mild cirrhosis and fatty liver. One of the signs of cirrhosis is enlarged spleen and his is 18cm, normal is around 10-12cm. Also he has low platelets. Both are very common with cirrhosis.
If he is not treating the Hepatitis he should ASAP if he can. It could possibly help the cirrhosis regress or at the least give the liver a break.
Very important to watch diet (low fat , salt & sugar) and NO alcohol !!!!
If he is not treating the Hepatitis he should ASAP if he can. It could possibly help the cirrhosis regress or at the least give the liver a break.
Very important to watch diet (low fat , salt & sugar) and NO alcohol !!!!
In part I'm responding to bump you up to the top. I'm hoping one of the sages of the board gives you a full explanation.
To my eye the inflammation is moderate and the fibrosis is mild to moderate. I think that would translate into a 2/2 or a 2/1. Generally people with this level of liver damage have a tough decision to make. There is no urgency to treat as there would be if the damage were more severe. OTOH, treatment is more successful with lower levels of liver damage and at a younger age. If I were in this situation, I would live a very healthy lifestyle with plenty of exercise, eliminate all alcohol and wait for what will now only be two years for more effective treatment to be approved by the FDA. The treatment is very difficult and anything that can increase its success and shorten its duration is worth considering.
Do you know your husband's genotype? That would definitely enter into the calculation.
The main thing is this is not bad new. It could've been much worse. But you do need to speak to informed people and decide on the course you want to follow.
To my eye the inflammation is moderate and the fibrosis is mild to moderate. I think that would translate into a 2/2 or a 2/1. Generally people with this level of liver damage have a tough decision to make. There is no urgency to treat as there would be if the damage were more severe. OTOH, treatment is more successful with lower levels of liver damage and at a younger age. If I were in this situation, I would live a very healthy lifestyle with plenty of exercise, eliminate all alcohol and wait for what will now only be two years for more effective treatment to be approved by the FDA. The treatment is very difficult and anything that can increase its success and shorten its duration is worth considering.
Do you know your husband's genotype? That would definitely enter into the calculation.
The main thing is this is not bad new. It could've been much worse. But you do need to speak to informed people and decide on the course you want to follow.
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